In an editorial in the same issue about the study, author David E. Griffith, M.D., of the University of Texas Health Center, Tyler, Texas, said that there had been an important shift in TB epidemiology in the U.S., with 50 percent of the new cases and approximately 69 percent of the multidrug-resistant TB cases diagnosed in persons born outside the U.S. They had acquired their disease before they entered the country. He called a contribution by surgery to the treatment of multidrug resistant TB "not unexpected,' but, as the most important factor in treatment related to favorable outcome was "surprising." He pointed out that the surgeons at the National Jewish Medical and Research Center were unquestionably the most experienced mycobacterial lung disease surgeons in the U.S. Since widely accepted preoperative criteria are not available to choose the best patients to benefit from surgery, these surgeons had the experience to assess very carefully the risk/benefit balance for these individual patients. The experience factor becomes doubly important when persons realize that mycobacterial lung disease surgery "can be associated with significant and unpredictable surgical complications."
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Journal
American Journal of Respiratory and Critical Care Medicine