Surgical treatment of multirresistant lung tuberculosis

RESUMO

The medical treatment of tuberculosis with chemotherapy has a rate of failure near 2 por cento, associated with drugs resistance of first, second and third line regimens. In such cases, lung resection plays a significant role as an adjuvant method in treating it by resection of localized lesions, so is possible to decrease the pool of bacilli and then improve the drug response. In a retrospective review of 139 patients with multirresistant pulmonary tuberculosis between 1980 and 1990 32 cases were operated on. There were 17 men and 15 women all of them infected by mycobacterium tuberculosis resistant to rifampin and isoniazid. The resections performed were pneumonectomy in 14 cases, lobectomy in 13 and segmentectomy in 5. The operative mortality was 6.2 por cento. The postoperative follow-up to 18 months showed a negative sputum culture in 90 por cento of the survivors and the others relapsed after the initial conversion. The results of this study show a high rate of conversion in patients with multiresistant tuberculosis treated with resective lung surgery