The Cavernostomy for Severe Pulmonary Tuberculosis
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概要
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An original classification of the severe pulmonary tuberculosis was attempted from the surgical point of view, especially in aspects of the pulmonary function and the findings of the chest films. According to this classification we discussed the indication of operations for each groups and the results of operations as well.Type I: The cases in which the lesions indicating pneumonectomy are found in the entire lung field of one side and some lesions in the opposite lung. In this type, pneumonectomy or thoracoplasty showed better results than cavernostomy, so that pneumonectomy was thought of the first choice, In cases showing cavity formations in the opposite lung or high resistance to antituberculous drugs, however, thoracoplasty was thought to be preferably performed, because there was a high incidence of complications after pneumonectomy.Type II: The cases in which the lesions indicating the upper lobectomy are found in both upper lung fields.In this type, both of lobectomy and thoracoplasty showed poor results, especially the fomer showed a high incidence of severe postoperative complications. On the contrary, the results of cavernostomy were much more excellent and, if any, the postoperative complications were easily treated.Type III: The cases in which the lesions indicating some surgical treatment are found in both lungs but the pre-operative % V. C. is below 60%.In this type, the results obtained were almost the same as in type 2. Lobectomy and thora coplasty were unsuccessful in many cases, with a high incidence of severe complications, while most of cavernostomied patients had good results and were rehabilitated to works.Type IV: The cases in which the pre-operative % V. C. is below 40%.In this type, no method of operations was of good result. Complications were frequent and severe.From these results, for severe pulmonary tuberculosis cavernostomy is believed to be one of the most favorable operations because of the slight loss in the pulmonary function and the low incidence of the postoperative complications.Especially in types 2 and 3, in which effect of the other kinds of operation are discouraging, cavernostomy proves to be powerful and appears to be properly indicated.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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