Abstract
Summary The operative and post-operative complications in 1,341 operations for pulmonary tuberculosis are discussed. Bronchial fistula occupies first place among the causes of death, followed by shock, pulmonary embolism, cardio-respiratory failure and specific exacerbation. The early mortality within four months in the hospital was 3.6 per cent. (8.6 per cent. in pneumonectomies). The complications are discussed in detail; the incidence of bronchial fistula decreased from 7.2 per cent. to 2.9 per cent. (1960). Streptomycin resistance and the presence of tuberculous lesions in the bronchus at the site of its section are the most important causes of bronchial fistula. At present, one out of four patients operated upon has streptomycin resistant bacilli. The cultural viability of tubercle bacilli recovered from operative specimens, found in 57 per cent. of cases, is due to inadequate previous chemotherapy. The viability of the bacilli in lesions is considered to be the principal cause of complications. The results of forty-two bilateral one- or two-stage resections are reviewed, with an overall mortality of 7 per cent.: only one patient (2.3 per cent.) now has a positive sputum. The late comparative results of resection and thoracoplasty and extrapleural pneumothorax are mentioned.
Published Version
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