The Value of Surgical Resection in Patients with Multidrug Resistant Tuberculosis
| Autor: | Altuğ Koşar, Bülent Arman, Alpay Orki, A. Saygı, Recep Demirhan |
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| Přispěvatelé: | Maltepe Üniversitesi, Tıp Fakültesi, Koşar, Altuğ |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Adolescent medicine.medical_treatment Bronchopleural fistula Young Adult Pneumonectomy Postoperative Complications Pharmacotherapy Tuberculosis Multidrug-Resistant Humans Medicine Tuberculosis Pulmonary Aged business.industry Sputum Middle Aged medicine.disease Empyema Surgery Treatment Outcome Chemotherapy Adjuvant Localized disease Female medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Complication Follow-Up Studies |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 57:222-225 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-0029-1185458 |
| Popis: | Background: Multidrug resistant tuberculosis (MDR-TB) still continues to be a serious health problem throughout the world. Although main treatment of MDR-TB is medical, surgical resection with adjuvant medical therapy may increase the chance of cure in selected patients. Methods: We performed surgical resections in 55 patients between 1997 and 2005; 36 were male and 19 were female with a median age of 34 years (range 13 to 66 years). Sputum was negative for 49 patients and positive for 6 patients in the preoperative period. Patients were treated according to a new therapy protocol for a mean of 3.7 months before the operation. Results: Lobectomy was performed in 37 patients, pneumonectomy in 17 patients and lobectomy + segmentectomy in 1 patient. One patient with positive sputum preoperatively died in the early postoperative period (mortality: 1.81 %). Various complications occurred in 16 (29.09 %) patients. Prolonged air leak was the most common complication (n = 8). Bronchopleural fistula (BPF) + empyema occurred in 2 (3.63 %) patients. In the postoperative period, sputum negativity was achieved in all patients except three cases throughout the 57 months of follow-up (cure rate 94.5 %). Patients received drug therapy for 24 months postoperatively. Conclusions: Surgical resection with adjuvant drug therapy increases the chance of cure in patients with localized disease if they have an adequate cardiopulmonary reserve, favorable nutritional status and are treated with a new therapy protocol for at least 3 months. |
| Databáze: | OpenAIRE |
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