Evaluation of surgical treatments for the major lesion of bilateral silicotuberculosis.

The present communication deals with the follow-up study of 24 patients with bilateral silicotuberculosis in whom only unilateral operation was carried out for major lesions. The operative procedure consisted of pulmonary resection, thoracoplasty or combined operation such as cavernostomy, intracavitary filling of a pedunculated muscle flap and thoracoplasty. The follow-up period ranged 1 year to 12 years and 5 months. The results of surgical treatment for unilateral major lesions and their effect on the contralateral minor lesions were clinically assessed by alterations in the chest x-ray findings and tubercle bacilli in sputum. In 16 of 24 patients (67%) alleviation was obtained, whereas no change occurred in 3 (13%) and aggravation in 5 (21%). The surgical treatment for unilateral major lesion brought about 41% of improvement in the contralateral minor lesions. Contralateral minor lesions remained unchanged in 46% of patients and aggravated in 14%. This shows a value of the surgical threatment for bilateral silicotuberculosis. It should be emphasized that surgical treatments more aggressive than have been heretofore practiced can be employed.