Extraperiosteal Polystan Plombage: Three to Five Years' Follow-up

¹ The Department of Thoracic Surgery. Municipal Chest Hospital (Gresundshospitalet), Copenhagen, Denmark.

Sixty-five cases of pulmonary tuberculosis were selected for extraperiosteal Polystan® plombage, mainly because they were considered inoperable by traditional methods. Severely impaired respiratory function and/or bilateral cavitation were the most common indications for plombage. Bilateral cavities were present in 26 per cent of these cases.

The plombages were undertaken during a two-year period (1950-52). In this period the total number of surgically-treated cases of pulmonary tuberculosis was about 700, of which plombages constituted less than 10 per cent.

Seventy-four plombages were performed in the 65 cases, nine of which were bilateral plombages. In 14 cases, other contralateral surgical interventions were employed.

No immediate or early postoperative mortalities or complications occurred.

Post-surgical follow-up of from three to five years showed cavity closure in 84 per cent of these cases. Twenty per cent had died, but half the deaths were attributable to contralateral activity or to non-tuberculous diseases. Fourteen per cent were positive, two thirds of them having closed cavities under the plombage, but contralateral activity. Of these cases, 66 per cent were converted, of which 62 per cent were attributable to plombage itself, the remainder to secondary pulmonary resection.

There was no mortality, no complications and no reexpansion of the collapsed lung following removal of the plombe and conversion of the plombage collapse to thoracoplasty. Two patients died later, one has a small fistula, seven were cured.