The value or Surgical Resection in patients with Multidrug Resistant Tuberculosis
Thoracic and Cardiovascular Surgeon, cilt.57, sa.4, ss.222-225, 2009 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 57 Sayı: 4
- Basım Tarihi: 2009
- Doi Numarası: 10.1055/s-0029-1185458
- Dergi Adı: Thoracic and Cardiovascular Surgeon
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.222-225
- Anahtar Kelimeler: Cure chance, MDR-TB, Resection
- Maltepe Üniversitesi Adresli: Evet
Özet
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. © Georg Thieme Verlag KG Stuttgart.