25 cases with pulmonary tuberculosis sequelae due to surgical procedures; Experience in Japan

25 cases with pulmonary tuberculosis sequelae due to surgical procedures; Experience in Japan

Global summit on TUBERCULOSIS AND LUNG DISEASE
September 20-21, 2017 | Philadelphia, USA

Mizu Nonaka, Hitomi Goto, Rie Shigemasa, Yuika Sasatani, Naoki Arai, Kai Yazaki, Hiroaki Ishikawa, Kentaro Hyodo, Kenji Nemoto, Yukiko Miura, Takio Takaku, Shuji Oishi, Kenji Hayashihara and Takefumi Saito

Ibaraki Higashi National Hospital, Japan

Scientific Tracks Abstracts : Int J Respir Med

Abstract:

Surgery was one of the main treatment options for tuberculosis before the introduction of effective antituberculosis medicines. Early surgical therapies consisted of a variety of collapse therapies including thoracoplasty, ball plombage, artificial pneumothorax and phrenicotomy and the first report of pulmonary resection was in 1891. Although surgery played a prominent role in tuberculosis management during the early twentieth century, it was largely abandoned with the introduction of modern antituberculosis chemotherapy and chemotherapy has been the main treatment method for tuberculosis until the present day. However, the global emergence of drug-resistant TB including multidrug resistant (MDR) and extensively drugresistant (XDR) disease has led to the re-examination of surgery as an adjunctive treatment for highly drug-resistant TB and there are few reports of long-term prognosis. We have carried out a retrospective analysis on 25 pulmonary tuberculosis sequelae cases due to surgical procedures. The analysis was based on the medical records of tuberculosis sequelae cases who visited Ibarakihigashi National Hospital from 2012 to 2016. They include 10 thoracoplasty cases, 6 pneumonectomy cases, 6 upper lobe resection cases, 2 artificial pneumothorax cases and 1 phrenicotomy case. Although 16 of 18 cases with spirometry data available had restrictive ventilatory defect after a median time of 60 years from surgical procedures, 25 cases survived for a media time of 56 years from surgery, though 7 cases needed longterm oxygen therapy and 5 cases did non-invasive positive pressure ventilation. Most cases of pulmonary tuberculosis sequelae due to surgical procedures survived for a long time after surgery. This study suggests that surgical procedures may be an important element of successful therapy for nontuberculous mycobacteria, MDR-TB or XDR-TB with limited therapeutic options.

Biography:

Mizu Nonaka has completed his MD from University of Tsukuba, Japan. He belongs to Department of Respiratory Medicine, Ibarakihigashi National Hospital.

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