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Am. J. Respir. Crit. Care Med., Volume 157, Number 5, May 1998, 1609-1615

Preliminary Results of Collapse Therapy with Plombage for Pulmonary Disease Caused by Multidrug-resistant Mycobacteria

STÉPHANE JOUVESHOMME, BERTRAND DAUTZENBERG, HAYSSAM BAKDACH, and JEAN-PHILIPPE DERENNE

Service de Pneumologie et de Réanimation Respiratoire, Hôpital Pitié-Salpétrière, Paris, and Centre Médico Chirurgical du Val d'Or, St. Cloud, France

Seven patients underwent collapse therapy with polystyrene sphere plombage for pulmonary disease caused by multidrug-resistant mycobacteria. Four patients were infected with multidrug-resistant strains of Mycobacterium tuberculosis, two with Mycobacterium xenopi, one with Mycobacterium avium. All patients were heavily pretreated before surgery, had extensive, bilateral cavitary disease and were considered unsuitable for resection because of extensive disease or functional respiratory impairment. Six patients had active disease at time of surgery. Collapse therapy with insertion of six to 18 spheres resulted in long-standing bacteriological conversion in six patients. Collapse therapy was unilateral in six and bilateral in one. No immediate postoperative complication or death was observed. Hospital stay was short (mean 12 d). Collapse therapy is a conservative alternative therapy in patients with pulmonary disease caused by multidrug-resistant mycobacteria at high risk of treatment failure considered unsuitable for pulmonary resection.




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