BACKGROUND FACTORS ' FOR EVALUATING THE PLACE OF RESECTION IN

PULMONARY resection for active tuberculosis was seldom employed at Fitzsimons Army Hospital prior to the introduction of streptomycin; hence, follow-up studies must of necessity be limited to the period subsequent to 1946 (figure 1). A tenfold increase in the utilization of excisional surgery has occurred coincident with improvement of antituberculosis drug therapy and surgical technic during the past six years. Included in this report are those patients proved to have tuberculosis before operation, and those who submitted to thoracotomy primarily for diagnosis and then continued on treatment after the excised lesion was judged to be tuberculous. It is not within the scope of this paper to discuss the diagnostic aspect of this problem, but it should be pointed out that the frequency of small nontuberculous pulmonary lesions simulating tuberculosis (granulomata from various causes, tumors, cysts, vascular anomalies, hematoma, chronic lipoid pneumonia, infarctions, etc.) makes it hazardous to diagnose tuberculosis without bacteriologic proof and to claim success i