STUDIES ON THE PERIOD OF HOSPITALIZATION AFTER SURGICAL TREATMENT FOR PULMONARY TUBERCULOSIS

Abstract

This study was carried out to analyse the actual status of the period of hospitalizationand to determine the adequate period of hospitalization after the surgical treatment. Thematerial consisted of 1, 155 cases who had been operated upon at 40 institutionsparticipating to the Research Committee of Tuberculosis (Ryoken) in 1970, and theoperation failure cases, empyema cases and dead cases not related to the operation andtuberculosis were excluded.
After dividing the period of postoperative hospitalization into 5 groups, i. e. within 3, 6-12, more than 12 months and still hospitalized, cases were analysed, in relation todistricts, institutions, preoperative, bacteriologic findings in sputum and surgical procedures applied.
The period of postoperative hospitalization in 6 districts in Japan, i. e., Hokkaido and Tohoku, Kanto, Chubu, Kinki, Chugoku and Shikoku, and Kyushu showed markeddifference. For instance, the majority of cases were hospitalized for the period of 6 to 12 months postoperatively in Hokkaido and Tohoku, and Kyushu, wheras the majority of cases were hospitalized for the period of 3 to 6 month in Kinki, Chubu and Kanto. The proportion of postoperative hospitalization period differed, quite significantly in eachinstitution. Both preoperative bacteriologic findings in sputum and surgical proceduresapplied showed a close relation to the period of postoperative hospitalization; in bacillipositive cases, hospitalization period was less than 6 months in 32.3%, 6 to 12 months in 39.9% and more than 12 months in 20.3%, while in bacilli negative cases, it was 43.8%, 44.8% and 7.6%, respectively. Cases hospitalized for less than 6 months were 44.8% inpulmonary resections excluding pneumonectomy, 38% in pneumonectomy, 36.7% inthoracoplasty, wheras cases hospitalized for 6 to 12 months were 44.8%, 46.2% and 40.4%, and cases hospitalized for more than 12 months were 7.4%, 14.3% and 26.0%, respectively, in each mode of operation.
According to this finding it can be said that the period of hospitalization after pulmonary resection excluding pneumonectomy is the shortest and that, after thoracoplasty is the longest. The attempt of analysing the reason for difference of the period ofpostoperative hospitalization found between districts as well as institutions revealed thatsuch a difference was not based on the medical conditions but on the old concept aboutsurgical treatment for pulmonary tuberculosis made before chemotherapy era and on theefforts to maintain high occupancy rate of tuberculosis beds. The period of postoperativehospitalization is considered, in general, to be too long and it might be enough tohospitalize them less than 6 months according to the results obtained in this study.