The changing picture in surgery of pulmonary tuberculosis.

In a review of the operative treatment of 1,271 patients with pulmonary tuberculosis in an 11-year period, it was noted that, beginning with 1947, there was a great increase, relatively, in the number of cases in which pulmonary resection was carried out. In 1943, the first year of the period of study, there were six minor operative procedures to every four major operations; in 1953 the ratio was one minor to nine major. This reversal reflects the discoveries of antibiotics for conservative therapy on the one hand and the advances in surgical techniques for major operative treatment on the other. Now that it is safer, resection will probably be used more and more-including bilateral resection in "salvage" cases. On the other hand, with specific antibiotics available, there is a tendency at present to treat conservatively for longer periods in cases in which, formerly, minor operative procedures would have been carried out early.