Surgical Management in Pulmonary Tuberculosis
The anti-tuberculosis medications have changed the perspective of tuberculosis (TB) management, as effective medical management has significantly reduced the need for surgical intervention. However, recently the tuberculosis management in patients that are immunocompromised with HIV infection and poor drug compliance and drug resistance has become a challenge. The human mycobacterium tuberculosis is developing drug resistance, and the need for surgery in developing countries is increasing in multidrug resistance (MDR) and extreme drug resistance (XDR) cases. Modern surgeons will have to learn from the history of surgery in thoracic tuberculosis rather than reinventing the wheel. Surgery in these cases should be planned, and spread of this global disease needs to be curtailed by monitoring and education of the healthcare professionals, patients and their relatives. In Western countries developing countries, TB has varied presentation and can mimic many diseases, and surgery is performed more frequently for its diagnosis. Parenchyma-preserving surgery should be considered in successfully medically managed cases where scarred lung parenchyma needs resection.
KeywordsTuberculosis Decortication Segmental Resection Thoracoplasty Balloon Dilatation Broncopleural Fistula Pneumonectomy
- 2.Global Tuberculosis control—surveillance, planning, financing. WHO Geneva. 2007. http://www.who.int/tb/publications/global_report/en/
- 3.Wright A, Atkinson P, Maguire H. Communicable disease surveillance in London 2000. London: Communicable Disease Surveillance Centre; 2001.Google Scholar
- 5.STOP TB partnership. The global plan to stop TB 2006-2015. The executive summery available at: www.stoptb.org/globalplan/assets/documents/GP_ES_Eng.pdf. Full document available at http://www.who.int/tb/publications/global_plan_to_stop_tb/en/index.htm/