Bilateral Resection Therapy in Pulmonary Tuberculosis

¹ The "Beatrix Oord Sanatorium."

Bilateral resection therapy has yielded surprisingly good results in the first six patients. These were all young people who, even though their tuberculosis was only slightly active, were socially incapacitated owing to their expectoration of weekly positive sputum.

It is of course impossible to say with absolute certainty that they are permanently cured, but this is true for every recovered tuberculous patient.

The most important tuberculous foci have been removed, and it is to be expected that, with prolonged aftertreatment and a sensible way of living, they have a reasonable chance of gaining the fight against the bacillus with their own defensive powers.

It was of course of great importance that the resection was always as selective as possible, and that, apart from the last case, it was always possible to carry out segmental resection.

In our opinion this explains why the loss of function has remained so slight. The total loss of vital capacity and of M.R.M.V. after successful lobectomy is sometimes not much greater than after segmental resection, because it is possible that after the latter operation the spared parts of the lobe participate little in the ventilation and gas exchange (Hirdes). We are of the opinion, however, that when the expansion of the lung is good, these parts are still of significance and that the loss of oxygen uptake of the operated lung can be small (Kraan and Van Der Drift).

The determinations in our patients Nos. 3, 4 and 5 show how slight the loss can be after uncomplicated bilateral resections (Table XIII).[SEE TABLE XIII IN SOURCE PDF]

We therefore believe that in patients with a localized bilateral affection resection therapy constitutes the only possibility of obtaining clinical cure with complete restoration of fitness for work.