Adjuvant resectional surgery improves cure rates in multidrug-resistant tuberculosis
| Autor: | Tülay Törün, Altan Kir, Ilhan Inci, Kemal Tahaoğlu, Ali Atasalihi |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Thorax Surgical results medicine.medical_specialty Tuberculosis Adolescent medicine.medical_treatment Bronchopleural fistula law.invention Randomized controlled trial law Tuberculosis Multidrug-Resistant medicine Humans Pneumonectomy Aged Chemotherapy Medical treatment business.industry Middle Aged medicine.disease Combined Modality Therapy Surgery Female Cardiology and Cardiovascular Medicine business Adjuvant |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 131:693-696 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2005.09.033 |
| Popis: | Objective Multidrug-resistant tuberculosis still continues to be a major health problem. Adjuvant surgical resection combined with antituberculous drug management is the most favorable treatment modality for patients with multidrug-resistant tuberculosis. In this article we report the results of surgical resections we performed during the years 1993 through 2005. Methods We performed 81 lung resections in 79 patients with multidrug-resistant tuberculosis. All these patients had at least 2 months of medical therapy before resection. Bronchial reinforcement was performed in 4 of the 81 operations. We present here the surgical results of the 81 procedures. Because 5 of 79 patients were lost to follow-up, we provide the medical treatment results on 74 of the patients. Results During this period, we performed 4 completion pneumonectomies, 39 pneumonectomies, 7 lobectomies with segmentectomy, 30 lobectomies, and 1 segmentectomy. Operative mortality was 2.5% (2/81). Bronchopleural fistula developed in 4 (4.9%) cases. Our overall cure rate was 94.5% (70/74). Relapse and treatment failure were 1.3% (1/74) and 1.3% (1/74), respectively. All but 5 patients are still under our follow-up. Conclusions Surgical resection of patients with multidrug-resistant tuberculosis combined with chemotherapy provides a favorable outcome. Our results will need to be validated more strongly by using randomized clinical trials that compare surgical resection plus chemotherapy with chemotherapy alone. |
| Databáze: | OpenAIRE |
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