Surgical intervention for pumlmonary 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 still some roles in well elected
circumstance.
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 classification, 6 cases (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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