# Surgery linked to lower relapse in tuberculous empyema in 420-patient cohort across three centers

- Published: 2026-11-13 21:38 UTC
- Section: Life & Health › Medicine
- Tags: tuberculous empyema, pleural tuberculosis, open surgery, VATS, relapse risk, pleural exudation, drug resistance, acid-fast bacilli, multicenter cohort, BMC Pulmonary Medicine
- URL: https://realtech.media/news/rt-6adbdd11821023d831e12bb4_surgery_linked_to/

**In a retrospective study of 420 patients from three centers, surgery and localized disease were linked to fewer relapses; drug resistance to prolonged disease.**

![Surgery linked to lower relapse in tuberculous empyema in 420-patient cohort across three centers](https://realtech.media/media/2026/11/ec1edf28939a0acd.jpg)
*Staff Sgt. Benjamin Stratton, Wikimedia Commons, Public domain*

A multicenter retrospective study published in BMC Pulmonary Medicine analyzed outcomes of tuberculous empyema in patients treated between 2003 and 2023 at three specialized tuberculosis centers. Of 1052 screened patients, 420 met the inclusion criteria. The authors compared treatment strategy, microbiological characteristics and disease stage in relation to relapse, residual radiological changes and the duration of pleural exudation [1].

## Design and methods

The determinants of outcomes in tuberculous empyema, according to the authors, remain poorly defined. Predictors of relapse and residual radiological alterations were identified with multivariable logistic regression. The duration of pleural exudation was analyzed with a generalized linear model with a gamma distribution and a log link function. Because disease stage and treatment were collinear, separate models were built for each [1].

## Surgery, stage and bacterial burden

Localized empyema was associated with less residual disease (OR 0.30, p < 0.001) and fewer relapses (OR 0.50, p = 0.001) [1].

Open surgery was associated with lower odds of residual radiological alterations (OR 0.14, p = 0.002) and of relapse (OR 0.07, p < 0.001). It was also associated with a shorter expected duration of pleural exudation (exp(B) 0.162) [1].

Video-assisted thoracoscopic surgery (VATS) was associated with lower odds of relapse (OR 0.09, p < 0.001) and a shorter expected duration of pleural exudation (exp(B) 0.186). Unlike open surgery, VATS was not associated with residual radiological alterations [1].

Positivity for acid-fast bacilli (AFB) and drug resistance were associated with persistent and prolonged disease. The authors conclude that outcomes were primarily associated with microbiological burden and treatment strategy. They state that early identification of high-risk patients and timely surgical management may be important for optimizing outcomes [1].

The study is observational and retrospective, so the reported links describe associations in the cohort rather than the effect of an intervention.

## Sources

1. [BMC Pulmonary Medicine](https://doi.org/10.1186/s12890-026-04876-x)
2. [bioengineer.org](https://bioengineer.org/surgery-and-lower-bacterial-burden-link-to-better-outcomes-in-tuberculous-empyema)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-6adbdd11821023d831e12bb4_surgery_linked_to/