Summary
1. To date the results have been gratifying. There were ninety-one(91) operative
cases. Seventy-four(74) patients of 81.5% are well. Eleven or 13.0% of the surviving
cases developed complications. (four bronchopleural fistula, five spreads, and two
empyema). The incidence of negative sputum is 78% or seventy-two(72) cases. Six
patients died, a mortality rate or 6.5%. Three were direct operative deaths and three
died of post operative complications.
2. The following conclusions are mode based on studies of the resected specimens.
a. Cavity lesions, especially cirrhotic cavities, could not be expected to be completely
cured by chemotherapy is a absolutely indicated in these lesions.
b. The ideal preoperative medication for resection should be standard therapy of six to
twelve months duration. Resistance of bacilli is recognized in 90% of the specimens
which have received long term chemotherapy, over 24 months.
c. In twelve cases, 13%, no pleural adhesions were found, twelve others, 13%, had
areolar adhesions, and in sixty-six(66) cases, or 74%, fibrocirrhotic adhesions were
found. This indicate the difficulty in securing complete artificial pneumothorax as
collopse therapy.
d. Swelling of hilar lymph nodes was recognized in twenty-two(22) or 24% of the
cases, especially in early infiltration and in far advanced cases accompanied with mixed
infection.
e. Tuberculous bronchitis was revealed in 84% of the cases of draining bronchi. This
condition is directly related to complications and positive sputum postoperatively.
Whether chemotherapy was given or not. 90% of the specimens were positive for
tubercle vacilli. On the other hand eight cases were positive by smear and negative by
culture.
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