Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease
BACKGROUND: Adjuvant lung resection surgery benefits selected patients with nontuberculous mycobacterial pulmonary disease (NTM-PD); however, optimal timing remains controversial. This study evaluated surgical outcomes and prognostic factors, with a focus on the timing of surgical intervention. METH...
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International Union Against Tuberculosis and Lung Disease (The Union)
2025-07-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000007/art00005 |
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| author | T.-F. Kuo M.-R. Lee H.-L. Huang K.-C. Chen M.-W. Lin S.-W. Kuo P.-M. Huang H.-H. Chen J.-Y. Wang J.-S. Chen |
| author_facet | T.-F. Kuo M.-R. Lee H.-L. Huang K.-C. Chen M.-W. Lin S.-W. Kuo P.-M. Huang H.-H. Chen J.-Y. Wang J.-S. Chen |
| author_sort | T.-F. Kuo |
| collection | DOAJ |
| description | BACKGROUND: Adjuvant lung resection surgery benefits selected patients with nontuberculous mycobacterial pulmonary disease (NTM-PD); however, optimal timing remains controversial. This study evaluated surgical outcomes and prognostic factors, with a focus on the timing of surgical intervention. METHODS: This study included 41 patients with NTM-PD who underwent adjuvant lung resection surgery between January 2000 and August 2022. Data on patient characteristics, surgical procedures and postoperative outcomes were analyzed. The primary outcome, defined as freedom from unfavorable outcomes (mortality, failure to achieve sputum culture conversion, or microbiological recurrence), was estimated using the Kaplan–Meier method, with prognostic factors analyzed by Cox regression model. RESULTS: Extensive disease was observed in 35 (85%) patients. The median preoperative antibiotic duration was 3.2 months. Twenty-two (54%) patients received lobectomies, whereas 15 (37%) received wedge resections. Thirty-four (83%) achieved sputum culture conversion. The probability of being free from unfavorable outcomes within two years was 80%. Independent favorable prognostic factors included body mass index ≥ 18.5 kg/m2 (p=0.007) and early surgical intervention (preoperative antibiotic duration < 3 months, p=0.039). Additionally, early surgical intervention correlated with shorter operation time (p=0.03). CONCLUSIONS: Early surgical intervention, irrespective of the surgical approach, appeared feasible and potentially beneficial even in patients with extensive NTM-PD. |
| format | Article |
| id | doaj-art-eaad48703b9e4d51b0da92c852f58ac1 |
| institution | Matheson Library |
| issn | 3005-7590 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-eaad48703b9e4d51b0da92c852f58ac12025-07-14T13:45:10ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902025-07-012741241910.5588/ijtldopen.25.01275Early surgical intervention for extensive nontuberculous mycobacterial pulmonary diseaseT.-F. Kuo0M.-R. Lee1H.-L. Huang2K.-C. Chen3M.-W. Lin4S.-W. Kuo5P.-M. Huang6H.-H. Chen7J.-Y. Wang8J.-S. Chen9Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (R.O.C);Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan (R.O.C).Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C);BACKGROUND: Adjuvant lung resection surgery benefits selected patients with nontuberculous mycobacterial pulmonary disease (NTM-PD); however, optimal timing remains controversial. This study evaluated surgical outcomes and prognostic factors, with a focus on the timing of surgical intervention. METHODS: This study included 41 patients with NTM-PD who underwent adjuvant lung resection surgery between January 2000 and August 2022. Data on patient characteristics, surgical procedures and postoperative outcomes were analyzed. The primary outcome, defined as freedom from unfavorable outcomes (mortality, failure to achieve sputum culture conversion, or microbiological recurrence), was estimated using the Kaplan–Meier method, with prognostic factors analyzed by Cox regression model. RESULTS: Extensive disease was observed in 35 (85%) patients. The median preoperative antibiotic duration was 3.2 months. Twenty-two (54%) patients received lobectomies, whereas 15 (37%) received wedge resections. Thirty-four (83%) achieved sputum culture conversion. The probability of being free from unfavorable outcomes within two years was 80%. Independent favorable prognostic factors included body mass index ≥ 18.5 kg/m2 (p=0.007) and early surgical intervention (preoperative antibiotic duration < 3 months, p=0.039). Additionally, early surgical intervention correlated with shorter operation time (p=0.03). CONCLUSIONS: Early surgical intervention, irrespective of the surgical approach, appeared feasible and potentially beneficial even in patients with extensive NTM-PD.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000007/art00005ntm-pdpreoperative antibiotic durationwedge resectionsegmentectomylobectomypneumonectomy |
| spellingShingle | T.-F. Kuo M.-R. Lee H.-L. Huang K.-C. Chen M.-W. Lin S.-W. Kuo P.-M. Huang H.-H. Chen J.-Y. Wang J.-S. Chen Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease IJTLD Open ntm-pd preoperative antibiotic duration wedge resection segmentectomy lobectomy pneumonectomy |
| title | Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| title_full | Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| title_fullStr | Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| title_full_unstemmed | Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| title_short | Early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| title_sort | early surgical intervention for extensive nontuberculous mycobacterial pulmonary disease |
| topic | ntm-pd preoperative antibiotic duration wedge resection segmentectomy lobectomy pneumonectomy |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000007/art00005 |
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