PNEUMONECTOMY FOR TUBERCULOSIS - APPRAISAL OF RESULTS IN 143 CASES

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Abstract
A review is presented of a series of 143 pneumonec-tomies carried out between 1945 and 1965 inclusive at the Nova Scotia Sanatorium. Particular attention is given to the occurrence of late deaths, especially those due to the development of cor pulmonale. With the passage of time, the number of late deaths increased, and the over-all mortality rate of 23% observed in 1959 subsequently rose to 40%. Pneumonectomy is a relatively safe procedure (particularly insofar as the development of cor pulmonale is concerned) for those patients in whom a left-sided resection is carried out and disease in the contralateral lung is either absent or minimal from the start of treatment. Pneumonectomy would be an unjustifiable procedure in many patients not fulfilling these criteria, and for them the alternative procedure of massive extraperiosteal plombage is recommended. By this strict selection of patients for pneumonectomy the over-all results of the treatment will be vastly improved for those subjects with lungs extensively destroyed by tuberculosis.

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