Do Residual Findings After Lung Resection for Tuberculomas Affect Treatment Outcomes?

Objective: to evaluate the impact of specific residual changes at the lung resection margin on the early postoperative course and treatment outcomes in patients surgically treated for pulmonary tuberculoma.

Materials and Methods. This study included 275 patients who underwent surgical treatment for pulmonary tuberculoma at the Ural Institute of Phthisiopulmonology (URIP) clinic between 2017 and 2019. Patients were stratified into two groups according to the presence (Group I) or absence (Group II) of specific changes at the resection margin. Long-term treatment outcomes were evaluated 3 years after surgery.

Results. Residual findings at the resection margin were identified in 84 of 275 patients (30.5%). Long-term treatment outcomes were available for 247 (89.8%) of 275 patients, all of whom completed postoperative courses of anti-tuberculosis treatment. No exacerbation of tuberculosis (TB) process was observed during the early postoperative period. Within the 3-year follow-up, pulmonary TB relapse occurred in 8 of 80 patients in Group I (10.0%; 95% CI 4.42–18.76) and in 16 of 167 patients in Group II (9.6%; 95% CI 5.58–15.09); the differences were not statistically significant (p = 1.000).

Conclusion. The presence of specific residual findings at the resection margin in patients surgically treated for pulmonary tuberculomas did not significantly affect the early postoperative course or outcomes of TB treatment during the 3-year follow-up, provided that the comprehensive anti-tuberculosis treatment was tailored to the drug-resistance profile of the pathogen.

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