The global spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of M . tuberculosis have resulted in a resurgence of almost incurable and even fatal cases for which only a few therapeutic options are available. Surgery has been applied to improve treatment success rates in MDR-TB patients and a combined medical and surgical approach is increasingly being used to treat patients with M/XDR-TB. The effectiveness of surgery in the management of pulmonary TB (particularly MDR-TB) has not, however, been documented and evaluated, its role in the  Tuberculosis Control Programme is not well- established and practices vary 

we presents indications and contraindications for surgical treatment of pulmonary TB and M/XDR-TB, the conditions for and timing of surgery, types of operation, and preoperative and postoperative managemen