[Surgical treatment of pericostal tuberculosis]

The following two points must be considered on treating pericostal tuberculosis: the first is the appropriate time to treat pericostal tuberculosis surgically when the medical therapy fails to induce a remission, and the second is how to prevent postoperative relapse. In the present study, we investigated these two points by examining seven patients who underwent surgery at the department of thoracic surgery (Osaka Red Cross Hospital), during a 10 years period from January 1985 to December 1994. Antituberculotics were administered to these patients for an average of 3.9 months before surgery, but in vain. Therefore, they were surgically treated. In all cases, the incision was closed at once, and there were no severe complications. The signs and symptoms disappeared soon after surgery. It has been reported that the medical treatment leads to recovery or tendency to recovery within three months of drug administration. The conditions of pericostal tuberculosis patients during this period can be used as indicators to decide whether or not to carry out surgical treatment. Also, by active excision of the rib and tumor as one mass, and by administering antituberculotic for 13.1 months after surgery, no relapse took place during the follow-up period (average 37.4 months). And the postoperative respiratory functions did not decrease compared to those before surgery.