Prospective study of surgical management of drug resistant and complications associated with pulmonary tuberculosis

Abstract

Introduction: Tuberculosis (TB) is a ubiquitous, highly fatal contagious chronic granulomatous bacterial infection. It is mainly an infection of the lungs but can affect almost any part of the body. Although TB is a preventable and treatable disease, yet it still poses a significant threat globally. In 2012, an estimated 8.6 million people developed TB and 1.3 million died from the disease. Modern tuberculosis treatment relies on chemotherapy, surgery is accepted as adjuvant treatment for MDR TB.Methodology: This study include total of 40 diagnosed cases of MDR or XDR pulmonary tuberculosis with it’s complications.Known cases of pulmonary tuberculosis with multidrug resistance and Extensive drug resistance with complications in Department of surgery, M.G.M medical college and M.Y Hospital, Indore.Result: The mean age of presentation was 38.82 ± SD years, Thoracotomy with Decortication was the most commonly performed procedure in (72.5% patients), Lobectomy in 20%patients, Pneumonectomy in 5% patients and Segmentectomy3% patients. Postoperative complication occurred in 10 patients (25%), 2 deaths occured in this study within 3rd postoperative day. Overall mortality was 5%, Out of 40 Patients complete cure was obtained in 85% of the treated patients, All patients had adjuvant chemotherapy post operatively for mean duration of 15.58 months with follow up for 12 to 18 months.Conclusion: The resectional surgery has a distinct role in the management of MDR/XDR tuberculosis. The proper selection of the patients and early decision for surgical intervention can achieve a high success rate of drug resistant pulmonary tuberculosis with well localised pulmonary lesion.