Surgical Consideration for Bronchial Tuberculosis seen on the Resected Specimens

Abstract

In considering the surgical resections treatment for the pul. tbc., the very existence of the bronchial tbc. is Iiable to cause various post-operative complications such as broncho-pleural fistulas and spreadings of Iesions to healthy pulmonary resions. We have seen on the microscopic examination of the 115 resected Lnng specimens, 16 cases.(13.9%), who had preoperative combined therapy extending from 0 to 20 months duration, with tuberculous lesions on their bronchial walls. Of these 16 cases, 8 from cases of lobectomy and 8 from cases of segmental resections sere derived respectively, 15 were navy personnel and 1 was a civilian. Original lesions of these 16 cases were 13 cavitations, 1 tuberculoma, 2 small foci and the microbiological study on these showed 13 cases to be positive both on staining and cultures, 1 case to be negative on the staining while positive on the culture and 2 cases to be positive on the stainings while negative on the cultures. As for the sites of the lesions of these 16 cases of bronchial tuberculosis, 6 lesions seen on the mucosal layer, 6 in the submucosal, 5 in the muscular, 5 don't the serosal, 4 on the glands, and 1 invaded cartilage were noticed respectively. And describing the findings of lesions, 3were tubercles with liquefactions, 1 was tubercle with central calcification, 2 with squamous metaplasia of the mucosal epithelium and the rest of lesions showed solid tubercles only. The 5 cases with 7 complications out of these 16 cases were observed that is, 2 cases with blood in sputa, 3 with bronchopleural fistulated and 2 with lesions spread to the healthy regions. Of these last 2 one died accompanying bronchopleural fistule and pyothorax and the other is still receiving medical treatment for three years after the operation, although, except these 2 cases the rest showed drastic cures with massive antibiotic treatment provided.