Abstract | BACKGROUND:
Extensively drug resistant tuberculosis ( XDR-TB) has been reported in 58 countries around the world and has emerged as a major public health challenge. Our objective was to determine the impact of pulmonary resection on XDR-TB treatment outcomes in a resource-constrained setting. METHODS: We conducted a retrospective case review of 11 patients with XDR-TB who were referred for pulmonary resection between January 2007 and June 2010 at a tertiary care referral hospital in South Africa. Two pneumonectomies and three upper lobectomies were performed. Occurrence of surgical complications and TB treatment outcome were assessed. RESULTS: No perioperative mortality or major morbidity was noted. All patients achieved sputum conversion, with 4 regarded as "cured." One patient defaulted on treatment, but subsequently returned and is regarded as a probable cure. CONCLUSIONS: We describe pulmonary resection for XDR-TB management in Africa. Although the initial cohort of XDR-TB patients from Tugela Ferry demonstrated nearly complete mortality, our results demonstrate the potential of adjuvant surgical methods in XDR-TB treatment. With appropriate chemotherapy and timely adjuvant surgery, patients with XDR-TB localized to lobe or lung may achieve a "cure" with low morbidity and mortality. Consequently, this approach may be the most cost effective treatment for patients suitable for lung resection.
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Authors | Adam Iddriss, Nesri Padayatchi, Darshan Reddy, Anu Reddi |
Journal | The Annals of thoracic surgery
(Ann Thorac Surg)
Vol. 94
Issue 2
Pg. 381-6
(Aug 2012)
ISSN: 1552-6259 [Electronic] Netherlands |
PMID | 22633500
(Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Extensively Drug-Resistant Tuberculosis
(surgery)
- Female
- Humans
- Male
- Pneumonectomy
- Retrospective Studies
- South Africa
- Tuberculosis, Pulmonary
(surgery)
- Young Adult
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