Rediscovering high technology from the past: Thoracic surgery is back on track for multidrug-resistant tuberculosis

Evaluation of: Man MA, Nicolau D. Surgical treatment to increase the success rate of multidrug-resistant tuberculosis. Eur. J. Cardiothorac. Surg. 42, e9-e12 (2012). The global emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB represents a core challenge for global tuberculosis control. MDR-TB and extensively drug-resistant TB are more difficult to treat and have a worse outcome compared with drug-susceptible disease. Surgery has proved to improve treatment success in MDR-TB patients. This study was designed to assess the impact of surgery in a cohort of MDR-TB patients. The authors evaluate one of the largest cohorts treated by a single center, demonstrating that specialized thoracic surgery centers may achieve excellent results with a low rate of complications after surgery, and proposing an effective model of teamwork based on pulmonologists and surgeons. A review of the evidence supporting the role of surgery in addition to chemotherapy to improve treatment outcomes in difficult-to-treat cases of TB is also performed. © 2012 Expert Reviews Ltd.