Pneumonectomy for nontuberculous mycobacterial infections

Shiraishi, Yuji; Nakajima, Yutsuki; Katsuragi, Naoya; Kurai, Makoto; Takahashi, Nobumasa

doi:10.1016/j.athoracsur.2004.02.103

Cited by 64 publications

(33 citation statements)

References 13 publications

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“…Infections of soft tissue, lymph node or bone are less prevalent, and are often difficult to treat successfully with antimycobacterial drugs. Surgery is often necessary, and is also useful in localized pulmonary disease [23].…”

Section: Introductionmentioning

confidence: 99%

Non-tuberculous mycobacterial infections

Petrini¹

2006

Scandinavian Journal of Infectious Diseases

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Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms in contrast to those belonging to the M. tuberculosi complex (MTB). NTM infects and causes disease only in hosts with local or general predisposing factors. Lung infection following inhalation of NTM is the most common NTM disease but soft tissue infections may occur in connection with contaminated trauma or surgery. Microbiological diagnosis is obtained by microscopy for acid-fast bacteria (AFB) on secretions or biopsies, and by culture on special media. With the high specificity of MTB- polymerase chain reaction (PCR), a positive AFB smear combined with negative MTB-PCR denotes infection with NTM. Sophisticated species diagnosis of cultured NTM is attained by various molecular methods, where 16S rDNA-sequencing remains the gold standard. The panorama of infection with different rapidly growing (RGM) or slowly growing mycobacteria (SGM) in Sweden is described. Sensitivity testing in vitro to antimycobacterial drugs against NTM does not always preclude the in vivo efficacy. Standard antimycobacterial treatment regimens have been defined for infection with several NTM species. Sensitivity testing should be performed in selected cases only, as in case of relapse or suspected development of resistance of the NTM strain. The spectrum of disease caused by NTM species that display a very low pathogenic potential is likely to widen over time as severe immunosuppression will continue to be prevalent in several patient categories.

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Section: Introductionmentioning

confidence: 99%

Non-tuberculous mycobacterial infections

Petrini¹

2006

Scandinavian Journal of Infectious Diseases

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“…According to several reports of the recurrence rate of nontuberculous mycobacterial infection after surgery, the sputum negative conversion rate was high, at 82%-94%. 10,[19][20][21] It is commonly believed that the treatment duration includes 12 months of sputum culture negativity while on therapy, 22) and, in the present case, the patient continued to receive oral antibiotic therapy after surgery, and has been followed up carefully. Regarding surgery for M. chelonae, much is unknown, including the long-term prognosis and chemotherapy to prevent recurrence.…”

Section: )mentioning

confidence: 94%

“…[8][9][10] Since surgical treatment for the M. avium complex infection is generally effective in controlling infection, therefore, it is likely that surgical treatment for M. chelonae infection is also effective. 10,12,[19][20][21] Surgery may be useful in the following settings: i) patients with localized disease, ii) patients, in whom medical therapy is ineffective, and iii) patients who cannot tolerate medical therapy. 2,12) Pulmonary resection should be considered before the expansion of lesions in patients in whom complete resection is considered possible based on the number and extent of lesions.…”

Section: )mentioning

confidence: 99%

Pulmonary Resection for Mycobacterium Chelonae Infection

Goto

Hamaguchi

Maeshima

et al. 2012

ATCS

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Mycobacterium chelonae lung infection is rare and has long been recognized as an enigmatic infection resistant to medical therapy. Recently, we encountered a patient who underwent pulmonary resection for Mycobacterium chelonae infection. A 46-year-old man with no medical history was found to have an abnormal shadow in the left upper lung field on chest X-ray. Computed tomography showed a nodular shadow in the left upper lobe and disseminated shadows around it. Mycobacterium chelonae was detected from cultures of the sputum, bronchial washings, bronchoscopic biopsy specimens, and gastric fluid, and pulmonary infection with Mycobacterium chelonae was diagnosed. The shadow did not decrease in size despite antibiotic treatment. Since the lesion was confined to the left upper segment, we judged that a complete resection was possible, and performed left upper division segmentectomy. After surgery, no new foci of infection were observed in the lung. No effective therapy for Mycobacterium chelonae lung infection has been established to date, and reported cases of pulmonary resection for the treatment of Mycobacterium chelonae infection are extremely rare. However, surgery should be considered in patients in whom complete resection is deemed possible.

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“…Some authors advocate reinforcing the bronchial stump with adjacent tissues such as a pedicled pericardial fat pad, an intercostal muscle flap, or a pedicled pericardium flap. [20][21][22][23] We did not reinforce the bronchial stumps and only one patient suffered bronchopleural fistula in the current series. In our opinion, the reinforcement may be not the crux of bronchopleural fistula.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Pneumonectomy for Benign Disease: A Single Institution Retrospective Study on 59 Patients

Yang

Ding

Chang

et al. 2015

ATCS

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Introduction: Pneumonectomy is the only curative treatment for some benign diseases but the operation is a challenging procedure. Herein, we present our experiences of pneumonectomy for 59 patients. Methods: The medical records of 59 patients who undergone pneumonectomy for benign lung diseases from 2008 to 2013 at the Division of Thoracic Surgery in Beijing Chest Hospital were retrospectively reviewed. Results: There were 23 male and 36 female patients. Three procedures including pneumonectomy, pleuropneumonectomy and completion pneumonectomy were used. The operative time and intraoperative blood loss were statistically different in the patients who undergone different operations. The operative time of the patients with and without tuberculosis had no difference but the intraoperative blood loss was more in the patients with tuberculosis (P = 0.035). The operative type, age and operative blood loss were relevant with the morbidity, the P value were 0.024, 0.042 and 0.027 respectively. Conclusions: Pneumonectomy for patients with benign disease may be more difficult than for patients with lung cancer, mean while pleuropneumonectomy and completion pneumonectomy may be greater challenges. But with careful patient selection and operative technique, it is a satisfactory treatment method for benign lung disease. The morbidity is acceptable and associated with operative type, age and operative blood loss.

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Pneumonectomy for nontuberculous mycobacterial infections

Cited by 64 publications

References 13 publications

Non-tuberculous mycobacterial infections

Non-tuberculous mycobacterial infections

Pulmonary Resection for Mycobacterium Chelonae Infection

Analysis of Pneumonectomy for Benign Disease: A Single Institution Retrospective Study on 59 Patients

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