title: Long-term follow-up after thoracoscopic resection of solitary pulmonary tuberculoma.
abstract: BACKGROUND
  Pulmonary tuberculosis continues to be a significant health problem, especially due to increasing incidence of multi-resistant mycobacteria and patients with immunodeficiency. Pulmonary tuberculoma, like other solitary lung nodules, can often be a diagnostic challenge; moreover no consensus exists on the management strategy.
  
  
  OBJECTIVE
  To analyze the results of tuberculoma treatment with thoracoscopic lung resection, followed by anti-tuberculosis treatment (ATT).
  
  
  METHODS
  All patients who underwent thoracoscopic resection of tuberculoma between 1996 and 2008 were retrospectively analyzed. The diagnosis was confirmed morphologically and/or microbiologically. Data were collected from case reports, outpatient medical records, Estonian Tuberculosis Registry and National Population Registry.
  
  
  RESULTS
  Forty-three patients (25 men, 18 women) with mean age of 43.3 (range 15-68) years were included. Thoracoscopic approach was converted to thoracotomy in three cases. Median postoperative stay in surgical department was four days. No intra-hospital mortality occurred. Eleven patients received pre-operative ATT for 8 to 288 (median 115) days and 42 patients were treated post-operatively for 40 to 672 (median 185) days. One patient defaulted in ATT. First-line drugs were prescribed in 37 and second-line in five patients. During the median follow-up of 9.0 (range 3.2 to 16.1) years, none of the patients developed relapse.
  
  
  CONCLUSIONS
  Thoracoscopic pulmonary resection provides a minimally invasive opportunity for morphological and microbiological diagnosis of tuberculoma; and results in an excellent cure rate in combination with ATT.
authors.forename: Tanel
authors.initials: T
authors.lastname: Laisaar
authors.forename: Piret
authors.initials: P
authors.lastname: Viiklepp
authors.forename: Vahur
authors.initials: V
authors.lastname: Hollo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D014375:Tuberculoma / Q000188:drug therapy / Q000601:surgery*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents