Journal
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Volume 52, Issue 4, Pages 673-678Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezx209
Keywords
Tuberculosis; MDR-TB; Multidrug resistant; Surgery; Pulmonary resection; Treatment outcome
Funding
- National Research Foundation of Korea (NRF) - Ministry of Education, Science and Technology (MEST) [NRF-2015R1D1A1A01058565]
- Medical Research Center - NRF of the Ministry of Science, ICT and Future Planning, Republic of Korea [2008-0062287]
- National Research Foundation of Korea [2008-0062287] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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We investigated the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis. To weigh the survival benefit of pulmonary resection for patients with multidrug-resistant tuberculosis who have undergone surgical treatment combined with medical chemotherapy compared with medical chemotherapy alone, we did a meta-analysis of available studies containing a hazard ratio for pulmonary resection. Among 1726 articles, 6 clinical reports, with a mean sample size of 47 patients per report, met the inclusion criteria. The pooled hazard ratio of 0.68 with a 95% confidence interval of approximately 0.44-1.07 suggested that the survival benefit of surgical pulmonary resection combined with chemotherapy, in a comparison of the groups 'with surgery' and 'without surgery', is not significantly greater than that of chemotherapy alone. Selection bias, due to the absence of rigid predetermined indications for pulmonary resection, limited the validity of this analysis. Due to the heterogeneity of the patient groups, greater attention is required to compute additional hazard ratios in future studies with stratification of factors such as cardiopulmonary functions, disease extent and the presence of a cavity. These additional computations in future studies are necessary to determine the survival benefit and to support the rigid surgical indications.
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