The author studied the pulmonary resection for advanced pulmonary tuberculosis in 68
cases and particulary the postoperative complications during the period from April 1960
to March 1962.
In foreign countries, although they have good indication for it. ti is reported that 10%
of complication and 2% of mortality and 1/2 resemt. But in Korea, the most cases of
pulmonary tuberculosis, for pulmonary resection had a long history of disease, irregular
chemotherapy for long period and extensive lesions which were not good indication. The
high rate of complication and death are expected.
The major complications postoperatively were the bronchofistula, emphyema and
spread.
The causes of broeehofistula are those of the patholoigcal changes at the bronchial
stump, the insufficiency of expansion and the suture material of the bronchial stump.
The emphyema were caused by the direct contamination of the plural cavity drug
operation and secondary infection from the infected operative wound in the chest.
On the other hand, as the emergent complication postoperatively, there were bleeding,
oliguria, fall of blood pressure and dyspnea. In these case, the renal insufficiencies
accompanied with oliguria, increased non protein were fatal.
The author noticed that the renal insufficiencies were caused by postoperative and
anesthetic shock, renal toxin due to PAS and the overloading of blood transfusion.
1. In these cases, the segmintectomy was only 6% and pneumonectomy was 33%
which was higher than that of foreign countries.
2. As postoperative complications, there were 4.4% of bronchofistula, 1.4% of
emphyema, 4.4% of poor expansion and 2.9% of spread.
3. The postoperative complications were bleeding, oliguria, fall of blood pressure,
respiratory insufficiency and cardiac insufficiency. Among these, two cases were died by
acute renal insufficiency.
4. The postoperative critical complications were mostly seen in cases of abnormal
E.C.G and more than 3,000㏄ of blood transfusion.
5. To prevent the fall of blood pressure postoperatively, as the blood transfusion is
used, the special attention should be paid for it.
|