Content Status
Type
Linked Node
Role of Surgery in DR-TB Treatment
Learning ObjectivesRole of Surgery in DR-TB Treatment
In Drug-resistant TB (DR-TB) patients with localized disease, surgery, as an adjunct to chemotherapy, can improve outcomes; provided that skilled thoracic surgeons and excellent postoperative care is available.
A patient with a unilateral resectable disease may be considered for surgery if there is:
- Absence of clinical or bacteriological response to chemotherapy despite 6 to 9 months of treatment with effective anti-TB drugs
- High risk of treatment failure or relapse due to a high degree of resistance or extensive parenchymal involvement
- Morbid complications of parenchymal disease, e.g., hemoptysis, bronchiectasis, broncho-pleural fistula or empyema
- Relapse after completion of anti-TB treatment
The World Health Organization (WHO) has recommended surgical procedures like wedge resections or lobectomy in patients with localized lesions.
If a surgical option is under consideration, at least six to nine months of chemotherapy is recommended prior to surgery to ensure culture conversion.
States and districts should identify and establish linkages with institutions that have thoracic surgical facilities. This is to provide surgical options after thoroughly evaluating and reviewing a patient who requires such surgical intervention.
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020.
- Technical and Operational Guidelines for TB In India, 2016.
Kindly provide your valuable feedback on the page to the link provided HERE
Content Creator
Reviewer
- Log in to post comments