[Surgical treatment of pulmonary tuberculosis].

The indications for the surgical treatment of pulmonary tuberculosis are mainly for multidrug-resistant tuberculosis (MDR-Tb). In Fukujuji Hospital there have been 91 pulmonary resections for 83 MDR-Tb cases during the past 20 years. Of those resections, upper lobectomies with or without partial resection of other lobes comprised 55%, segmentectomies 10%, and pneumonectomies 30%. The following major postoperative complications occurred: prolonged air leakages in 19%, empyema in 9%, and respiratory failure in 6%. However, there were no operative deaths. After pulmonary resection for MDR-Tb, immediate negative conversion rate of expectoration of tuberculous bacilli was 98%, reexpectoration rate of them was 12%, The final cure rate was 92%. Surgical treatment is worth consideration for the treatment of refractory pulmonary tuberculosis.