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02.11.2018 | Original Article

Outcomes and risk factors after adjuvant surgical treatments for Mycobacterium avium complex lung disease

Zeitschrift:
General Thoracic and Cardiovascular Surgery
Autoren:
Katsuo Yamada, Yukio Seki, Taku Nakagawa, Yuta Hayashi, Mitsuaki Yagi, Kenji Ogawa

Abstract

Background

Limited information is currently available on the postoperative outcomes of Mycobacterium avium complex lung disease (MAC-LD).

Objective

To show the outcomes of pulmonary resection and identify risk factors after adjuvant surgical treatments for MAC-LD.

Methods

One hundred and eight patients underwent adjuvant lung resection for MAC-LD at two hospitals between January 2008 and July 2016. We retrospectively evaluated outcomes and risk factors.

Results

Postoperative complications occurred in 14 patients (13%). After lung resection, 98 out of 108 patients (91%) achieved sputum culture conversion, eight (8.2%) of whom developed microbiological recurrence during the follow-up period. As a result, the success rate of adjuvant surgical treatments for MAC-LD with drug resistance was 83%. A multivariable analysis showed that a longer period from the initial medical treatment to surgery (hazard ratio, 1.01; 95% confidence interval, 1.00–1.02; p = 0.008) was independently associated with an increased risk of unfavorable outcomes after adjuvant surgery.

Conclusions

Adjuvant surgical treatments for MAC-LD have acceptable outcomes. Better control of the disease may be achieved in some patients with drug resistance and indications for surgery through surgical treatments, and pulmonary resection needs to be performed earlier rather than continuing chemotherapy in these patients because it reduces unfavorable outcomes.

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