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Ann Thorac Surg 1998;66:183-186
© 1998 The Society of Thoracic Surgeons

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Original articles: general thoracic

Early pulmonary resection for localized mycobacterium avium complex disease

^a Department of Thoracic Surgery, National Tokyo Hospital, Kiyose, Tokyo, Japan
^b Department of Pulmonary Medicine, National Tokyo Hospital, Kiyose, Tokyo, Japan

Address reprint requests to Dr Shiraishi, Department of Thoracic Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, Tokyo, 204-0022, Japan

Presented at the Thirty-fourth Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 26–28, 1998.

Background. Results of antituberculous chemotherapy for Mycobacterium avium complex disease remain disappointing. Pulmonary resection during an early stage of the disease, therefore, may be beneficial to patients whose disease is localized and who can tolerate a resectional operation.

Methods. Thirty-three patients with localized M avium complex disease underwent 33 pulmonary resections between 1979 and 1996. There were 17 males and 16 females, with a mean age of 50 years (range, 30 to 69 years). Lobectomy was performed in 26 patients, pleuropneumonectomy in 1, segmentectomy in 5, and wedge resection in 1.

Results. There was no operative mortality. After pulmonary resection, 31 (94%) patients attained sputum-negative status. Bronchopleural fistula occurred in one patient who underwent a right upper lobectomy. There were two late deaths. A patient with bronchopleural fistula died of respiratory failure two years postoperatively. Another patient died of an unknown cause 12 years postoperatively. Of the 31 patients with negative sputum status postoperatively, only 2 patients (6%) had relapse at 1 and 9 years after operation.

Conclusions. We recommend that patients with this disease be considered for pulmonary resection as early as possible.

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