Early pulmonary resection for localized Mycobacterium avium complex disease.
BACKGROUND
Results of antituberculous chemotherapy for Mycobacterium avium complex disease remain disappointing. Pulmonary resection during an early stage of the disease, therefore, may be beneficial to patients whose disease is localized and who can tolerate a resectional operation.


METHODS
Thirty-three patients with localized M avium complex disease underwent 33 pulmonary resections between 1979 and 1996. There were 17 males and 16 females, with a mean age of 50 years (range, 30 to 69 years). Lobectomy was performed in 26 patients, pleuropneumonectomy in 1, segmentectomy in 5, and wedge resection in 1.


RESULTS
There was no operative mortality. After pulmonary resection, 31 (94%) patients attained sputum-negative status. Bronchopleural fistula occurred in one patient who underwent a right upper lobectomy. There were two late deaths. A patient with bronchopleural fistula died of respiratory failure two years postoperatively. Another patient died of an unknown cause 12 years postoperatively. Of the 31 patients with negative sputum status postoperatively, only 2 patients (6%) had relapse at 1 and 9 years after operation.


CONCLUSIONS
We recommend that patients with this disease be considered for pulmonary resection as early as possible.
Department of Thoracic Surgery, National Tokyo Hospital, Kiyose, Japan.
Y
Y
Shiraishi
K
K
Fukushima
H
H
Komatsu
A
A
Kurashima
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001983:Bronchial Fistula / Q000209:etiology; D002423:Cause of Death; D005260:Female; D005402:Fistula / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000601:surgery*; D010994:Pleura / Q000601:surgery; D010995:Pleural Diseases / Q000209:etiology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D012131:Respiratory Insufficiency / Q000209:etiology; D013183:Sputum / Q000382:microbiology; D015996:Survival Rate; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000601:surgery*
D000995:Antitubercular Agents