| Cohort size |
29 |
27 |
27 |
27 |
49 |
172 (includes cohort described in Iseman
et al18) |
36 (includes cohort described in Kir
et al22) |
62 |
|
|
|
|
|
|
|
|
|
| Time period |
1983–1989 |
1993–1996 |
1/1994–3/1998 |
12/1990–3/1999 |
1/1995–12/1999 |
8/1983–4/2000 |
3/1992–10/1999 |
1/1990–11/1995 |
|
|
|
|
|
|
|
|
|
| Inclusion/exclusion criteria |
Inclusion: High‐grade drug resistance, disease sufficiently localised to resect preponderance of disease; sufficient drug activity to diminish mycobacterial burden and allow healing of bronchial stump |
Inclusion: Same as Iseman et al18
Exclusion: HIV |
Inclusion: Positive sputum despite MDR‐TB therapy or significant parenchymal damage |
Inclusion: Not noted |
Inclusion: Failure to sputum convert or high risk of relapse due to remaining cavities
Exclusion: HIV, FEV1 <2.0, heart failure,
renal insufficiency |
Inclusion: Same as Iseman et al18
|
Inclusion: Same as Iseman et al18
|
Inclusion: Failure to convert, previous relapse(s), high profile of drug resistance, or high or potential risk of relapse (as gauged by destroyed lung or lobe) |
|
|
|
|
|
|
|
|
|
| Bilateral disease |
93.1% |
59.3% |
70.4% |
Not described |
63.3% |
Not noted |
Not noted |
Not noted |
|
|
|
|
|
|
|
|
|
| Preoperative bacteriological status |
69.0% smear‐positive before surgery |
96.3% had negative smear and culture before surgery |
40.7% smear‐negative before surgery |
22% with persistent culture‐positive status before surgery |
63.3% culture‐positive before surgery |
52.9% culture‐positive at time of surgery |
94% culture‐negative before surgery |
39% smear and/or culture positive at surgery |
|
|
|
|
|
|
|
|
|
| Length of preoperative treatment |
Median 5 months (range 2–12) |
Median 5.8 months (range 4–8) |
Median 15 months |
Mean 10 months (range 2–23) |
20 underwent surgery within 3 months of starting chemotherapy and 4 within 6 months;
7 after 6 months |
3 months in 20 patients, 6 months in 4 patients;
>6 months in 7 patients |
Mean 5.9 months (range 3–10) |
Not noted |
|
|
|
|
|
|
|
|
|
| Bacteriological outcome |
Sustained conversion: 87.1%;culture‐positive after surgery: 6.9% |
100% with negative cultures 4 months postoperative; 3.7% relapsed |
59.3% persistently culture‐positive postop; at 29 month follow‐up: 70.4% culture‐negative in treatment |
88.9% with postoperative culture conversion; at 42 months follow‐up:
1 later relapsed |
90.3% of preoperative positive patients achieved smear conversion; 1 subsequent relapse |
At 7.7 year follow‐up: 2% remained sputum positive |
89% with favourable outcome (with culture conversion) |
89% smear and/or culture negative immediately after surgery; 80% of those who converted with surgery remain disease‐free at 36 months |
|
|
|
|
|
|
|
|
|
| Surgical outcomes |
Intraoperative deaths: 0; non‐operative deaths within 30 days: 3.4 (6.8)%; complications: 6.9% |
Operative deaths: 3.7%; complications: 14.8% |
Operative deaths: 0;complications: 25.9% |
Operative deaths: 0 vs 3.7%; non‐
operative deaths: 8%; complications: 11.1% |
Intraoperative deaths: 0; complications: 16.3% |
Operative deaths (30 days): 3.3%;
late mortality: 6.4%; complications: 11.6% |
Operative deaths (30 days): 3.3%;
late mortality: 6.4%; complications: 11.6% |
Operative deaths (30 days): 1.6%;
late mortality: 8.1%; complications: 23% |
