Læknablaðið - 01.09.1960, Page 36

116
LÆKNABLAÐIÐ
is much higher following surg-
ery upon tlie „second liand“
cases.
Very few statistics classify
the patients like that and may
therefore be very misleading.
In countries where chest surg-
ery is in its childhood surgeons
have to tackle many poor risk
patients and borderline cases.
In tlie authors series 17% of
llie patients were sputum posi-
tive at the time of surgery with
drug resistant hacilli. Tlie aver-
age age of the patients was 39,3
years.
The average stay at a sana-
torium hefore surgery was 2,55
years.
The type of operative proce-
dure was as follows:
7% had pneumonectomies,
4% hilohectomies, 16% lobect-
omies plus segment, 15% lob-
ectomies, 56% segmental re-
sections and 2% wedge resecti-
ons.
The significant major compli-
cations were bronchopleural
fistula 5% and tuherculous
empyema 5%.
The post operative mortality
in the series is 3% i. e. 3 pati-
ents died within 3 months fol-
lowing surgery. These were all
very poor risk patients „second-
Iiand“ cases sputum positive at
tlie time of surgery with drug
resistant hacilli. Two of the
patients had pneumonectomy
done and one liad one lobe plus
a segment removed.
Tliere are no deatlis among
the primary surgical cases and
tlie mortality is nil following
segmental resection and lobect-
omy.
Clinical alelectasis following
surgery occurred never in the
series and it is the authors opini-
on that a vigilant post opera-
tive care is imperative although
the surgical technique also is
very important in preventing
tliis complication.
Post operative spread of the
disease occurred never. There
liave heen 3 later deatlis all from
tuberculosis.
1 patient (1%) is living with
disease, 93 patients (93%) are
living and well.
A conqilete follow up study
will soon he finished. The maj-
ority of patients has already had
1 or 2 gastric waslies which
liave all been negative.
Several statistics are quoted
and compaired with the results
in this series.
Helztu heimildir:
C. Semb and Sven Hjort (Oslo,
Norway): The Indication for
operative Treatment in Pulmon-
ary Tuberculosis. Acta Chirurgica
Scandinavica Vol. 107: 348—357,
1954.
Tage Kjœr and Jens L. Hansen
Copenhagen, Danmark): Indicat-
ions for the Surgical Treatment
of Pulmonary Tuberculosis. Acta
Chir. Scand. Vol. 107: 358—370, 1954.
Leif Efskind, Bjarne Fretheim and
Paul Vaksvik (Oslo, Norway):
500 Cases of Lung Resection for
Tuberculosis. Acta Chir. Scand.
Vol. 107: 392—396, 1954.
Hjalti Þórarinsson: Skurðaðgerðir
við tuberculosis pulmonum,
Læknablaðið: 39. árg. bls. 33—55,
1955.
E. J. Zerbini, M. D. (Sáo Paulo,
BraziX): Pulmonary Resection in
the Treatment of Lung Tubercu-
lois, The Journal of Thoracac
Surgery 25: 82—95,1953.
Arnotd Pines and Richard Row-