慢性膿胸の治療としての胸膜肺全摘術
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概要
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In order to treat chronic thoracic empyema, pleropneumonectomy is one of the best methods of radical operation. In our institute 35 cases (23%) out of 110 were operated in the recent ten years by this procedure. This procedure is the most risky operation due to possible huge amount of bleeding during operation and possible post-operative impairment of pulmonary function.<BR>The cure rate of this operation is 89% (68% by a single-step operation and 20% by multi -steps operation). The failure cases (11%) consist of four operational deaths and one case with external fistula. The post-operative change of pulmonary function (%VC, FEV<SUB>1.0</SUB>/pr. VC%) were 20%-30% reduction of pre-operative values at 6month after operation; no more remarkable changes were seen during long-term observation, and %FEV<SUB>1.0</SUB>showed no change or slightly upward trend. The reason of no more reduction of pulmonary function during the long-term observation is that almost all cases survive under nearly lowest limit of pulmonary function for survival and below this level they could not survive. Comparing cases with and without thoracoplasty, there was no distinct difference in post-operative pulmonary function.<BR>Nevertheless, those with thoracoplasty could not survive longer than those without it. In conclusion, <BR>1) Pleuropneumonectomy is one of the radical but risky operation of treatment of chronic thoracic empyema with low pulmonary function.<BR>2) The cure rate was 89%.<BR>3) Cases without thoracoplasty could survive longer than those with it.
- 一般社団法人 日本結核病学会の論文
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