Long-term effectiveness of surgery treatment of TB patients

<b>Introduction:</b> Traditional methods of tuberculosis (TB) treatment outcomes assessment, based on laboratory results at the end of the therapy, does not permit distinguish advantage of surgery TB treatment. Long-term effectiveness such as TB relapses (RL), conversion to chronic cases (CHR), death from TB, HIV or concomitant diseases (CD), can be used as more vivid indicators of surgery effectiveness. <b>Methods:</b> Data of 2 cohorts of new and re-treatment TB cases from Moscow residents, who had treatment in 2010-2012 (A) and 2013-2016 (B), were analyzed. Each cohort, containing 10143 and 9807 respiratory TB patients, included 2 subgroups: 1) having and 2) not having surgery treatment for RTB (SG and NS, accordingly). Long-term indicators included share of RL, CHR, deaths from TB, HIV or CD, which were happened until 01/01/2016 and 01/01/2020 for A and B cohort respectively. Expansion of indications for surgical treatment in the B period compared with A has led to an increase in the number of surgery treated TB patients from 343 to 624. <b>Results:</b> Patients from A cohorts in SG and NS groups, respectively, accounted for: 2.3% and 1.7% RL (p &gt; 0.05), 5.5% and 9.4% CHR (p &lt; 0.05), 8.5% and 21.6% deaths (p &lt; 0.01), including 1.7% and 5.4% death from TB (p &lt; 0.01), 2.6% and 10.5% death from HIV and CD (p &lt; 0.01). Patients from B cohorts in SG and NS groups, respectively, accounted for: 2.1% and 7.4% RL (p &lt; 0.01), 3.5% and 9.4% CHR (p &lt; 0.01), 5.6% and 23.0% deaths (p &lt; 0.01), including 1.1% and 5.6% death from TB (p &lt; 0.01), 1.6% and 11.3% death from HIV and CD (p &lt; 0.01). <b>Conclusion:</b> Surgery treatment, evaluated by long-term indicators, demonstrates a high effectiveness both in general and after significant expansion of indications for surgery.