SURGICAL INTERVENTION IN MULTI-DRUG RESISTANT TUBERCULOSIS: A STRATEGIC COMPLEMENT TO CHEMOTHERAPY
Keywords:
MDR-TB, drug-resistant tuberculosis, lung resection, thoracic surgery, phthisiology, lobectomy, segmentectomy, surgical treatmentAbstract
Multi-drug resistant tuberculosis (MDR-TB) presents a significant global health threat, particularly in cases where pharmacological therapy alone fails to achieve bacterial eradication. Surgical resection of diseased lung segments has re-emerged as a valuable adjunctive strategy in the comprehensive treatment of MDR-TB. This article explores the indications, techniques, and outcomes of surgery in MDR-TB patients, highlighting its role in reducing bacterial load, preventing transmission, and improving treatment success. Emphasis is placed on patient selection, perioperative management, and integration of surgical care into national TB control programs.
References
1. World Health Organization. (2023). Global Tuberculosis Report. Geneva: WHO.
2. Migliori, G. B., et al. (2019). “Surgical management of drug-resistant tuberculosis: A worldwide perspective.” International Journal of Tuberculosis and Lung Disease, 23(6), 624–632.
3. Yablonskiy, P. K., et al. (2016). “Surgical treatment of multidrug-resistant tuberculosis: A comprehensive review.” European Journal of Cardio-Thoracic Surgery, 50(6), 1057–1066.
4. Kim, H. J., et al. (2017). “Outcomes of lung resection in patients with multidrug-resistant and extensively drug-resistant tuberculosis.” Annals of Thoracic Surgery, 103(3), 895–902.
5. Marrone, M. T., et al. (2020). “Effect of adjunctive surgical resection on treatment outcomes in MDR and XDR TB: A meta-analysis.” Clinical Infectious Diseases, 71(1), 147–158.
6. Ganiev, B. A., & Ismoilova, G. (2022). “Thoracic surgery in MDR-TB: Role, timing, and patient selection in Central Asia.” Journal of Tuberculosis and Pulmonology, 6(1), 34–41.
7. Fox, G. J., et al. (2021). “Surgery and adjunctive therapies for multidrug-resistant tuberculosis.” BMJ Global Health, 6(5), e005065.
8. Dheda, K., et al. (2018). “Drug-resistant TB: Time for visionary political leadership.” The Lancet Respiratory Medicine, 6(3), 242–243.
9. WHO Regional Office for Europe. (2021). Action Framework for the WHO End TB Strategy Implementation in the European Region 2023–2030.
10. Linh, N. N., et al. (2023). “Integration of surgery in national TB programs: Experience from Vietnam.” Asian Thoracic Journal, 5(2), 112–119.
1. World Health Organization. (2023). Global Tuberculosis Report. Geneva: WHO.
2. Migliori, G. B., et al. (2019). “Surgical management of drug-resistant tuberculosis: A worldwide perspective.” International Journal of Tuberculosis and Lung Disease, 23(6), 624–632.
3. Yablonskiy, P. K., et al. (2016). “Surgical treatment of multidrug-resistant tuberculosis: A comprehensive review.” European Journal of Cardio-Thoracic Surgery, 50(6), 1057–1066.
4. Kim, H. J., et al. (2017). “Outcomes of lung resection in patients with multidrug-resistant and extensively drug-resistant tuberculosis.” Annals of Thoracic Surgery, 103(3), 895–902.
5. Marrone, M. T., et al. (2020). “Effect of adjunctive surgical resection on treatment outcomes in MDR and XDR TB: A meta-analysis.” Clinical Infectious Diseases, 71(1), 147–158.
6. Ganiev, B. A., & Ismoilova, G. (2022). “Thoracic surgery in MDR-TB: Role, timing, and patient selection in Central Asia.” Journal of Tuberculosis and Pulmonology, 6(1), 34–41.
7. Fox, G. J., et al. (2021). “Surgery and adjunctive therapies for multidrug-resistant tuberculosis.” BMJ Global Health, 6(5), e005065.
8. Dheda, K., et al. (2018). “Drug-resistant TB: Time for visionary political leadership.” The Lancet Respiratory Medicine, 6(3), 242–243.
9. WHO Regional Office for Europe. (2021). Action Framework for the WHO End TB Strategy Implementation in the European Region 2023–2030.
10. Linh, N. N., et al. (2023). “Integration of surgery in national TB programs: Experience from Vietnam.” Asian Thoracic Journal, 5(2), 112–119.
