Indication, type and complications of surgery performed for pulmonary NTM disease
| First author [ref.] | Patients n | Surgical indications | Type of surgery | Hospital stay | Complications |
| Studies without clarithromycin | |||||
| Elkadi [23] | 48 | Medical treatment failure | Lobectomy 67% Segmentectomy 21% Pneumonectomy 6% Wedge resection 4% Extrapleural plombage 2% | 2.4–4 months# | Total=13% Bronchopleural fistula 4% Wound dehiscence 4% Infection 2% Haemorrhage 2% |
| Pomerantz [36] | 38 | Localised disease with complications | Lobectomy 59% Pneumonectomy 41% Both (7%) | Not reported | Total=50% Bronchopleural fistula 21%¶ Prolonged air leak 11% Respiratory failure 5% Wound dehiscence 3% Pericardial effusion 3% Horner's syndrome 3% |
| Ono [35] | 8 | Medical treatment failure Persistent symptoms | Lobectomy 75% +partial resection 25% | Not reported | None reported |
| Nelson [38] | 28 | Medical treatment failure Significantly destroyed lung Severe haemoptysis | Partial resection 71% Pneumonectomy 29% | Not reported | Total=32% Bronchopleural fistula 4% Prolonged air leak 14% Atelectasis requiring bronchoscopy 4% Severe post-thoracotomy pain 4% Death due to post-operative MI 4% |
| Shiraishi [34] | 33 | Symptomatic localised disease | Lobectomy 79% Segmentectomy 15% Pneumonectomy 3% Wedge resection 3% | Not reported | Total=18% Bronchopleural fistula 3% Residual pleural space 15% |
| Studies incorporating clarithromycin | |||||
| Shiraishi [28] | 21 | Medical treatment failure or drug intolerance | Lobectomy 76% Two lobes 5% Pneumonectomy 14% (90% right sided) | Not reported | Total=29% Bronchopleural fistula 10% Prolonged air leak 4% Residual pleural space 10% Pneumonia 4% |
| Shiraishi [29] | 11 | Multiple cavities or total lung destruction | Pneumonectomy 100% | Not reported | Total=45% Bronchopleural fistula 27% Empyema 9% ARDS 9% |
| Watanabe [39] | 22 | Medical treatment failure Persistent symptoms | Lobectomy 64% + Two lobes 5%+ Partial lung resection 27%+ Segmentectomy 18%+ Wedge resection 27%+ Multiple resections 45% | Not reported | Total=9% Residual pleural space 5% Home oxygen for 2 months 5% |
| Mitchell [43] | 236 | Medical treatment failure Focal persistent lung damage | Lobectomy 48% Segmentectomy 21% Pneumonectomy 17% Mixed procedures 15% | Not reported | Total=19% Bronchopleural fistula 4% Prolonged air leak 4% Respiratory failure/pneumonia 3% Post-operative bleeding 2% Wound dehiscence 1% ARDS 1% Atrial fibrillation 4% |
| Koh [40] | 23 | Medical treatment failure 48% Remaining cavity relapse risk 35% Persistent symptoms 17% | Lobectomy 70% Two lobes 9% Two sides 13% Segmentectomy 13% Pneumonectomy 17% | 9 days (IQR 6–15 days) | Total=35% Bronchopleural fistula 9% Prolonged air leak 9% Pneumonia 13% Wound dehiscence 4% Pneumonectomy syndrome 4% |
| van Ingen [19] | 8 | Treatment failure Infected destroyed lung | Lobectomy 63% Two lobes 13% Wedge resection 13% Pneumonectomy 25% | Not reported | Total=63% Pneumothorax 38% Atelectasis requiring bronchoscopy 13% Respiratory distress 13% Pneumonia 13% |
| Yu [30] | 134 | Localised disease ±cavitation Medical treatment failure Persistent symptoms | Lobectomy 100% Middle 59% Lingulectomy 41% | 3 days (1–15 days) | Total=8% Prolonged air leak 4% Wound infection 1% Atelectasis 1% Pleural effusion 1% Atrial fibrillation 1% |
| Jarand [41] | 24 | Localised bronchiectasis 86% Cavitary disease 37% Haeptysis 11% | Lobectomy 83% Pneumonectomy 21% Segmentectomy 10% Wedge resection 3% | Not reported | Total=25% Haemorrhage 4% Bronchopleural fistulae 4% Wound infection 4% Brachial plexus injury 4% Frozen shoulder 4% Respiratory failure/death 4% |
| Shiraishi [31] | 60 | Medical treatment failure 87% Persistent symptoms 10% Secondary infection 3% | Lobectomy 90% Two lobes 5% Segmentectomy 7% Pneumonectomy 2% Wedge resections 3% | Not reported | Total=12% Prolonged air leak 6% Atelectasis 3% Respiratory failure 1% Haemorrhage 1% Atrial fibrillation 1% |
| Asakura [37] | 125 | Medical treatment failure 56% Cavities; severe bronchiectasis 29% Persistent symptoms 15% | Lobectomy 88% Two lobes 10% Pneumonectomy 25% Segmentectomy 11% Wedge resection 2% | Not reported | Total=22% Bronchopulmonary fistula 6% Bronchopleural fistula 2% Prolonged air leak 1% Wound dehiscence 1% Pneumonia or empyema 7% Bronchial stenosis 1% Diaphragmatic hernia 1% Left atrial rupture 1% |
MI: myocardial infarction; ARDS: acute respiratory distress syndrome. #: patients were kept in hospital until sputum conversion; ¶: 15% of bronchopleural fistula occurred post-right pneumonectomy; +: primarily as 45% of this cohort had multiple resections.