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Surgical Management of NTM Diseases

  • James A. Caccitolo
Chapter
Part of the Respiratory Medicine book series (RM)

Abstract

Prior to the discovery of antimicrobial medications, treatment of mycobacterial disease was primarily supportive. The development of many thoracic surgical techniques was in large part due to attempts to treat tuberculosis and its complications. While antibiotic therapy is the mainstay treatment for nontuberculous mycobacterial (NTM) infections today, cure rates with medication alone remain low. In experienced centers, a multidisciplinary approach employing antibiotic therapy and surgical resection has been shown to be effective in eradicating NTM infections in highly selected patients. This chapter will present proposed indications for surgical intervention in patients with NTM disease, the recommended preoperative evaluation of potential surgical patients, surgical techniques, post-op management, and management of postsurgical complications. Additionally, surgical management for extrapulmonary infections is discussed.

Keywords

NTM Nontuberculosis mycobacteria Surgery VATS Lobectomy Thoracotomy Lung resection 

References

  1. 1.
    Hippocrates, (trans: Potter P.) Hippocrates Volume VI. Cambridge: Harvard University Press; 1988. p. 39–43.Google Scholar
  2. 2.
    Bertolaccini L, Viti A, Di Perri G, Terzi A. Surgical treatment of pulmonary tuberculosis: the phoenix of thoracic surgery. J Thorac Dis. 2013;5(2):198–9.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Naef AP. The mid-century revolution in thoracic and cardiovascular surgery: part 2 prelude to 20th century cardio-thoracic surgery. Interact Cardiovasc Thorac Surg. 2003;2(4):431–49.CrossRefGoogle Scholar
  4. 4.
    Griffith DE. Risk-benefit assessment of therapies for Mycobacterium avium complex infections. Drug Saf. 1999;21(2):137–52.CrossRefGoogle Scholar
  5. 5.
    Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr, Winthrop K. ATS mycobacterial diseases subcommittee, American Thoracic Society, infectious disease Society of America. Am J Respir Crit Care Med. 2007;175(4):367–416.CrossRefGoogle Scholar
  6. 6.
    Guideline for surgical therapy of non-tuberculous acid-fast bacterial infection of the lung. Committee on the Management of non-Tuberculous Acid-Fast Bacterial Infections of the lung, the Japanese Society for Tuberculosis. Kekkaku. 2008;83(7):527–8.Google Scholar
  7. 7.
    Yu JA, Pomerantz M, Bishop A, Weyant MJ, Mitchell JD. Lady Windermere revisited: treatment with thoracoscopic lobectomy/segmentectomy for right middle lobe and lingular bronchiectasis associated with non-tuberculous mycobacterial disease. Eur J Cardiothorac Surg. 2011;40:671–5.CrossRefGoogle Scholar
  8. 8.
    Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med. 2000;28:1642–7.CrossRefGoogle Scholar
  9. 9.
    Shigemura N, Wan IY, Yu SC, et al. Multidisciplinary management of life-threatening massive hemoptysis: a 10-year experience. Ann Thorac Surg. 2009;87:849–53.CrossRefGoogle Scholar
  10. 10.
    Haponik EF, Fein A, Chin R. Managing life-threatening hemoptysis: has anything really changed? Chest. 2000;118(5):1431–5.CrossRefGoogle Scholar
  11. 11.
    Yoon W, Kim JK, Kim YH, et al. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics. 2002;22:1395–409.CrossRefGoogle Scholar
  12. 12.
    Fernando HC, Stein M, Benfield JR, et al. Role of bronchial artery embolization in the management of hemoptysis. Arch Surg. 1998;133:862–6.CrossRefGoogle Scholar
  13. 13.
    Uflacker R, Kaemmerer A, Picon PD, et al. Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results. Radiology. 1985;157:637–44.CrossRefGoogle Scholar
