[Surgical treatment of tuberculosis and its modifications--collapse therapy and resection treatment and their...

Surgical treatment of tuberculosis is now largely a thing of the past. After it had been realized that a tuberculous lung process can be cured by shrinkage, i.e. by reducing the volume of both the lung and the thorax, attempts were made to actively promote such shrinkage processes by means of suitable measures. The so-called collapse therapy was initiated by the Italian physician Forlanini in 1888. By pumping air into the free cavity of the pleura the diseased lung as brought into a state of dosed collapse so that infiltrative and cavernous processes could heal with scar formation. However, application of a pneumothorax was prevented by pleural processes that occurred frequently during the course of a disease, especially also as sequels to pleuritis. The operative alternative was an attempt to achieve lung collapse by surgery. Thus the idea was born to enable lung collapse by mobilising the external thoracic wall, i. e. by means of rib resection: this principle was known as thoracoplasty. A little later, attempts were made to circumvent such a crippling intervention by surgically detaching the lung "on target" over the diseased area and by filling the cavity created in this manner, with air to produce a so-called "extrapleural pneumothorax". Lung surgery advanced rapidly after intubation anaesthesia developed since 1945. It was now possible to remove isolated diseased parts of the lung, so that the collapse therapy receded more and more to the background. Side by side with this development of new surgical procedures drug treatment of tuberculosis made rapid progress.(ABSTRACT TRUNCATED AT 250 WORDS)