Treatments of Tuberculosis

Removal of one lobe of a lung (lobectomy) or of an entire lung (pneumonectomy) is a relatively new procedure in the treatment of tuberculosis. At the present time it is proving a great benefit to a limited number of patients. Like thoracoplasty, this surgery requires the services of a highly-trained and experienced thoracic surgeon. When lobectomy is done, the remaining portion of the lung expands to fill the chest cavity. A thoracoplasty is sometimes performed following a lobectomy in tuberculosis to prevent over-distension of the remaining tissue. In pneumonectomy, the space from which the entire lung is removed fills up with a harmless fluid, which gradually diminishes, and the central structures of the chest, together with the opposite lung, move toward the side of operation. As in lobectomy, a thoracoplasty is sometimes done following pneumonectomy on the side from which the lung has been removed to prevent the stretching of the opposite lung.

As a rule, lobectomy and pneumonectomy are employed only in those cases which cannot be controlled by the simpler collapse procedures.

This sort of operation was approached with hesitation when first it arrived during the mid-1940s, but improved anesthesia was a great help and within 20 years this type of major lung surgery was commonplace. Furthermore when the patient had adequate special drug treatment, the fear of spread of tuberculosis from cutting into the lung pretty much disappeared.