Surgery
The Role of Surgery in the Management of NTM
Surgery is a form of treatment that works in conjunction with antibiotics for some patients with NTM infections. Surgery never replaces the need for antibiotics but may eliminate the need for some antibiotics and shortens the length of time others are used. Surgery is recommended for patients with localized NTM disease such as those with middle lobe or lingula disease. Patients with large or thick-walled lung cavities, and patients with destroyed portions of the lung are candidates for surgery. The remainder of the lung should be relatively free of disease and calculated pulmonary function after surgery should be in the range of acceptable to relatively normal or reasonable.
Our recent experience includes 274 surgical resections in 241 patients. These surgeries were reported at the 2007 Society of Thoracic Surgeons Annual Meeting, identifying NTM as EM (environmental mycobacterial) infection.
There has been no mortality in the last 140 patients. Up to 75% of the operations are now done through the “scope.” Using the scope usually shortens a patient’s hospital stay and decreases postoperative discomfort. Pre- and postoperative antibiotics and other forms of therapy are closely coordinated with referring centers and physicians.
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