| Cavernoplasty for Intractable Cavitary Pulmonary Tuberculosis on 100 Cases |
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Yie Yonn Kim, Dong Soo Whang |
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Pusan City Branch Clinic, Korean National Tuberculosis Association, Pusan, Korea |
| 난치성 폐결핵 공동에 시행한 공동성형술 100예에 대한 임상적 고찰 |
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김의윤, 황동수 |
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| Abstract |
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It’s long been well-known to keep the affected part collapsing gives beneficial effects to the healing of pulmonary tuberculosis. This healing mechanism is believed that the local ischemia and low oxygen tension of the collapsed paπ promote the proliferation of connective tissues prosperously and this fact was recognized experimentally and clinically by many investigators.
In this point of view, one hundred cases of cavernoplasty (cavernoplasty 7 cases and cavernoplasty with thoracoplasty and apicolysis 93 cases) were performed in order to preserve the apical ribs, to reduce the deformity of thorax postoperatively by lessening the numbers of resected ribs, to minimize the undesirable collapsing of normal lung tissues and collapse the cavitary lesions more completely among the about 3,000 patients registered at Pusan City Branch Clinic of Korean National Tuberculosis Association for four years from Jun. 1986 to Jun. 1990.
The clinical evaluations were as follows :
1) The cases of cavernoplasty only were 7 and cavernoplasty with thoracoplasty and apicolysis were 93. In 93 cases of thoracoplasty, the mean number of resected ribs was 3.49 and staging procedure was used in only 3 cases (3%).
2) There were 66 males and 34 females whose ages ranging from 18 to 67, and mean ages were 40 in male and 34 in female.
3) Duration of the diseases before operation was extended from under 1 year through 31 years and the mean was 8.97 years in male and 6.76 years in female respectively.
4) The resistance tests for drugs were done in 83 cases. 82% (68 cases) showed resistant for more than 3 drugs and for Isoniazid and Rifampicin, the resistance rate reached to 91.5% (76 cases).
5) Among the 87 sputum positive cases, 81 cases (93%) were converted to sputum negatives within 6 months after operation.
The author believes that the cavemoplasty with thoracoplasty and apicolysis procedure may be justifiably considered in certain salvage cases, in which intractable cavitary disease and highly productive of durg-resistant organisms |
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