Changing Role of Surgery in the Treatment of Pulmonary Tuberculosis in Children

¹ Thoracic-Cardiovascular Surgery Service, Brooke General Hospital, Fort Sam Houston, Texas and the Thoracic Surgery Service, San Antonio State Chest Hospital, San Antonio

This report of 47 children operated upon for pulmonary tuberculosis at the San Antonio State Tuberculosis Hospital reveals a considerable reduction in the indications for surgical resection during the past 12 years in spite of a relatively constant admission rate. Currently only 2.5 percent of children hospitalized with this disease come to surgery, and represent those few patients who remain positive or retain significant residuals (destroyed lobes, lobar segmental atelectasis or saccular bronchiectasis, thick-walled cavities, or large residual nodules) after 18 months of intensive drug therapy. The low risk of surgery in these patients and the high incidence of viable organisms found in the surgical specimens justify resection of those lesions because of their significant potential for breakdown in later years.