[Surgical treatment of 133 cases of multi-drug-resistant pulmonary tuberculosis].

Objective: To evaluate the clinical significance of pulmonary resection for multi-drug-resistant pulmonary tuberculosis.

Methods: The clinical data were retrospectively reviewed for patients with multi-drug-resistant pulmonary tuberculosis for which surgical resection of the lung was undertaken.

Results: From January 1980 to December 2007, 1188 patients with pulmonary tuberculosis, including 133 multi-drug resistant cases, underwent pulmonary resection in Beijing Chest Hospital. Surgical procedures included pneumonectomy in 45, pulmonary lobectomy in 73 (including sleeve resection of the bronchus in 5), pleuropneumonectomy in 13, segment resection in 1, and wedge resection in 1 cases. Preoperative and postoperative antituberculosis chemotherapy was given for no less than 6 months and 6 to 18 months, respectively. Two cases died of perioperative respiratory failure, and 1 died of internal bleeding, the mortality rate being 2.3% (3/133). The incidence of postoperative complications was 17.3% (23/133), including 9 cases with stump fistula of bronchus. Follow-up lasted for 6 months to 15 years (average 52 months), and medical treatment lasted for 6 - 18 months. After follow-up, the sputum negative conversion rate was 90.2% (101/112).

Conclusions: Pulmonary resection is an effective approach to multi-drug resistant pulmonary tuberculosis with long-term sputum positivity of limited local lesions, or negative sputum of local lesions but failure to antituberculosis chemotherapy for at least 3 months.