Clinical outcomes for drug-resistant TB patients after adjunctive resectional lung surgery

OBJECTIVE This study aimed to evaluate the performance of adjunctive resectional lung surgery for patients with drug-resistant TB (DR-TB). METHODS From January 2015 to January 2019, 40 consecutive pulmonary resections were performed for DR-TB patients at Wuhan Jinyintan Hospital. Clinical outcomes of extensively drug-resistant TB (XDR-TB), multidrug-resistant TB (MDR-TB), and rifampin-resistant TB (RR-TB) were analysed with a minimum of 5 years of postoperative follow-up. RESULTS The mean age of the patients was 32.28 ± 11.79 years, with 62.3% being female. Seven patients (17.5%) had RR-TB, 23 (57.5%) had MDR-TB, and 10 (25.0%) had XDR-TB, all of whom received second-line anti-TB drugs. Thirty patients (75.0%) presented with solitary lung cavities, 7 (17.5%) had multiple lung cavities, and 3 (7.5%) had destructive lung disease. Surgical interventions included lobectomy (25, 62.5%) and pneumonectomy (6, 15.0%), with a low complication rate of 12.5%. Postoperatively, 89.5% of the patients achieved sputum smear conversion, and 91.3% achieved culture conversion. The overall cure and survival rates were both 97.5%. The mean follow-up duration was 7.1 years. CONCLUSION Our data indicate that adjunctive resectional lung surgery is a feasible therapeutic option for RR/MDR/XDR-TB patients, with subsequent second-line drug therapy playing a crucial role in determining the final clinical outcomes.