Pulmonary resection as an adjunct in the treatment of multiple drug-resistant tuberculosis

Ann Thorac Surg. 1997 May;63(5):1368-72; discussion 1372-3.


Background: Over the past decade the incidence of pulmonary disease due to drug-resistant strains of Mycobacterium tuberculosis has increased worldwide. We reviewed our local experience to clarify the benefits and risks of pulmonary resection in the management of drug-resistant strains of Mycobacterium tuberculosis.

Methods: A retrospective review was performed of 62 patients undergoing pulmonary resection for drug-resistant strains of Mycobacterium tuberculosis between January 1990 and November 1995.

Results: Fifty-three percent were men and 47% women with an average age of 34 years (range, 16 to 72 years). There was one postoperative death, for a perioperative (30-day) mortality of 1.6%. Sixteen complications occurred in 14 patients for an overall morbidity of 23%. Eighteen of 24 patients (75%) who were persistently sputum positive at the time of operation immediately converted to a negative sputum smear and culture. For all patients who were sputum negative after operation 80% remain relapse-free by actuarial analysis.

Conclusions: We believe that operation plays an important ancillary role in the treatment of drug-resistant strains of Mycobacterium tuberculosis. The operation can be performed with acceptable morbidity and mortality and must be combined with appropriate and well-monitored pre- and postoperative antituberculous drug therapy.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonectomy*
  • Recurrence
  • Retrospective Studies
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / surgery*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / surgery*


  • Antitubercular Agents