Surgery for First Line Drug-Resistant Tuberculosis

¹ Ruttonjee Sanatorium

Resection for first line drug resistant pulmonary tuberculosis was performed on 208 Chinese patients in Hong Kong. The chemotherapeutic regimen prescribed as a surgical cover was a combination of pyrazinamide and ethionamide.

Recovery was uncomplicated in 170 patients (82 per cent). Second thoracotomy was performed on 29 patients for fistulæ or leaks (16) ; postoperative hemorrhage (11); unexpanded lobe (1); and empyema (1). Recovery in these 29 patients was thereafter uneventful.

There was no death attributed to surgery or to the disease, but one patient died three months postoperatively from carcinoma of the liver.

Jaundice attributed to pyrazinamide occurred in one patient after four months' treatment and the drug was withdrawn. The patient otherwise pursued an uneventful course.

The sputum remained positive postoperatively in seven patients, but three of these later converted. Four patients (2 percent) failed to become sputum negative and so they are considered as treatment failures.