外科的難治肺結核の外科療法

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In spite of the recent improvement in chemotherapy for pulmonary tuberculosis, there still remains the problem of hardly curable cases with decreased pulmonary function and pre-operative positive bacilli. As the surgical treatment is the only way for obtaining clinical healing in these cases, a trial was made to improve of the results of surgical treatment for such cases.<BR>Histological studies were performed on 228 resected lung specimens with tuberculous l e sions with special reference to tuberculous findings at the bronchial stump, and the results were analysed in relation to preoperative bacilli discharge in sputum and postoperative complications.<BR>The grade of tuberculous inflammation at the bronchial stump correlated with the amount and duration of pre-operative bacilli discharge in sputum, but not with the drug resistance. The incidence of postoperative complications, usually bronchial fistula, was higher among cases with positive bacilli within three months prior to surgery (Table 1). Accordingly, particular efforts must be made to minimize bacilli discharge before surgery, and the operation must be indicated in time before tubercle bacilli become resistant to drugs. The pulmonary resection is recommended as a first choise, if possible.
一般社団法人日本結核病学会の論文