• Katsuo Yamada, Yukio Seki, Taku Nakagawa, Yuta Hayashi, Mitsuaki Yagi, Masahiro Sano, and Kenji Ogawa.
• Department of Thoracic Surgery, National Hospital Organization Higashinagoya National Hospital, Nagoya, Japan. Electronic address: k123yamada@gmail.com.
• Ann. Thorac. Surg. 2021 Jan 1; 111 (1): 253-260.

BackgroundNontuberculous mycobacterial lung disease often spreads to multiple lobes, and extensive lung resection (ELR) is sometimes required to control the disease. The safety and feasibility of ELR for nontuberculous mycobacterial lung disease remain unclear, however.MethodsThis retrospective study included patients with nontuberculous mycobacterial lung disease who underwent adjuvant lung resection. Characteristics were compared between patients who underwent ELR and those who underwent simple anatomic lung resection (SALR). The outcome data were analyzed by a Cox regression analysis.ResultsA total of 146 patients underwent ELR (n = 54) or SALR (n = 92). ELR was associated with a longer operative time (306 vs 237 minutes; P < .001) and higher incidence of prolonged air leak (17% vs 3.3%; P = .016) than SALR. Rates of mortality, sputum culture conversion (positive to negative), and microbiological recurrence did not differ markedly between the groups. In the multivariate analysis, ELR was not a significant risk factor for an unfavorable outcome after nontuberculous mycobacterial lung disease surgery (hazard ratio, 2.23; 95% confidence interval, 0.82-6.03; P= .11).ConclusionsELR for nontuberculous mycobacterial lung disease has some drawbacks compared with SALR but seems as safe and feasible as SALR. ELR may provide improved disease control in some cases of nontuberculous mycobacterial lung disease with multilobar lesions.Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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