Tohoku J. Exp. Med., 2016 December, 240(4)

Treatment Outcomes of Patients Treated for Pulmonary Tuberculosis after Undergoing Gastrectomy

IN YOUNG JUNG,¹ MOO HYUN KIM,² WOO YONG JEONG,² MI YOUNG AHN,² YONG DUK JEON,² HEA WON AHN,² JIN YOUNG AHN,² JE EUN SONG,² DONG HYUN OH,² YONG CHAN KIM,² EUN JIN KIM,² SU JIN JEONG,² NAM SU KU,² JUNE MYUNG KIM² and JUN YONG CHOI¹

¹Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
²AIDS Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

Gastrectomy is a proxy of malnutrition, which may lead to increased risk for developing pulmonary tuberculosis (TB). Malabsorption in gastrectomy patients could lead to low serum levels of rifampicin, which may be related to higher treatment failure. However, there is limited information on treatment outcomes of TB in patients who have undergone gastrectomy. This study aims to determine treatment outcomes and adverse effects in patients treated for TB after undergoing gastrectomy for gastric cancer. During the study period, 112 patients were treated for active TB that developed after gastrectomy for gastric cancer. Among them, we selected 15 patients who were culture positive at initial diagnosis and had evidence of active TB on imaging studies; namely, the remaining 97 patients without initial culture or imaging studies were excluded. We thus performed a case-control study of gastric cancer patients treated for TB after undergoing gastrectomy (n = 15). The control group was defined as age- and sex-matched TB patients who had not received gastrectomy (n = 45). Treatment failure in clinical, microbiological aspects, and adverse events were analyzed. Patients who had undergone gastrectomy exhibited higher 4-month clinical failure rates, compared to non-gastrectomy patient: 4 (26.7%) vs. 1 (2.2%), P = 0.012. Gastrointestinal adverse effects were more frequent in patients with gastrectomy, compared to non-gastrectomy patients: 9 (60%) vs. 5 (11.1%), P < 0.001. In conclusion, patients treated for TB after undergoing gastrectomy are associated with higher rates of gastrointestinal adverse events and treatment failure.

keywords —— gastrectomy; gastric cancer; gastrointestinal adverse events; pulmonary tuberculosis; treatment failure

© 2016 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2016, 240, 281-286

Correspondence: Jun Yong Choi, M.D., Ph.D., Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu Seoul 120-752, Republic of Korea.

e-mail: seran@yuhs.ac