腎摘除術に化学療法を併用した腎結核症例の予後調査成績について

Abstract

According to many literatures, the post-operative su r vival rate of patients with renal tuberculosis was 70 to 80% before chemotherapy became available and it improved to 80 to 90% after chemotherapy became a wide use. However, these reports were based on the results of relatively short-term follow-up studies. This report deals with the 1 0 year survival rate of renal tuberculosis analysed on 461 cases who were treated at the Department of Urology of Kyoto University Hospital with a combination of nephrectomy and chemotherapy during the period of 16 years from 1949 to 1964, and whose difinite prognostic outcome was available. Among the all cases, death was con f irmed in 37, and the actual overall 10 year survival rate was 0.930. There was no difference in 10 year survival rate between both sexes or among various extents of tuberculous foci in the extirpated kidney. However, the rate was found to be 0.816 in the cases who showed roentgenological abnormalities in the opposite kidney at the time of operation, and it was lower than the value of 0.957 obtained from the cases without roentgenological abnormalities in the opposite kidney. Since the average expected survival rate o f Japanese population during the examination period was 0.960, the 10 year relative survival rate, 0.969, obtained from our all cases must be considered to be a satisfactory result. It is proper to consider that th e treatment of unilateral renal tuberculosis must be consisted of positive performance of nephrectomy with a combination of supplementary chemotherapy, because a single chemotherapy is still providing unsettled problems.