抄録
The authors investigated the prognosis after thoracoplasty, particularly of tuberculouss lesions of contralateral lung, on 359 cases during the period of five years ending 1951 in which patients lived half a year or longer after operation. Of this number, 118 were treated with streptomycin at operation and 241 were not treated. In general post operative progress was good in about 80%. The results are as follow:
1) 125 cases (34.3%) had no tuberculous lesion in contralateral lung before operation and their improvement-rate was about 85%. There was no remarkable difference between streptomycin treated-group and non-treated-group. In only 2 cases now lesions appeared.
2) Of the cases which had some lesions in the contralateral lung, 148 (63.2%) were not managed by any operative procedure. Their aggravation-rate was about 12%, all of which accurred more than 6 months after operation. The streptomycin-treated group showed a lower aggravation-rate than the non-treated group. In the former there was no case in which cavitation was obserable while in one-third of the latter cases, new cavitation appeared. However, the natural healing was found in considerable number of cases. 20-30% of the cases with increased infiltration and no cavity and 30-50% of those with cavity improved. Therefore, the authors believe that streptomycin can be used with advantage when the contralateral lung is involved.
3) In one half of 46 cases (19.6%) in which pneumothorax treatment was instituted pleural adhesion developed on the contralateral lung operation, regardless streptomycin treatment was given or not. And one half of adhesion cases were not benefited by the pneumothorax therapy. Of 21 cases (8.9%) treated with pneumothorax after operation spontaneous pneumothorax developed one month after operation in 3 cases. The other cases in which artificial pneumothorax treatmeut given at the period when the operation influences became no longer effective, showed a favourable progress. The authors interpreted that when the artificial pneumothorax of contralateral lung becames necessary, it must be induced within 2 or 3 months after thoracoplastic operation.
4) The thoracoplasty of contralateral lung was carried out in 15 cases (6.4%) and the artificial pneumoperitoneum in 4 (1.7%). No discussion is made on these as the number so treated is small.
