Changing concepts in the indications for pulmonary resection
Betts, Reeve H.; Thomas, T. and Gopinath, N. (1955) Changing concepts in the indications for pulmonary resection. Indian Journal of Tuberculosis, 2 (2). pp. 41-46.
Full text available as:
The experiences of the first six years of our thoracic surgical service have been reviewed in regard to the cases having had pulmonary resections done during that time. There were 499 resections with a mortality of 7.4%. Tuberculosis and bronchiectasis, including cystic disease of the lung, were of practically equal frequency and were operated upon with almost identical mortality rates. There is a gradual, but definite, trend in the tuberculosis cases to carry out excisional surgery for the less advanced cases and in preference to thoracoplasty instead of using resection as a last resort procedure when all else has failed. This is a logical step when proper regard is taken to excise only those segments that are damaged. This is a practical plan now that segmental resection has become more or less standardized. Lung abscess accounts for over 20% of the cases and resection for this condition has all but completely replaced the older drainage type of operation. These cases are often difficult from the technical standpoint, but with adequate blood transfusions and competent anesthetists they can be carried through the operative procedure with an acceptable surgical risk (7%). We now believe that most all of the uncomplicated pulmonary hydatids can be treated by enucleation rather than pulmonary resection, as we formerly practised. This preserves all the pulmonary parenchyma and in our recent cases (4) there have been no complicating factors from the large intrapulmonary space after removal of the parasites. Carcinoma of the lung comprised only about 2% of the resections which, we believe, is a reflection of the comparatively low incidence of the lesion in this country and the late recognition of those cases until they are beyond surgical resection.
Archive Staff Only: edit this record