The Analysis of Risk Factors of Pulmonary Tuberculosis Patients Failed in Retreatment.

Kim, Hyoung Soo; Lee, Won Jin; Kong, Seok Jun; Shon, Mal Hyun

doi:2000.49.6.684

Tuberc Respir Dis > Volume 49(6); 2000 > Article

Original Article

Tuberculosis and Respiratory Diseases 2000;49(6):684-690.
DOI: https://doi.org/10.4046/trd.2000.49.6.684 Published online December 1, 2000.

The Analysis of Risk Factors of Pulmonary Tuberculosis Patients Failed in Retreatment.

Hyoung Soo Kim, Won Jin Lee, Seok Jun Kong, Mal Hyun Shon

Abstract

BACKGROUND
Surgery may have a role when medical treatment alone is not successful in patients with multi-drug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. METHODS: A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). RESULTS: The thirteen patients were 37.5±12.4 years old (mean±S.D.)(M:F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods (109.7±132.0 months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative FE1 was 2.37±0.83 L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After 41.5±58.9 days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. CONCLUSION: When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

Key Words: Multi-drug resistant pulmonary tuberculosis, Surgery