부산대학교 도서관

Introduction: The indications for surgery are limited to the management of complicated forms of tuberculosis (TB), and mostly to cases in which medical treatment is failing. There is, however, limited good quality data on the effectiveness of using surgery alongside drug treatment for TB. This study investigated the prognosis of patients with an incidental pulmonary TB finding after surgical resection. Methods: The study enrolled patients who received video-assisted thoracic surgery (VATS) wedge resection or lobectomy for lung lesions from 2013 to 2017. The Pulmonary TB diagnosis was based on pathological examination with acid-fast stain or the mycobacterial culture result of surgical specimens. Medical records were reviewed and clinical data, including age, gender, surgical type, pathological reports, microbiological cultures, treatment and follow-up duration were analyzed. Results: A total of 443 patients from National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan, were included. Of those, 200 patients (45.1%) had primary lung cancer, 31 (7.0%) had metastatic cancer, 20 (4.5%) were diagnosed as having mycobacterial infection, and 11 patients (2.5%) had cryptococcosis. Thirteen of the 20 patients (65.0%) with mycobacterial infection received anti-TB treatment, and the remaining 7 patients (35.0%) were followed at the clinic without a therapeutic medication prescription. All of these patients were stable after lung lesions resection without evidence of pulmonary TB recurrence. Conclusion: Anti-TB treatment may not be essential after surgical resection with an incidental finding of pulmonary TB. There is a need for well-designed trials to provide more information about the effectiveness of surgery.