Boeke, Hendrik Enno.
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ABSTRACTIn the Introduction an explanation is given of the purpose of this study: firstly: to give a critical review of the case-histories of 40 patients, who in the period between the first of October 1954 and mid-February 1956 were operated upon in the "St. Borromeus Hospital" at Bandung with the resection-therapy for their tuberculosis of the lungs. Secondly : to present a discussion of the treatment of these patients before and after the operation; of the operative technique which I have used and of the many complications that followed. Thirdly : to venture a speculation as to the place, which the resection-therapy in the future may occupy in the treatment of tuberculosis of the lungs in Indonesia.
Hereafter some considerations are given about the "lung-team" and about the difficulties and imperfections in the work at Bandung. :
1.the scarcity of sufficient sanatorium-beds and our efforts towards a solution of this problem.
2.the impossibility in Bandung of determining the resistance of the tubercle bacilli against the tuberculostatica.
3.the impossibility of making bronchospirometrical researches of the function of the lungs.
In Chapter I a description is given of the normal course of events in the St. Borromeus Hospital when a patient is taken into the hospital to undergo a resection operation. A detailed report is given of the technique of the operation. In the second part of this chapter a discussion is produced, starting with a review of the indications and contra-indications. Before discussing the scheme of indications an extensive review is made of the particular circumstances reigning in the field of the tuberculosis in Indonesia, which have in a considerable way influenced our indications.
I deem the following 7 factors of the greatest importance
1.The social circumstances of most of our tuberculous patients.
2.The comparative scarcity of lung specialists in Indonesia.
3.The comparative scarcity of available sanatoriumbeds.
4.The impossibility of determining the resistance of tuberclebacilli against streptomycine, P.A.S. and T.N.H.
5.The impossibility of making bronchospirometrical lung-function determinations.
6.Our preference for resectiontherapy against thoracoplasty.
7.The fear to operate in the case of bilateral tuberculous processes,
when a longstanding observation of the patient by a lungspecialist has been impossible.
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