JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shiraishi, Y.
Right arrow Articles by Takahashi, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Shiraishi, Y.
Right arrow Articles by Takahashi, N.
Related Collections
Right arrow Minimally invasive surgery

J Thorac Cardiovasc Surg 2004;128:523-528
© 2004 The American Association for Thoracic Surgery

Resectional surgery combined with chemotherapy remains the treatment of choice for multidrug-resistant tuberculosis

Yuji Shiraishi, MD*, Yutsuki Nakajima, MD, Naoya Katsuragi, MD, Makoto Kurai, MD, Nobumasa Takahashi, MD

Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan

Read at the Eighty-fourth Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 25-28, 2004.

Received for publication April 11, 2004; revisions received May 23, 2004; accepted for publication June 16, 2004.

* Address for reprints: Yuji Shiraishi, MD, Section of Chest Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-8522 Japan (E-mail: yujishi{at}mvb.biglobe.ne.jp).

OBJECTIVE: Multidrug-resistant tuberculosis remains a significant health problem. The best available treatment for multidrug-resistant tuberculosis is the combination of pulmonary resection and antituberculous chemotherapy. We herein report the results of pulmonary resection combined with chemotherapy for multidrug-resistant tuberculosis at our institution during the years 2000 through 2002.

METHODS: Between 1983 and 2002, 87 patients underwent 95 pulmonary resections for multidrug-resistant tuberculosis. Of these, the 30 (34%) patients operated on from January 1, 2000, to December 31, 2002, are reviewed in the present study. All patients were maintained on multidrug regimens preoperatively and postoperatively. Indications for surgical intervention included persistently positive sputum and a high risk of relapse. Thirty-three pulmonary resections were performed, consisting of pneumonectomy (n = 12), lobectomy (n = 17), and segmentectomy (n = 4). The bronchial stump was reinforced with a latissimus dorsi muscle flap in 29 resections.

RESULTS: There was no operative mortality. Bronchopleural fistulas occurred in 2 patients. Five patients had a space problem. All patients attained sputum-negative status after the operation. Relapse occurred in 3 patients: 2 had a relapse at the bronchial stump, and the remaining patient had a relapse in the postlobectomy space. One late death occurred. Of the 29 survivors, 27 (93%) were free from disease, with a median follow-up of 24 months (range, 8-47 months).

CONCLUSIONS: An increasing number of patients with multidrug-resistant tuberculosis are requiring resectional surgery in the 21st century. Pulmonary resection combined with chemotherapy achieves high cure rates with acceptable morbidity and remains the treatment of choice for multidrug-resistant tuberculosis.

Keywords 11




This article has been cited by other articles:


Home page
 ICVTSHome page
Y. Shiraishi, N. Katsuragi, H. Kita, M. Toishi, and T. Onda
Experience with pulmonary resection for extensively drug-resistant tuberculosis
Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1075 - 1078.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Wang, H. Lin, and G. Jiang
Pulmonary Resection in the Treatment of Multidrug-Resistant Tuberculosis: A Retrospective Study of 56 Cases
Ann. Thorac. Surg., November 1, 2008; 86(5): 1640 - 1645.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Mohsen, A. Abou Zeid, and S. Haj-Yahia
Lobectomy or pneumonectomy for multidrug-resistant pulmonary tuberculosis can be performed with acceptable morbidity and mortality: A seven-year review of a single institution's experience
J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 194 - 198.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
R. Naidoo
Active Pulmonary Tuberculosis: Experience with Resection in 106 Cases
Asian Cardiovasc Thorac Ann, April 1, 2007; 15(2): 134 - 138.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
H. J. Kim, C. H. Kang, Y. T. Kim, S-W. Sung, J. H. Kim, S. M. Lee, C-G. Yoo, C-T. Lee, Y. W. Kim, S. K. Han, et al.
Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis
Eur. Respir. J., September 1, 2006; 28(3): 576 - 580.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Adjuvant resectional surgery improves cure rates in multidrug-resistant tuberculosis.
J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 693 - 696.



HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2004 by The American Association for Thoracic Surgery.