An Evaluation of Extrapleural Pneumonolysis

Based on a Follow-up Study of Seventy Cases with Lucite Plombage

¹ Resident in Thoracic Surgery, National Jewish Hospital., The National Jewish Hospital in Denver and the University of Colorado Medical Center.
² Chief of Thoracic Surgery, National Jewish Hospital., The National Jewish Hospital in Denver and the University of Colorado Medical Center.
³ The National Jewish Hospital in Denver and the University of Colorado Medical Center.

1) Extra-pleural pneumonolysis can control tuberculous disease in the lung in a high proportion of cases.

2) Its main weakness is due to the anatomical and pathological factors involved.

3) For the purpose of avoiding the complications of an early broncho-extra-pleural fistula, a thorough x-ray work-up including tomography should be done to exclude giant or peripheral cavitation.

4) If during the extra-pleural stripping, dense adhesions are encountered, the operation should be discontinued and no attempt be made to separate them forcibly.

5) To avoid the risk of late broncho-extra-pleural fistula, the operation should be planned ideally in every case as a temporary collapse procedure and thoracoplasty, sufficient to collapse the space, be performed as soon as the extra-pleural shelf has stabilized satisfactorily (about six months).

6) The extra-pleural plomb increases the danger of bronchopleural fistula after resection under it, and it is recommended that the plomb be removed and thoracoplasty be done before proceeding with resection. Cases who have successful resection under the extra-pleural plomb will not necessarily require removal of the plomb and thoracoplasty.