A retrospective review comparing treatment outcomes of adjuvant lung resection for drug-resistant tuberculosis in patients with and without human immunodeficiency virus co-infection

Alexander, Gerard R.; Biccard, Bruce

doi:10.1093/ejcts/ezv228

Cited by 16 publications

(10 citation statements)

References 17 publications

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“…In a retrospective study of 14 XDR-TB patients and 36 MDR-TB cases undergoing surgical resection, Alexander and Biccard. 42 from South Africa concluded that lung resection for drug-resistant TB may be safely undertaken in selected patients who are HIV positive, with cure rates equivalent to HIV-negative patients, and that the patients treated surgically also have significantly higher cure rates than those treated with medical therapy alone.…”

Section: Drug-resistant Pulmonary Tuberculosismentioning

confidence: 99%

Surgical aspects of pulmonary tuberculosis: an update

Dewan

Pezzella

2016

Asian Cardiovasc Thorac Ann

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Tuberculosis remains a major global medical challenge and concern. In the world's population of over 7.4 billion people, 8.6 million are estimated to be infected with Mycobacterium tuberculosis; another 2.2 billion have latent tuberculosis. There is an annual incidence of 16,000 new cases in the USA and 7-8 million new cases worldwide, of which 440,000 are multidrug-resistant or extensively multidrug-resistant, mainly in developing countries or emerging economies. According to the World Health Organization, the incidence of tuberculosis is 133 cases per 100,000 of the population; 3.3% new cases are drug resistant and 20% are already treated cases. Of the drug-resistant cases, 9.7% are extensively drug-resistant. The annual global mortality attributable to tuberculosis is over 1.3 million people. The association with HIV/AIDS in 430,000 people has compounded the global concern and challenge. This review presents the historical indications for surgical treatment of tuberculosis, reviews the current literature and clinical experience, and collates this into increased awareness and contemporary understanding of the indications and need for surgery in primary active tuberculosis, adjuvant surgical therapy for multidrug-resistant tuberculosis, and the complications of chronic tuberculosis sequelae or previous tuberculosis surgery.

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Section: Drug-resistant Pulmonary Tuberculosismentioning

confidence: 99%

Surgical aspects of pulmonary tuberculosis: an update

Dewan

Pezzella

2016

Asian Cardiovasc Thorac Ann

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“…The outcomes of resectional surgery for MDRTB disease are summarized in ►Table 3, which depicts results from the Table 3 Case series, surgery for MDRTB/XDRTB 8,9,[11][12][13][14][33][34][35][36] n XDRTB (%) Morbidity (%) Mortality (%) Cure rate (%) (negative sputum) larger case series in the literature. 8,9,[11][12][13][14][33][34][35][36] In general, these operations, despite their complexity, may be performed with low morbidity and mortality. Some of the reported differences may be attributed to the varying patient populations, operations described, and health care systems.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Pulmonary Mycobacterial Disease

Mitchell

2018

Semin Respir Crit Care Med

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There is renewed interest in the use of adjuvant surgical resection in the treatment of pulmonary mycobacterial disease. For pulmonary , the emergence of significant drug resistance has led clinicians to reconsider surgery in select cases, where a clear benefit in bacterial conversion and cure has been noted. Less data exist for the use of anatomic resection in the setting of pulmonary nontuberculous mycobacterial disease, although multiple reports have supported the use of surgery in select cases. Resection is generally well tolerated, and may often be performed through a minimally invasive approach. While medical treatment clearly remains the mainstay of therapy, more research is needed regarding the use of adjuvant resection in this patient population.

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“…The mechanism of development of pleural tuberculosis remains to be elucidated. Based on currently available information, the mechanism underlying pleural tuberculosis is associated with these factors ( 7 , 9 – 11 ): i) Allergic effusion or immune defense disorders of organism and the gradual expansion of proliferation of mycobacterium tuberculosis or caseous lesions prior to undergoing standard treatment, formation of caseous necrotic briquettes encapsulated by fibers; ii) tuberculous pleurisy is encapsulated through pleural effusion absorption, which forms caseous spherical or briquette lesions encapsulated by fibrous tissues after further concentration; iii) mycobacterium tuberculosis reach pleura by hematogenous spread or lymphatic system spread, which forms tuberculous granulation and then caseous necrosis occurs, followed by limited fiber encapsulation; iv) caseous necrosis and liquidation occur in sub-pleural lymph gland and break into pleural cavity to cause pleurisy. Pleurisy absorbs left pleural adhesions; tuberculous lesions which originally occurred under pleura are encapsulated and condensed by fibrous connective tissues to form pleural tuberculosis; v) the early, sufficient and combined application of anti-tuberculosis drugs lowers human body's inflammatory reaction to pathogenic bacteria and the role of fibrinolytic enzyme, which results in effusive pleurisy concentration, drying and further forms tumors of pleural tuberculosis; and vi) non-timely and non-standard treatments to pleurisy and unreasonable use of hormones are important reasons for the formation of tumors of pleural tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy for the treatment of pleural tuberculosis

Geng¹,

Liu³

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the study was to compare the mid- and long-term effects of different treatments such as CT-guided percutaneous pulmonary paracentesis, tuberculoma perfusing chemotherapy and whole-body standard chemotherapy or extended chemotherapy on safety and effectiveness for pleural chemotherapy. A total of 60 subjects diagnosed to have pleural tuberculosis between February 2010 and February 2014 were prospectively selected for this study and were considered as the experimental group. Seventy pleural tuberculosis patients who underwent treatment between February 2006 and February 2010 were considered as the control group. The patients in the experimental group were treated with CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy of not more than three courses with each course consisting of administration of 0.1 g isoniazid, n 0.5 gkanamyci, 0.2 g levofloxacin, and 1 ml lidocaine once a week for four times. The patients in the control group were treated with whole-body standard or extended chemotherapy regimen 3~6HRZE(S)/6~12HR. The patients were followed up for 18 months and the treatment effects were compared. The diameter of tuberculoma in patients of the experimental group during 6, 12 and 18 months was shorter than that of the control group (P<0.05). The total effective rate of treatment and the duration of treatment in experimental group during 18 months were higher than that of control group (P<0.05). The frequency of drug-related complications were lower in comparison with the control group (P<0.05). No surgically acquired complications were observed in the experimental group. Thus, treatments such as CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy for pleural tuberculosis are safe and effective, which has greater value and can be promoted for use in the clinical setting.

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A retrospective review comparing treatment outcomes of adjuvant lung resection for drug-resistant tuberculosis in patients with and without human immunodeficiency virus co-infection

Abstract: Lung resection for DR-TB may be safely undertaken in selected patients who are HIV-positive with cure rates equivalent to that of HIV-negative patients. More importantly, these patients also have significantly higher cure rates than those patients treated with medical therapy alone.

Cited by 16 publications

References 17 publications

Surgical aspects of pulmonary tuberculosis: an update

Surgical aspects of pulmonary tuberculosis: an update

Surgical Management of Pulmonary Mycobacterial Disease

Safety and effectiveness of CT-guided percutaneous pulmonary paracentesis and tuberculoma perfusing chemotherapy for the treatment of pleural tuberculosis

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