  14. 14.
    Poyanli A, Acunas B, Rozanes I, et al. Endovascular therapy in the management of moderate and massive haemoptysis. Br J Radiol. 2007;80:331–6.CrossRefGoogle Scholar
  15. 15.
    Ittrich H, Klose H, Adam Radiologic G. Management of Haemoptysis: diagnostic and interventional bronchial arterial embolisation. Fortschr Röntgenstr. 2015;187(04):248–59.Google Scholar
  16. 16.
    Cahill BC. Ingbar DH massive hemoptysis. Assessment and management. Clin Chest Med. 1994;15(1):147.PubMedGoogle Scholar
  17. 17.
    Shiraishi Y, Katsuragi N, Kita H, Hyogotani A, Saito MH, Shimoda K. Adjuvant surgical treatment of nontuberculous mycobacterial lung disease. Ann Thorac Surg. 2013;96:287–91.CrossRefGoogle Scholar
  18. 18.
    Shiraishi Y. Surgical treatment of nontuberculous mycobacterial lung disease. Gen Thorac Cardiovasc Surg. 2014;62:475.CrossRefGoogle Scholar
  19. 19.
    Field SK, Cowie RL. Treatment of Mycobacterium avium-intracellulare complex lung disease with a macrolide, ethambutol, and clofazimine. Chest. 2003;124:1482–6.CrossRefGoogle Scholar
  20. 20.
    Tanaka E, Kimoto T, Tsuyuguchi K, Watanabe I, Matsumoto H, Niimi A, Suzuki K, Murayama T, Amitani R, Kuze F. Effect of clarithromycin regimen for Mycobacterium avium complex pulmonary disease. Am J Respir Crit Care Med. 1999;160:866–72.CrossRefGoogle Scholar
  21. 21.
    Wallace RJ Jr, Zhang Y, Brown BA, et al. Polyclonal Mycobacterium avium complex infections in patients with nodular bronchiectasis. Am J Respir Crit Care Med. 1998;158:1235–44.CrossRefGoogle Scholar
  22. 22.
    Wallace RJ Jr, Zhang Y, Brown-Elliott BA, Yakrus MA, Wilson RW, Mann L, Couch L, Girard WM, Griffith DE. Repeat positive cultures in Mycobacterium intracellulare lung disease after macrolide therapy represent new infections in patients with nodular bronchiectasis. J Infect Dis. 2002;186:266–73.CrossRefGoogle Scholar
  23. 23.
    Maliwan N, Zvetina JR. Clinical features and follow up of 302 patients with Mycobacterium kansasii pulmonary infection: a 50-year experience. Postgrad Med J. 2005;81:530–3.CrossRefGoogle Scholar
  24. 24.
    Griffith DE, Brown-Elliott BA, Langsjoen B, Zhang Y, Pan X, Girard W, Nelson K, Caccitolo J, Alvarez J, Shepherd S, et al. Clarithromycin resistant Mycobacterium avium complex lung disease. Am J Respir Crit Care Med. 2006;174:928–34.CrossRefGoogle Scholar
  25. 25.
    Nelson KG, Griffith DE, Brown BA, et al. Results of operation in Mycobacterium avium-intracellulare lung disease. Ann Thorac Surg. 1998;66:325–30.CrossRefGoogle Scholar
  26. 26.
    Brunelli A, Kim AW, Berger KI, Addrizzo-Harris DJ. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e166S–90S.CrossRefGoogle Scholar
  27. 27.
    British Thoracic Society. Society of Cardiothoracic Surgeons of great Britain and Ireland working party BTS guidelines: guidelines on the selection of patients with lung cancer for surgery. Thorax. 2001;56(2):89.CrossRefGoogle Scholar
  28. 28.
    UMazzone. Preoperative evaluation of the lung resection candidate. Cleve Clin J Med. 2012;79(Electronic Suppl 1):eS17–22.Google Scholar
  29. 29.
    Berry MF, Villamizar-Ortiz NR, Tong BC, Burfeind WR Jr, Harpole DH, D'Amico TA, Onaitis MW. Pulmonary function tests do not predict pulmonary complications after thoracoscopic lobectomy. Ann Thorac Surg. 2010;89(4):1044–51. discussion 1051-2CrossRefGoogle Scholar
  30. 30.
    DeRose J Jr, Argenziano M, El-Amir N, Jellen PA, Gorenstein LA, Steinglass KM, Thomashow B, Ginsburg ME. Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema. Ann Thorac Surg. 1998;65(2):314–8.CrossRefGoogle Scholar
  31. 31.
