Pulmonary resection for extensively drug resistant tuberculosis in KwaZulu-Natal, South Africa.
Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier.
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. This is the first
report to describe pulmonary resection for XDR-TB management in Africa. Methods—We conducted a retrospective case review of XDR-TB patients who underwent pulmonary resection between January 2007 and December 2009. Results—Two pneumonectomies and two right upper lobectomies were performed. No operative mortality or major morbidity was noted. All patients achieved sputum conversion and were ultimately regarded as either a “cure” or “probable cure”. Conclusions—Although the initial cohort of XDR-TB patients from Tugela Ferry demonstrated near complete mortality, our results demonstrate the potential of adjuvant surgical methods in
XDR-TB treatment. With appropriate neoadjuvant chemotherapy and timeous surgery, patients with disease localized to lobe or lung XDR-TB 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.
Description
Keywords
Multidrug-resistant tuberculosis--KwaZulu-Natal., Mycobacterium tuberculosis., Multidrug resistance--KwaZulu-Natal., Tuberculosis, Pulmonary--Drug therapy--KwaZulu-Natal., Lungs--Surgery.
Citation
Published in final edited form as: Iddriss, A., et al. 2012. Pulmonary resection for extensively drug resistant tuberculosis in KwaZulu-Natal, South Africa. Ann Thorac Surg. 94 (2) pp. 381–386.