化学療法の発達した現在における肺結核外科的療法

抄録

From an inquiry into the long-term prognosis of cases controlled solely by chemotherapy, we have come to take the view that indications for surgical treatments are to be found among cases which has discharge of bacilli even after chemotherapy, and that in future only the cavity as source of bacilli discharge will require to be given consideration, while changes other than the cavity will not require consideration, at least in terms of surgery.
We have found that, by widening the indications for c a vernoplasty which has achieved remarkable results as local surgical treatment for cavities, and carrying over into them a considerable part of the indications for lung resection, we will be able to cut down sharply such serious complications as bronchial fistula and empyema which occur after lung resection and which pose a serious problem at present.
We have also pointed out that at present there are almost no indications for thoracoplasty which is still being applied to a considerable number of cases, and that these are mostly indications for cavernoplasty.
At present the sterilizing effect of RFP on the tuberculous bacilli in lesions is raising a question, and it is to be hoped that with the future development of chemotherapy even the indications for lung resection will be cut down sharply, and that in the surgical treatment for pulmonary tuberculosis the leading role will be played by cavernoplasty which is a local treatment for cavities.
We should like to conclude that it is our ideal as investigators engaged in the treatment of tuberculosis to see the fruits of all surgical treatments for pulmonary tuberculosis be further condensed into such a simple and sure form, supported by the progress of chemotherapy and improvements in social conditions, in an advanced country like ours where there are still a considerablenumber of pulmonary tuberculosis patients.