A total of 217 cases were operated upon for pulmonary tuberculosis ; among these,
152 were operation in the 4 year period between 1956 to 1959. There were 1234
resection and 83 thoracoplastices, the ratio being 1.6 : 1. The over-all operative mortally
of 217 cases was 1.8% ; the operative mortality for resection being 2.2% and for
thoracoplasty 1.2%. Major complications arose in 14 or 10.4% of the entire resected
cases and, among theses, empyema with or without bronchopleural fistula was the most
prominent feature(6%). However, all of those responded favorably to intercostal drainage
alone or in combination with a small-scale thoracoplasty.
82 patients were followed from 6 months to 4 years after surgery. Among these, 68
reached an inactive stage, 13 remained active and 1 died 9 months following surgery
form renal failure and uremia. following factor, among other seem to influence the
outcome of operation in a significant way.
1. Patients in the age group of 21 to 30 appeared to do pooly(79.0% inactive state) as
compared to either younger or older patients.
2. The severity of the disease had a definite bearing on the out-come of the operation
In far advanced cases, the patients who reached inactive stage was only 80.8% as
compared to 85.7% in moderately advanced and 100% in minimal cases.
3. Cases who showed positive sputum preoperatively showed poorer result(83.8%
inactive state) than sputum negative cases(90.0% inactive state)
4. There was essentially no difference between resection and thoracoplasty as far as
the results are concerned.. Following resection, 82.6% reached inactive state as compared
to 83.4% in thoracoplasty. Also the patients remaining active were 15.4% in the resected
cases and 16.6% in thoracoplasty patients.
5. Patients who under-went surgery during the first 2 years of disease did pooly as
compared to those who had surgery after 2 or more years of disease. This seem to
indicate that the latter group obtained better result because of their natural resistance
against tuberculosis
Majority of these patients were operated on under no sanatorium care, after prolonged
irregular anti-tuberculosis therapy and in highly advanced state. Even under this
unfavorable conditions, the results appear to be acceptable.
In this series, the outcome following pulmonary resection, particularly in view of the
fact that thoracoplasty cases were much more advanced than the cases selected for
resection. It is suggested that resectional therapy be retained as the procedure of choice
in selected cases and that thoracoplasty be reserved as a procedure which can be highly
effective in cases whose disease condition is less amenable for resection.
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