Current role of surgery in Mycobacterium tuberculosis

Treasure, Robert L.; Seaworth, Barbara

doi:10.1016/0003-4975(95)00145-b

Cited by 86 publications

(70 citation statements)

References 5 publications

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“…7 In view of these issues, with the increasing incidence of TB and improving TB survival, the incidence of TB complications that need surgery has increased and merits more thorough consideration. 8,9 Pneumothorax is one of the important TB complications that requires surgery. [8][9][10][11] Pneumothorax secondary to TB usually occurs after extensive TB involvement of the lung, and the sudden onset of bronchopleural fistulization and empyema 12 with severe cavitary formations or occasionally with miliary TB.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis-Associated Secondary Pneumothorax: A Retrospective Study of 53 Patients

Shamaei¹,

Tabarsi²,

Pojhan

et al. 2011

Respir Care

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BACKGROUND: Pneumothorax is a well known complication of pulmonary tuberculosis (TB), particularly in patients with advanced TB. METHODS: At our national TB-referral hospital, we compared the medical records of 53 TB patients with pneumothorax and 106 TB patients without pneumothorax, seen in 2003 to 2008. We analyzed data on demographics; TB type (smear-positive, smear-negative, extrapulmonary); patient type (new patient, relapse, treatment default, treatment failure); clinical and radiological manifestations; surgeries; and outcomes. RESULTS: Of the 53 pneumothorax patients, 34 (64%) were male. The pneumothorax group's mean age was 34 y (range 14 -76 y). Thirty-six (68%) of the pneumothorax patients were new TB cases (ie, TB undiagnosed before they presented with pneumothorax). Pneumothorax was not significantly associated with sex, smoking, or drug use. Pneumothorax was significantly more common in patients < 30 years old (P < .001). In terms of radiological manifestations, 20 pneumothorax patients (38%) had cavitary lesions, and pulmonary infiltration and effusion were present in 19 (36%) and 17 (32%) patients, respectively. Cavitary lesion was significantly more common among the pneumothorax patients (P ‫؍‬ .006). Overall, 47 (89%) of the pneumothorax patients were relieved with chest-tube insertion; the other pneumothorax patients were only observed. CONCLUSIONS: In patients < 30 years old or with cavitary lesions, worsening of the patient's respiratory condition should prompt consideration of pneumothorax.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis-Associated Secondary Pneumothorax: A Retrospective Study of 53 Patients

Shamaei¹,

Tabarsi²,

Pojhan

et al. 2011

Respir Care

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“…However, compared to anti-TB drugs for the treatment of TB, surgery is destructive and risky [1]. With the development of effective anti-TB drugs, knowledge of lung function and anatomy, and improved surgical techniques, surgical treatment for TB has become safe, and the surgical complications and perioperative mortality rates are within an acceptable range [2,3]. A report on a nationwide random survey for the epidemiology of TB in 2000 by the Ministry of Health of The People's Republic of China [4] showed that the national prevalence of active pulmonary TB was 367/10 million, and it was estimated that there were 4.51 million (4.11-4.90 million) active pulmonary TB patients.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Bai

Hong

Gong

et al. 2011

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES: Compared to the use of anti-TB drugs for the treatment of tuberculosis (TB), surgery is destructive and is associated with higher risk. Whether surgery is needed for the treatment of TB-destroyed lungs (for short: destroyed lungs) is still controversial and unresolved in the clinic. METHODS:Retrospective analysis of treatment efficacy was performed on 172 cases of destroyed lungs (176 surgeries) in the Thoracic Surgery Department of our hospital from April 1992 to June 2010. RESULTS:A total of 83 male and 89 female patients was analyzed. The youngest patient was 7 years old, and the oldest was 72 years old, with a mean age of 38.4 years. A total of 120 cases had a preoperative cough, 31 cases had fever, and 42 cases had hemoptysis. A total of 49 cases was positive for Mycobacterium tuberculosis by sputum test before surgery, yielding a positive TB rate of 28.5% (49/172). A total of 116 patients had a destroyed left lung and 56 cases had a destroyed right lung. In all, 110 cases underwent total pneumonectomy, 37 pleuropneumonectomy, one lobectomy, 10 residual lobectomy, two total pneumonectomy and tracheoplasty, 11 cases bronchopleural fistula (BPF) repair and other surgeries, and one case underwent thoracoplasty. A total of four patients underwent thoracoplasty 30 days after surgery due to a thoracic cavity infection or empyema. The overall perioperative mortality rate was 2.9% (5/172). The surgical complication rate was 18.6% (32/172). The sputum negative conversion rate was 87.8% (43/49), and the clinical cure rate was 91.9% (158/172). CONCLUSIONS:Our findings suggested that surgical treatment efficacy in destroyed lungs was satisfactory with strict surgical indications, standard preoperative anti-TB treatment, adequate preoperative preparation, and careful intraoperative operations.

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“…Needless to say, these approaches are somewhat variant, and though many may favour a long period of medical treatment before considering surgical decortication, we could find no good documentation of 'pharmacological' decortication in the literature. The infrequency with which medical specialists and thoracic surgeons are now faced with this problem adds further to the uncertainty about how to proceed (8). In the present paper, the case of a large tuberculous pleural peel, managed both medically and surgically, is presented; the response to each treatment modality was carefully documented.…”

Section: Abstract: Tuberculous Pleural Peelmentioning

confidence: 98%

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

Long

Fanning²,

McNamee³

et al. 2001

Canadian Respiratory Journal

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The role and timing of surgical decortication in the management of a primary tuberculous pleural peel remains controversial. The present report describes the case of a young man with an extensive primary tuberculous pleural peel that responded dramatically to medical therapy. A serious attempt at surgical decortication three weeks into antituberculous drug therapy may have removed some compressive aspects of the peel, facilitating lung expansion. However, it had almost no measurable impact on the size of peel and was technically very difficult. Response to treatment was measured anatomically (computed tomography scans) and physiologically (pulmonary function tests).

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Current role of surgery in Mycobacterium tuberculosis

Cited by 86 publications

References 5 publications

Tuberculosis-Associated Secondary Pneumothorax: A Retrospective Study of 53 Patients

Tuberculosis-Associated Secondary Pneumothorax: A Retrospective Study of 53 Patients

Surgical treatment efficacy in 172 cases of tuberculosis-destroyed lungs

Medical versus Surgical Treatment of a Primary Tuberculous Pleural Peel

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