The role of video-assisted thoracoscopic therapeutic resection for medically failed pulmonary tuberculosis

Yau Lin Tseng, Jia Ming Chang, Yi Sheng Liu, Lili Cheng, Ying Yuan Chen, Ming Ho Wu, Chung Lan Lu, Yi Ting Yen

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

There are few reports regarDing video-assisted thoracoscopic therapeutic resection for medically failed pulmonary tuberculosis (TB). We reviewed our surgical results of video-assisted thoracoscopic surgery (VATS) therapeutic resection for pulmonary TB with medical failure, and its correlation with image characteristics on chest computed tomography (CT) scan. Between January 2007 and December 2012, among the 203 patients who had surgery for TB, the medical records of 89 patients undergoing therapeutic resection for medically failed pulmonary TB were reviewed. Clinical information and the image characteristics of CT scan were investigated and analyzed. Forty-six of the 89 patients undergoing successful VATS therapeutic resection had significantly lower graDing in pleural thickening (P<0.001), peribronchial lymph node calcification (P<0.001), tuberculoma (P=0.015), cavity (P=0.006), and aspergilloma (P=0.038); they had less operative blood loss (171.0218.7 vs 542.8622.8mL; P<0.001) and shorter hospital stay (5.22.2 vs 15.615.6 days; P<0.001). They also had a lower percentage of anatomic resection (73.9% vs 93.0%; P=0.016), a higher percentage of sublobar resection (56.5% vs 32.6%; P=0.023), and a lower disease relapse rate (4.3% vs 23.3%; P=0.009). Eighteen of the 38 patients with multi-drug resistant pulmonary tuberculosis (MDRTB)who successfully underwentVATShadsignificantlylower graDing in pleural thickening (P=0.001), peribronchial lymph node calcification (P=0.019), and cavity (P=0.017). They were preoperativelymedicatedfor a shorterperiodof time(221.690.8 vs596.1432.5 days; P=0.001), and had more sublobar resection (44.4% vs 10%), less blood loss (165.3148.3 vs 468.0439.9mL; P=0.009), and shorter hospital stay (5.42.6 vs 11.86.9 days; P=0.001). Withoutmultiple cavities, peribronchial lymph node calcification, and extensive pleural thickening, VATS therapeutic resection could be safely performed in selected patients with medically failed pulmonary TB as an effective adjunct with satisfactory results.

Original languageEnglish
Pages (from-to)e3511
JournalMedicine (United States)
Volume95
Issue number18
DOIs
Publication statusPublished - 2016

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Fingerprint Dive into the research topics of 'The role of video-assisted thoracoscopic therapeutic resection for medically failed pulmonary tuberculosis'. Together they form a unique fingerprint.

Cite this