The surgical management of tuberculosis.
Due to unpredicted factors, the incidence of tuberculosis is increasing in the United States. Despite excellent anti-tuberculous medication, some patients will require surgical management. The majority of these patients present with multi-drug-resistant tuberculosis (MDRTB). Surgery is indicated, but only after the best possible anti-tuberculous regime has been instituted. In those patients who become sputum-negative and have a destructive pulmonary process, or in those patients with persistent positive sputum and destroyed pulmonary parenchyma, operative management may be beneficial. Surgery can be done with a low mortality and morbidity incidence. Muscle flaps are useful in minimizing postoperative complications. Continued postoperative medical therapy combined with surgery offers a cure in more than 90% of patients. In patients with MDRTB and localized parenchyma disease, surgery combined with continued medical therapy is the treatment of choice in the majority of patients.
Pomerantz
M
M
Section of General Thoracic Surgery, University of Colorado Health Sciences Center, Denver 80262, USA.
Brown
J
J
D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D015994:Incidence; D011013:Pneumonectomy; D011859:Radiography; D013524:Surgical Flaps; D018088:Tuberculosis, Multidrug-Resistant / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D014481:United States / Q000453:epidemiology
D000995:Antitubercular Agents