Surgical Treatment of Pulmonary Tuberculosis

Chemotherapy followed by resection of significant residual tuberculous disease has largely supplanted the prolonged bed rest and collapsed therapy program of a few years ago. The risk of resection (0.3 per cent in a total of 311 operations on 285 patients from 1954 to 1955) now is as low or lower than that by collapse therapy. Total mortality (60 days) for 817 operations at Glen Lake Sanatorium from 1928 through 1955 was 1.95 per cent. In special groups: (1) 25 resections in children under 14, no mortality; (2) In diabetics—3 pneumonectomies, 16 lobectomies, and 31 partial lobectomies on 40 patients, one death—mortality 2 per cent; (3) In Indians—175 operations on 164 patients—22 pneumonectomies, 52 lobectomies, 102 partial lobectomies, mortality rate 1.71 per cent. Complications of all types, many not serious—15.4 per cent. Relapses or recurrences following chemotherapy and resection are closely related to short term chemotherapy and presence of resistant organisms and to incomplete treatment programs.