    Brunelli A, Charloux A, Bolliger CT, Rocco G, Sculier JP, Varela G, Licker M, Ferguson MK, Faivre-Finn C, Huber RM, Clini EM, Win T, De Ruysscher D, Goldman L, European Respiratory Society and European Society of Thoracic Surgeons joint task force on fitness for radical therapy. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy). Eur Respir J. 2009;34(1):17–41.CrossRefGoogle Scholar
  32. 32.
    Ali MK, Mountain CF, Ewer MS, Johnston D, Haynie TP. Predicting loss of pulmonary function after pulmonary resection for bronchogenic carcinoma. Chest. 1980;77(3):337–42.CrossRefGoogle Scholar
  33. 33.
    Eugene H, Brown SE, Light RW, et al. Maximum oxygen consumption: a physiologic guide to pulmonary resection. Surg Forum. 1982;33:260.Google Scholar
  34. 34.
    Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT, American College of Chest Physicians. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):161S–77S.CrossRefGoogle Scholar
  35. 35.
    Rodriguez-Larrad A, Lascurain-Aguirrebena I, Abecia-Inchaurregui LC, Seco J. Perioperative physiotherapy in patients undergoing lung cancer resection. Interact Cardiovasc Thorac Surg. 2014;19(2):269–81.CrossRefGoogle Scholar
  36. 36.
    Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and Management of Patients Undergoing Noncardiac Surgery. J Am Coll Cardiol. 2014;6:e77–e137.CrossRefGoogle Scholar
  37. 37.
    Stijn MF, Korkic-Halilovic I, Bakker MS, van der Ploeg T, van Leeuwen PA, Houdijk AP. Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review. Parenter Enteral Nutr. 2013;37(1):37–43.CrossRefGoogle Scholar
  38. 38.
    Mitchell JD, Bishop A, Cafaro A, Weyant MJ, Pomerantz M. Anatomic lung resection for nontuberculous mycobacterial disease. Ann Thorac Surg. 2008;85:1887–92. discussion 92–3CrossRefGoogle Scholar
  39. 39.
    Mitchell JD, Yu JA, Bishop A, Weyant MJ, Pomerantz M. Thoracoscopic lobectomy and segmentectomy for infectious lung disease. Ann Thorac Surg. 2012;93:1033–9. discussion 9–40CrossRefGoogle Scholar
  40. 40.
    Sagawa M, Sugita M, Takeda Y, Toga H, Sakuma T. Video-assisted bronchial stump reinforcement with an intercostal muscle flap. Ann Thorac Surg. 2004;78(6):2165–6.CrossRefGoogle Scholar
  41. 41.
    Schede M. Die Behandlung der Empyeme. Verh Cong Innere Med Wiesbaden. 1890;9:41–141.Google Scholar
  42. 42.
    Alexander J. The collapse therapy of pulmonary tuberculosis. Springfield, IL: Charles C. Thomas; 1937.Google Scholar
  43. 43.
    Pomerantz M, Denton JR, Huitt GA, Brown JM, Powell LA, Iseman MD. Resection of the right middle lobe and lingula for mycobacterial infection. Ann Thorac Surg. 1996;62:990–3.CrossRefGoogle Scholar
  44. 44.
    Ono N, Satoh K, Yokomise H, Tamura K, Horikawa S, Suzuki Y, et al. Surgical management of Mycobacterium avium complex disease. Thorac Cardiovasc Surg. 1997;45:311–3.CrossRefGoogle Scholar
  45. 45.
    Shiraishi Y, Fukushima K, Komatsu H, Kurashima A. Early pulmonary resection for localized Mycobacterium avium complex disease. Ann Thorac Surg. 1998;66:183–6.CrossRefGoogle Scholar
  46. 46.
    Shiraishi Y, Nakajima Y, Takasuna K, Hanaoka T, Katsuragi N, Konno H. Surgery for Mycobacterium avium complex lung disease in the clarithromycin era. Eur J Cardiothorac Surg. 2002;21:314–8.CrossRefGoogle Scholar
  47. 47.
    Shiraishi Y, Nakajima Y, Katsuragi N, Kurai M, Takahashi N. Pneumonectomy for nontuberculous mycobacterial infections. Ann Thorac Surg. 2004;78:399–403.CrossRefGoogle Scholar
  48. 48.
    Sherwood JT, Mitchell JD, Pomerantz M. Completion pneumonectomy for chronic mycobacterial disease. J Thorac Cardiovasc Surg. 2005;129:1258–65.CrossRefGoogle Scholar
  49. 49.
