Clinical study of pulmonary resection for tuberculosis [III]

결핵에 대한 폐절제술의 임상적 고찰

Pulmonary tuberculosis is still one of unsolved problems in Korea due to increased number of far-advanced and drug-resistant patients, who have poor pulmonary function. We have analyzed 1332 operated Gases during the period of 1958-1981. Annual incidence of the disease decreased from 110 [1960] to 21 [1980]. The ratio between male and female was 7:3 and the age of peak incidence was in the 3rd and 4th decades. Recently, patients below the age of 20 years were slightly decreased, but above 50 years were slightly increased. The patients consisted of far-advanced case in 60% and moderately-advanced in 39% in 1980, as compared with 40% and 59% correspondingly in 1965. Preoperative sputum positively decreased from 91% [1958-1963] to 43.8% [ 1974-1981 ]. Medically treated patients for more than 3 years increased from 16% [1958-1963] to 51% [1974-1981]. From the view of surgical indication, totally destroyed hung increased from 27% [1958-1963] to 4396 [1974-1981 ]. Therefore, pneumonectomy occupied 53.8% of total surgical management recently. Mode of surgical treatment showed that thoracoplasty [33%], resection [57%] in 1958-1963 and thoracoplasty [2%], resection [98%] in 1974-1981. As Semb`s thoracoplasty was the first choice of treatment until 1960, thereafter resection became the choice. Postoperative mortality increased from 1.6-2.096 to 396 recently as well as morbidity. It was mainly due to increased number of poor pulmonary function and postoperative spread of disease. On the basis of our experience, far-advanced and drug-resistant patients increased in number recently, whose pulmonary function was poor. So postoperative mortality and morbidity increased. Proper surgical intervention should be considered before the appearance of resistance for all chemotherapeutic drugs.