Diagnostic Surgical Procedures for Pulmonary Disease: Review of a Two-Year Experience

¹ The Pulmonary Disease Service, Valley Forge Army Hospital
² Thoracic Surgical Service, Valley Forge Army Hospital.

1. It is imperative to establish the diagnosis in undetermined pulmonary lesions and to resort to one of several diagnostic surgical biopsy procedures, providing the clinical aids of fungal and tuberculin skin tests, smears and cultures of sputums, gastric washings, aspirated bronchial secretions and of material from pleural and pericardial cavities, as well as fungal serological studies have been of little or no value.

2. Diagnostic thoracotomy has proved to be of the greatest value in the authors' experience. It Should not be delayed unnecessarily. It can be done with considerable safety.

3. Fat pad, pleural and pericardial biopsies did not aid in the determination of the etiology of the underlying disease in the majority of our cases. These results differ greatly from those reported in the medical literature.

4. One can save the patient, with undiagnosed pulmonary disease, considerable inconvenience and may better his prognosis, by earlier surgical intervention. The practice of "watchful waiting," which is still quite prevalent, is no longer justifiable.