    Watanabe M, Hasegawa N, Ishizaka A, Asakura K, Izumi Y, Eguchi K, et al. Early pulmonary resection for Mycobacterium avium complex lung disease treated with macrolides and quinolones. Ann Thorac Surg. 2006;81:2026–30.CrossRefGoogle Scholar
  50. 50.
    Koh WJ, Kim YH, Kwon OJ, Choi YS, Kim K, Shim YM, et al. Surgical treatment of pulmonary diseases due to nontuberculous mycobacteria. J Korean Med Sci. 2008;23:397–401.CrossRefGoogle Scholar
  51. 51.
    van Ingen J, Verhagen AF, Dekhuijzen PN, van Soolingen D, Magis-Escurra C, Boeree MJ, et al. Surgical treatment of non-tuberculous mycobacterial lung disease: strike in time. Int J Tuberc Lung Dis. 2010;14:99–105.PubMedGoogle Scholar
  52. 52.
    Jarand J, Levin A, Zhang L, Huitt G, Mitchell JD, Daley CL. Clinical and microbiologic outcomes in patients receiving treatment for Mycobacterium abscessus pulmonary disease. Clin Infect Dis. 2011;52:565–71.CrossRefGoogle Scholar
  53. 53.
    Kang HK, Park HY, Kim D, Jeong BH, Jeon K, Cho JH, Kim HK, Choi YS, Kim J, Koh WJ. Treatment outcomes of adjuvant resectional surgery for nontuberculous mycobacterial lung disease. BMC Infect Dis. 2015;15:76.CrossRefGoogle Scholar
  54. 54.
    Zvetina JR, Neville WE, Maben HC, Langston HT, Correll NO. Surgical treatment of pulmonary disease due to Mycobacterium kansasii. Ann Thorac Surg. 1971;11(6):551–6.CrossRefGoogle Scholar
  55. 55.
    Kozower BD, O'Brien SM, Kosinski AS, Magee MJ, Dokholyan R, Jacobs JP, Shahian DM, Wright CD, Fernandez FG. The Society of Thoracic Surgeons composite score for rating program performance for lobectomy for lung Cancer. Ann Thorac Surg. 2016;101(4):1379–86. discussion 1386-7CrossRefGoogle Scholar
  56. 56.
    Mahadevan M, Neeff M, Van Der Meer G, Baguley C, Wong WK, Gruber M. Non-tuberculous mycobacterial head and neck infections in children: analysis of results and complications for various treatment modalities. Int J Pediatr Otorhinolaryngol. 2016;82:102–6.CrossRefGoogle Scholar
  57. 57.
    Johnson MG, Stout JE. Twenty-eight cases of Mycobacterium marinum infection: retrospective case series and literature review. Infection. 2015;43(6):655–62.CrossRefGoogle Scholar
  58. 58.
    Kohler P, Kuster SP, Bloemberg G, Schulthess B, Frank M, Tanner FC, Rossle M, Boni C, Falk V, Wilhelm MJ, Sommerstein R, Achermann Y, Ten Oever J, Debast SB, Wolfhagen MJ, Brandon Bravo Bruinsma GJ, Vos MC, Bogers A, Serr A, Beyersdorf F, Sax H, Bottger EC, Weber R, van Ingen J, Wagner D, Hasse B. Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. Eur Heart J. 2015;36(40):2745–53.CrossRefGoogle Scholar
  59. 59.
    Bowles P, Miller MC, Cartwright S, Jones M. Presentation of Mycobacterium abscessus infection following rhytidectomy to a UK plastic surgery unit. BMJ Case Rep. 2014.Google Scholar
  60. 60.
    Edens C, Liebich L, Halpin AL, Moulton-Meissner H, Eitniear S, Zgodzinski E, Vasko L, Grossman D, Perz JF, Mohr MC. Mycobacterium chelonae eye infections associated with humidifier use in an outpatient LASIK clinic Ohio- 2015. MMWR Morb Mortal Wkly Rep. 2015;64(41):1177.CrossRefGoogle Scholar
  61. 61.
    Umer I, Mocherla S, Horvath J, Arora S, Ahmed Y. Mycobacterium abscessus: a rare cause of vascular graft infection. Scand J Infect Dis. 2014;46(11):813–6.CrossRefGoogle Scholar
  62. 62.
    Thomas M, D’Silva JA, Borole AJ, Chilgar RM. Periprosthetic atypical mycobacterial infection in breast implants: a new kid on the block! J Plast Reconstr Aesthet Surg. 2013;66(1):e16–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Cardiothoracic SurgeryCHRISTUS Trinity Clinic, University of Texas Health Science Center TylerTylerUSA

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