Læknablaðið - 01.09.1960, Page 35

LÆKNABLAÐIÐ
)
115
leifai’, sem líkur eru til að verið
geti hættulegar framtíðarörj’ggi
sj úklingsins. Sé það gert, geta
sjúklingarnir verið iivað von-
beztir um varanlegan bata. Auk
þess verður sjúkdómstími
þeirra styttri, og síðast en ekki
sízt, verður áhættan við aðgerð-
ina hverfandi lítil, þegar við fá-
um tilfellin þannig fersk.
Thorarinsson, Hjalti:
Surgical treatment of tubercu-
losis of the lung.
S u m m a r y.
The author’s first 100 cases
of pulmonary resection for tu-
berculosis are reported. These
operations were performed in
the years 1953—1954 and 1955
—1957 w'hen resectional surgery
was started in Iceland.
The importance of a long
term chemotherapv before and
after pulmonary resections is
stressed, esp. is a long term post
operative chemotherapy advis-
able in tliose patients where
some visihle or palpable dis-
ease is left behind at the time
of surgery.
The indications for resecti-
onal surgery are listed and dis-
cussed further.
It is the autliors o])inion and
experience, that pulmonary res-
eotion is the method of choice
in the treatment of tuberculos-
is of the lungs, and that it can
he chosen in almost everv case.
There still is however, an oc-
casional use for the collapse
procedures either alone or in
connectioii with resection as
space reducing operations, when
tlie remaining lung does not
ciuite fill out the chest cavity.
The autlior has done only three
therapeutic thoracoplasties dur-
ing this period of time. The
space reducing thoracoplasties
were performed either simult-
aneously with the resection, if
the condition of the patient al-
lowed it, or 10—14 days later
Very few such operations wliere
neecled. There were only three
concomitant thoracoplastics car-
ried out and 5 patients had
thoracoplasty later because of
residual air space or B.P. fistula.
Tliese additional procedures are
certainly very few, when it is
remembered that 42 patienls
liad one lohe or more removed
at tlie time of surgery.
In the series there are 54
cases which represent primary
surgical treatment i. e. patients
who had received no surgical
treatment hefore and as a rule
tliey liave their surgery earlv
in the course of the disease fol-
lowing several months of che-
motherapv. There are, however,
in tliis group many patients
with recurrence or relapse of
their disease.
Tliere are 46 „second hand“
cases i. e. patients \\4io have
undergone some surgical treat-
ment before such as tlioraco-
plasty, plomhage, phrenicexair-
esis, extrapleural pneumothorax
and intrapleural pneumothorax.
The prohlems are entirely
different in these two groups.
Most thoracic surgeons have
very good results when operat-
ing upon patients belonging to
the first group, whereas post
operative coinplications are
more common and the mortality