Lobectomy and Pneumonectomy in Pulmonary Tuberculosis

¹ The Department of Surgery, University of Tennessee, College of Medicine.
² Chief of Surgical Service, Kentucky State Sanatorium; Chief, Thoracic Surgery, University of Louisville Medical School and Louisville General Hospital.

Pulmonary resection in the treatment of tuberculosis is a valuable addition to the armamentarium of the phthisiotherapist. It offers an opportunity to salvage a number of patients whose outlook for continuation of life or complete arrest of the disease would otherwise be exceedingly poor. The immediate mortality rate of the operation itself is gratifyingly low. However, the operation has been in general use too short a period of time to evaluate accurately the late and permanent results. The reappearance of activity in lesions previously quiescent is a disturbing observation, especially since the exacerbation can occur long after the patient is thought to be "well". This would indicate that all results published at the present time must be accepted with well modulated enthusiasm. Until the problem of overdistention of the remaining lung tissue, bronchogenic spread of the disease and tuberculous empyema can be regularly and uniformly overcome, a pulmonary resection must be reserved for those patients in whom collapse therapy will obviously prove ineffective. At present it cannot compete with thoracoplasty for safety and lasting beneficial results.