Tuberc Respir Dis > Volume 38(3); 1991 > Article
Tuberculosis and Respiratory Diseases 1991;38(3):245-249.
DOI: https://doi.org/10.4046/trd.1991.38.3.245    Published online September 1, 1991.
A clinical review of the surgical treatment for pulmonary tuberculo- sis.
Cheol Shick Shin, Hyo Kyu Jo, Dong Cheol Jang, Young Jun Kim, Seok Shin Koh, Sun Dae Song
Department of Internal Medicine, National Kongju, Tuberculosis Hosþital, Kongju, Korea
Abstract
Surgical intervention for pulmonary tuberculosis has been controverted for last several decades. Although it is widely held that the chemotherapy is the best modality for treatment of pulmonary tuberculosis, surgical intervention has sti11 some roles in well elected circumstances. At the National Kongju Tuberculosis Hospital in Korea , we performed a retrospective case Cohort study through the regular follow-up of 463 cases, who underwent the surgical intervention for pulmonary tuberculosis between January 1986 and April 1990. The results were as follows 1) The male to female ratio was 1. 8:1 and 84.4% of the patients were between 20 and 49 years of age. 2) According to the NAT c1assification, 6cases (1. 3%) were minimal, 216 (46 .7%) moderately advanced and 241 (52%) far advanced. 3) One hundred and thirty four cases (28.9%) had the treatment history of 5 to 10 years and 129 cases (27 .9%) of 3 to 4 years 4) As for the pathologic entities, 172 cases (37.1%) had the totally destroyed lung and 137 (29.6%) destroyed lobe or segment 5) A total of 238 cases (51. 4%) underwent pneumonectomy and 153 (33 .0%) lobectomy. 6) As the post-operative complications, 21 cases (4 .5%) had empyema and 11 (2 . 4%) bleeding. The rate of complication after pneumonectomy and lobectomy was 5.8% and 3.2%, respectively. 7) Six cases (1. 3%) died post-operatively. 8) Out of 238 cases with pre-operative positivity for AFB, 212 achieved the negative conversion, its rate being 89 . 1% . It follows from these results that although it has a limit, surgical intervention may play an important role in treating some patients with pulmonary tuberculosis.


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