Other Talks in the Series: Tuberculosis

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Dear colleagues, my name is Richard Zaleskis. I am a medical doctor and have a PhD in surgery. For 12 years I was Regional Advisor for TB control in the WHO regional office for Europe and I came back to my country Latvia in 2012 and continue my professional activities as an international expert on TB control, as well as a lecturer and facilitator of the WHO Collaborating Center for Research and Training in the Management of MDR-TB in Riga, Latvia. I am also the Chairman of the Latvian Society against TB. The topic of my lecture today is "The Role of Surgery in Tuberculosis Management". Although significant progress has been achieved in the treatment of drug susceptible TB cases, we have still serious challenges to successfully treat drug-resistant TB that have posed a substantial threat to global TB control. With few treatment options for such base search, we are pushed often to the pre-antibiotic era and many patients remain untreatable. With such challenges circumstances of a need of a region to treat MDR-TB and extensively drug-resistant TB in particular, the role of surgery is being reoriented as one of the main treatment options for TB and drug-resistant TB.
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The effectiveness of surgery in the management of pulmonary TB and drug-resistant TB has not yet been duly documented and evaluated. Its role is not well established and practices vary across the WHO European region. That's why in 2012, the WHO regional office for Europe established a special task force on the role of surgery in drug-resistant TB to review the current evidence-based papers and to provide an expert opinion on surgical treatment of pulmonary TB and multidrug-resistant TB, as well as extensively drug-resistant TB. I have the great pleasure and honor to coordinate this taskforce and participants of this taskforce for surgery from the East and from the West and from the former Soviet Union. That's why it's not so easy at the beginning to achieve some consensus on the different topics, of different issues on indications and contraindications for TB surgery. But finally, we achieved a very good consensus and developed a special Consensus paper.
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The role of surgery in tuberculosis management

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