Immediate Outcomes of Surgical Treatment for Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis

Abstract

Objective: To study and compare surgical risks and immediate effectiveness of surgical treatment in patients with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB).Materials and methods: We examined immediate treatment outcomes of 1180 patients who underwent surgery for destructive MDRTB, pre-XDR-TB, and XDR-TB between 2011 and 2023. The patients were grouped: group 1 for patients with MDR-TB (744 cases) and group 2 for patients with pre-XDR-TB and XDR-TB (436 cases). Moreover, patients were further subdivided based on the extent of surgery.Results: The complete clinical response, ie, cavity closure and elimination of bacilli (CV-, MBT-), was achieved in all 405 patients who underwent radical surgery, in 673 (97.1%) of 694 patients who underwent semiradical surgery, and only in 10 (12.3%) of 81 patients who underwent palliative surgery.Conclusions: The immediate outcomes of surgical treatment for MDR-TB were superior in all parameters compared with those for pre-XDR-TB and XDR-TB; however, we found no significant differences when we evaluated treatment effectiveness in patients who underwent radical and semiradical surgery.

Keywords

• tuberculosis
• surgery
• multidrug resistance
• extensive drug resistance