A Surgical Aspect of Pulmonary Tuberculosis in African Children

Abstract

The main purpose of this paper is to present a plea for a rational approach to hilar lymphadenectomy in the prevention of bronchiectasis, destroyed lung, emphysema and a massive tally of crippling respiratory disease. Operation should be considered at an early stage if drug therapy and physiotherapy are not clearly relieving bronchial compression or perforation by mediastinal lymph glands, either where the bronchial obstruction in itself is causing symptoms or where the resulting pulmonary lesion may be regarded as still reversible. This is an infinitely more attractive proposition to me as a surgeon than to be presented with the late effects of bronchostenosis and to be asked to salvage a respiratory cripple. I want to condemn in the strongest possible terms the indiscriminate use of drugs and bed rest in pulmonary tuberculosis when an obvious mechanical problem exists.