Pulmonary resection for patients with multidrug-resistant tuberculosis based on survival outcomes: a systematic review and meta-analysis

被引:9
作者
Roh, Hyunsuk Frank [1 ]
Kim, Jihoon [2 ]
Nam, Seung Hyuk [3 ]
Kim, Jung Mogg [1 ]
机构
[1] Hanyang Univ, Coll Med, Dept Microbiol, 222 Wangsimni Ro, Seoul 133791, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Thorac & Cardiovasc Surg, Seoul, South Korea
[3] Hanyang Univ, Guri Hosp, Dept Thorac & Cardiovasc Surg, Gyunggi, South Korea
基金
新加坡国家研究基金会;
关键词
Tuberculosis; MDR-TB; Multidrug resistant; Surgery; Pulmonary resection; Treatment outcome; LONG-TERM SURVIVAL; SURGICAL-TREATMENT; DRUG-RESISTANCE; SURGERY; MANAGEMENT; MORTALITY; CURE; TB;
D O I
10.1093/ejcts/ezx209
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:673 / 678
页数:6
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