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October 19, 1940


JAMA. 1940;115(16):1366-1368. doi:10.1001/jama.1940.02810420052015

The simplicity and safety of intrapleural pneumothorax as a measure for collapsing the lung in the treatment of tuberculous cavitation is well known. In a number of cases, however, intrapleural space cannot be produced because of adhesions between the parietal and visceral pleural leaves; in some cases inadequate or contraselective collapse takes place; these conditions make imperative a search for other methods. Thoracoplasty is far more efficient than pneumothorax but is a major operative procedure, deforming and resulting in an irreversible state as far as the compressed lung is concerned. Extrapleural pneumothorax is a recently advocated procedure aimed to produce a selective extrapleural pocket to be maintained by air pressure. The method was first tried by Tuffier in 1891 for a pulmonary hemorrhage. He applied this technic in several cases and attempted to maintain the space by introduction of nitrogen gas. The results of the operation were disappointing because of

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