Surgical therapy of multidrug-resistant pulmonary tuberculosis in Peru: report of 304 cases

Abstract

Treatment for pulmonary tuberculosis (TB) is drug-based but the emergence of drug-resistance has decreased its therapeutic efficacy. Pulmonary surgery is an important beneficial adjuvant strategy for MDR TB treatment in this context. Objectives. To describe the clinical characteristics results and complications in a series of 304 patients with MDR TB submitted to surgical therapy. Material and methods. Between May of 1999 and January of 2007 a total of 336 surgical interventions were performed on 304 patients from the National Program of TB Control who, were operated by a surgical team of the Ministry of Health in the Hipolito unanue National Hospital and in a Private Center in Lima. Results. Most cases were male (60%) and the mean age was 28 years. Patients were resistant to a median of 5 drugs. Cavitary lesions were the most common (91.8%) and lobectomy was the most commonly performed surgical procedure (68.4%). Postoperative morbidity and mortality occurred in 12.8% and 2% respectively. Patients were followed post-operatively for a maximum time of 79.3 months and healing was reached in the 77.2% of cases. Conclusions. Pulmonary adjuvant surgery on MDR TB patients is an effective alternative for cure. This strategy should be included as part of treatment programs for MDR TB.