Multidrug-resistant pulmonary tuberculosis

The advent of effective antituberculous medication has greatly diminished the role of surgery in the management of tuberculosis (TB). More recently, diseases that are resistant to medical treatment have emerged as a major challenge. Multidrug-resistant tuberculosis (MDRTB) is defined as resistance to two or more drugs, including rifampin and isoniazid. In such cases, high relapse rates with medical therapy alone have been reported and adjuvant surgical resection has been proposed as a therapeutic option in selected patients. Although many studies have shown good results with this surgical strategy, the role of minimally invasive surgery in this scenario has yet to be established. Here we review the indications of surgical resection for MDRTB and the role of minimally invasive surgery for infectious / inflammatory diseases of the lungs.