From Our 2007 Archives

TB Lung Surgery for Andrew Speaker

Speaker's Tuberculosis Lung Surgery to Remove Tuberculosis Bacteria and Damaged Lung Tissue

By Miranda Hitti
WebMD Health News

Reviewed By Brunilda Nazario, MD

July 17, 2007 -- Tuberculosis patient Andrew Speaker will undergo lung surgery this morning in Colorado to remove diseased and damaged tissue in his lung.

The goal is to remove as much of the tuberculosis bacteria as possible from Speaker's lungs, as well as any lung tissue damaged by tuberculosis.

Speaker's lung surgery is intended to complement -- not replace -- his antibiotic treatment for multidrug-resistant tuberculosis.

The TB lung surgery will be performed at the University of Colorado Hospital at the Anschutz Medical Campus in Aurora, Colo., by John D. Mitchell, MD, chief of general thoracic surgery at the University of Colorado Hospital.

The operation is expected to take about two hours. Speaker will likely stay in the University of Colorado Hospital for three to six days before returning to National Jewish Medical and Research Center, where he is being treated for multidrug-resistant tuberculosis.

Speaker's Tuberculosis

Speaker, an Atlanta lawyer, was recently in the headlines when the CDC ordered him into medical isolation after he and his bride took two transatlantic flights.

At the time, Speaker was believed to have extensively drug-resistant tuberculosis (XDR TB). But on July 3, Speaker's tuberculosis diagnosis was changed to multidrug-resistant tuberculosis (MDR TB).

Multidrug-resistant tuberculosis doesn't respond to the first preferred treatments. But it's more responsive to tuberculosis drugs than extensively drug-resistant tuberculosis.

When doctors announced that Speaker had MDR TB instead of XDR TB, they said Speaker might not need lung surgery as part of his tuberculosis treatment, but no firm decision had been made about that while doctors monitored Speaker's tuberculosis antibiotic treatment.

Speaker's TB Lung Surgery

After consulting with his doctors, Speaker decided yesterday to undergo lung surgery today, according to the National Jewish Medical and Research Center.

Speaker's tuberculosis lung surgery is a complement to the antibiotic therapy he is currently undergoing, and improves his chances of a complete and long-term cure from the disease, states the National Jewish Medical and Research Center

Mitchell plans to use a minimally invasive surgical approach called video-assisted thoracic surgery (VATS), according to an earlier news release from the National Jewish Medical and Research Center.

In VATS, surgeons access the lung through a 2-inch incision in the patient's side, as well as two incisions (each 1 centimeter long) for surgical instruments and a tiny, fiber-optic camera.

If Mitchell finds that the VATS technique isn't feasible or doesn't provide adequate access to the infected portion of the lung, he will enlarge one of the incisions, spread Speaker's ribs, and perform a more standard surgery that would require a longer recovery time, notes the National Jewish Medical and Research Center news release.

The infected part of Speaker's lung has been described as roughly the size of a tennis ball, notes the National Jewish Medical and Research Center.

"This type of surgery requires that we take special care to contain any infected tissue I remove, and that we identify and completely resect (remove) any spread of the infection to the chest wall," Mitchell states in the National Jewish Medical and Research Center news release.

"Given the localized nature of the disease, I am optimistic about the chances for a successful surgery," Mitchell adds.

SOURCES: WebMD Health News: "Andrew Speaker's TB Reclassified." News releases, National Jewish Medical and Research Center.

© 2007 WebMD Inc. All rights reserved.





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