title: Surgery and pleuro-pulmonary tuberculosis: a scientific literature review.
abstract: Tuberculosis (TB) is still a major public health concern, mostly affecting resource-constrained settings and marginalized populations. The fight against the disease is hindered by the growing emergence of drug-resistant forms whose management can be rather challenging. Surgery may play an important role to support diagnosis and treatment of the most complex cases and improve their therapeutic outcome. We conducted a non-systematic review of the literature based on relevant keywords through PubMed database. Papers in English and Russian were included. The search was focused on five main areas of intervention as follows: (I) diagnosis of complicated cases; (II) elimination of contagious persisting cavities, despite appropriate chemotherapy; (III) treatment of destroyed lung; (V) resection of tuberculomas; (VI) treatment of tuberculous pleural empyema. Although specific practical guidelines concerning surgical indications and approaches are currently unavailable, a summary of the evidence emerged from the scientific literature was elaborated to help the clinician in the management of severely compromised TB patients. The decision to proceed to surgery is usually individualized and a careful assessment of the patient's risk profile is always recommended before performing any procedure in addition to appropriate chemotherapy.
authors: Clinic for Thoracic Surgery - Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia;
authors: Dragan
authors: D
authors: Subotic
authors: Federal State Institute of Phthysiopulmonology, St. Petersburg, Russian Federation ;
authors: Piotr
authors: P
authors: Yablonskiy
authors: Department of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV and for TB elimination - University of Brescia, Brescia, Italy ;
authors: Giorgia
authors: G
authors: Sulis
authors: Department of Thoracic Surgery, National Institute of Pneumology, Bucharest, Romania ;
authors: Ioan
authors: I
authors: Cordos
authors: St Sophia University Hospital of Pulmonary Diseases, Medical University, Sofia, Bulgaria ;
authors: Danail
authors: D
authors: Petrov
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy ;
authors: Rosella
authors: R
authors: Centis
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy;; Public Health Consulting Group, Lugano, Switzerland;
authors: Lia
authors: L
authors: D'Ambrosio
authors: Department of Biomedical Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari-Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy.
authors: Giovanni
authors: G
authors: Sotgiu
authors: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Tradate, Italy ;
authors: Giovanni Battista
authors: GB
authors: Migliori
keywords: Tuberculosis (TB); lobectomy; pneumonectomy; review; surgical treatment; tuberculoma