Recent surgical experience for pulmonary tuberculosis.

Lung resection for pulmonary tuberculosis is unusual today. Over a 10-year-period 31 patients with pulmonary tuberculosis underwent thoracotomy at this Regional Centre. Five of these were for complications of known tuberculosis; two subsequently proved to be complications of pulmonary tuberculosis, and the remainder were for suspected malignancy. The clinical features, radiology, microbiology, and pathology are reviewed and the contemporary role of the surgeon in the management of pulmonary tuberculosis is examined.

Cervical thymectomy in the treatment of myasthenia gravis.

Treatment modalities in myasthenia gravis consist of surgery, chemotherapy and plasmapheresis. Thymectomy can be accomplished either through a median sternotomy or through a small, transverse cervical incision. Forty patients who underwent cervical thymectomy for non-thymomatous myasthenia gravis were studied retrospectively. Twenty-six patients (65%) showed a favourable response to thymectomy and there were statistically significant improvements in myasthenic symptoms and reductions in medication requirements. Age, sex, duration of symptoms and thymic histology were not predictive of response to thymectomy. Operative mortality was zero and operative morbidity was minimal. During the last 6 years, only two of 22 patients required admission to the intensive care unit postoperatively. The postoperative hospital stay ranged from 2 to 23 days. Cervical thymectomy does not preclude later sternotomy in those patients who fail to respond favourably. We therefore recommend cervical thymectomy as the initial surgical procedure in the treatment of non-thymomatous myasthenia gravis.