Clinical Review of Thoracoplasty for Pulmonary Tuberculous Patients in Recent Years
スポンサーリンク
概要
- 論文の詳細を見る
Based cn the results of thoracoplasty conducted on 40 cases of pulmonary tuberculous patients in the authors' sanatorium during the period from 1959 to 1961, clinical analysis was made on the indication and technique of thoracoplasty with special reference to the indication and limit of pulmonary resection and chemotherapy.<BR>Most of the cases operated by thoracoplasty were in older age group, with advanced and bilateral lesions and reduced pulmonary function, and showed continuous bacilli discharge with resistance to chemotherapeutics in spite of long-term chemotherapy, and this fact suggests that thoracoplasty has been indicated for more severe cases of pulmonary tuberculosis.<BR>The reason why thoracoplasty was indicated for these cases was as follows; lesions in the other lobes of the operation side, lesions in the other side of the lung, operations conducted on the other side of the lung, pleural adhesion, reduced pulmonary function, drug resistance and poor general conditions. But, for cases with indication of thoracoplasty and pulmonary resection, the choice of the surgical procedure will depend on the opinion of each opeator or insitution.<BR>Technique of thoracoplasty used in most of these cases was selective upper thoracoplasty with extrafascial apicolysis, and care was taken in the grade of collapse to get effective collpase with minimum reduction in pulmonary function so as to avoid the post-operative marked insufficiency of pulmonary function.<BR>Cases were followed up for 1 to 4 years after operation, and 23 cases (57.5 %) were improved and discharged from the sanatorium, 11 (27.5 %) were still hospitalized and 6(15.0 %) died, among them 2were related directly to the operation. Post-operative complications were observed in 3 cases. Regarding bacteriological findings, 24 cases (60%) converted to negative. In 16 cases (43.3 %) p post-operative %VC was less than 40%.<BR>The results of thoracoplasty mentioned above were not superior to those already reported by many authors, but in evaluating the results, the fact that the material in this report consisted of more sever cases beyond the limit of chemotherapy and pulmonary resection, must be taken into consideration. As it was mentioned in this report, thoracoplasty has been, and in future, will be indicated for more and more severe cases, and in order to improve the results of thoracoplasty for such cases, the choice of technique suitable for each case should be needed.
- 一般社団法人 日本結核病学会の論文