Results of Lung Resection in Tuberculosis Four to Seven Years after Operation

With a Discussion of Present Indications for Operation

¹ Göteborg, Sweden
² Surgical and Medical Thoracic Units, Renströmska Sjukhuset

1. The results of lung resection on 403 patients, operated upon during the period 1954-1957, were examined four to seven years after operation.

2. The postoperative mortality was 1.5 per cent for all cases, the deaths being limited to pneumonectomies and lebectomies combined with segmental resections, where the mortality was 5 per cent. In lobectomies and segmental resections there was no mortality.

3. The postoperative mortality was mainly related to bacillary resistance to one or more of the standard drugs.

4. After the postoperative period, one patient died from pulmonary tuberculosis, two from respiratory insufficiency, and ten from unrelated causes, late tuberculosis mortality being 0.25 per cent.

5. The disease of two patients was not arrested by operation and they are still positive.

6. Relapse (radiologic and/or bacteriologic) occurred in 20 cases, mainly related to bacillary resistance at the time of operation or later developing resistance, or to other defects in the chemotherapy.

7. Of the 378 surviving and traced cases, 356 healed directly after operation and postoperative chemotherapy (93.3 per cent). Further, 19 of the 20 relapse cases were later brought under control. Thus altogether 99.2 per cent became healed or were under control.

8. Working capacity was full or partial in 370 of the 378 cases (97.9 per cent).

9. The present indications for surgery are discussed and it is felt that due to the good results of long-term chemotherapy, the operative treatment has mainly to be reserved for cases with: (a) bacillary resistance to the standard drugs, particularly isoniazid, and (b) patient's drug-intolerance and/or lack of cooperation.