Document Detail


The value of surgical resection in patients with multidrug resistant tuberculosis.
MedLine Citation:
PMID:  19670116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Orki; A Kosar; R Demirhan; A Saygi; B Arman
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-05-20
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  57     ISSN:  1439-1902     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart New York.
Affiliation:
Thoracic Surgery, Heybeliada Chest Diseases and Chest Surgery Center, Istanbul, Turkey. alpayorki@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Chemotherapy, Adjuvant
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pneumonectomy / methods
Postoperative Complications
Sputum / microbiology
Tomography, X-Ray Computed
Treatment Outcome
Tuberculosis, Multidrug-Resistant / drug therapy,  mortality,  radiography,  surgery*
Tuberculosis, Pulmonary / drug therapy,  radiography,  surgery*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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