January 1923


Arch Surg. 1923;6(1_PART_II):274-281. doi:10.1001/archsurg.1923.01110170286005

Extrapleural posterior mediastinotomy is an operation which probably has a surgical value far greater than has been generally supposed. By the methods which I have worked out, the exposure is so complete that not only the posterior but also the middle and superior divisions of the mediastinum can be reached with facility and with comparative safety. The thoracic esophagus can be exposed, and operations on the portion between the lower limits of the aortic arch and the opening in the diaphragm can be safely performed in suitable cases; and, by enlarging the hiatus, it is not unlikely that the cardia may be drawn up within the retropleural space.

Suppurative infection of the mediastinum can be treated by drainage; enlarged lymph nodes and new growths can be reached; the bodies of the vertebrae can be exposed for operative procedures; the entire thoracic aorta can be examined visually, and, in certain not

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