Surgical treatment of pulmonary tuberculosis; a decade of change.

To observe trends in the surgical therapy of pulmonary tuberculosis, the records of patients treated during the last ten years at the Tuberculosis Division of the San Diego County General Hospital (Vauclain Home) were reviewed. In this decade, a chemotherapeutic revolution permitted more patients to be treated with fewer beds, lower mortality and shorter hospitalization. Pneumoperitoneum has replaced other forms of temporary collapse. Pneumothorax, phrenic nerve interruption and pneumonolysis have been abandoned in favor of extraperiosteal plombage, particularly in older, poor risk patients. The use of permanent collapse measures as definitive treatment has decreased, thoracoplasty and extrapleural pneumothorax having been virtually abandoned. The use of resection in patients with permanent collapse failure, residual cavities, bronchostenosis and destroyed lobes or lungs has become common, and good results have been obtained.