A STUDY ON THE DURATION OF CHEMOTHERAPY AFTER SUR ICAL TREATMENT FOR PULMONARY TUBERCULOSIS

Comparison between the Results of Cases Operated in 1973 and 1974

Abstract

It is likely that the duration of chemotherapy after sur ical treatment for pulmonary tuber culosis is shortened in accordance with the development of chemotherapy, however, it is not clear whether this is true or not. The Subcommittee on Sur ical Treatment of RYOKEN carried out this study to clarify the present duration of postoperative chemotherapy and to prepare a material for determinin the appropriate duration of postoperative chemotherapy for pulmonary tuberculosis.
Out of 1325 cases who were treated sur ically durin 1973 and 1974 at 47 institutions belon in to Tuberculosis Research Committee, 492 cases in which the duration of postoperative chemothe rapy, pre- and postoperative back round factors were known, were subjected to this study.
Cases were divided into two roups; a group operated in 1973 and a group operated in 1974. The duration of postoperative chemotherapy in both roups were classified into four cate ories; within 6 months, 6 to 12 months, 12 to 18 months and 18 to 24 months. In each cate ory, the proportion of cases by several factors such as pre- or postoperative back round factors, sur ical procedures applied, postoperative complication or sputum findin and duration of postoperative hospitalization were calculated. Then these rates in group 1973 and in group 1974 were compared. Moreover, the rates in each cate ory were calculated on all cases operated in both years. Finally, the main purposes of postoperative chemotherapy were investi ated.
The results were as follows: 1) Duration of postoperative chemotherapy in group 1974 was shorter than that in group 1973. Accordin to analysis by District, duration of postoperative chemotherapy in KANTO district was remarkably shortened durin one year. In the other districts, however, it did not show si nificant decrease during one year. 2) Duration of postoperative chemotherapy was remarkably shortened in the cases with favourable background factors such as youn er a e, ne ative sputum before operation, good lung function before operation, without residual lesion and resection except pneumonectomy. 3) Even among cases who developed post operative complications or positive sputum, about two thirds of them completed chemotherapy within one year after operation. 4) It is likely that the duration of postoperative chemotherapy will be shortened further due to the following reasons; the duration of postoperative chemotherapy was proportional to the duration of postoperative hospitalization, about one fourth of cases without residual lesion continued postoperative chemotherapy for more than 12 months, postoperative chemotherapy was administrated for prevention of postoperative complications or as a routine practice in 71% of all cases, and the difference in the duration of postoperative chemotherapy by district became smaller.