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Article
September 1938

TREATMENT OF INTRACTABLE BRONCHIAL ASTHMA BY BILATERAL RESECTION OF THE POSTERIOR PULMONARY PLEXUS

Author Affiliations

BALTIMORE
From the Surgical and Medical Clinics of the Johns Hopkins University.

Arch Surg. 1938;37(3):456-469. doi:10.1001/archsurg.1938.01200030105006
Abstract

Although it is relatively small, there exists a group of patients afflicted with typical bronchial seizures which are unamenable to medicinal therapy. It is to the amelioration of these attacks in such patients that our attention has been drawn. Only cases of unquestionable bronchial asthma have been selected, and only patients totally incapacitated physically have been subjected to operation. The rationale of the procedure of bilateral resection of the posterior pulmonary plexus is based on the anatomic fact that only at this point can the extrinsic nerve supply of the lung be completely interrupted. The preganglionic efferent fibers of both the vagus and the sympathetic bronchomotor tracts from the same and contralateral sides, together with the sensory or afferent fibers emerging from the lung, form a rather limited anastomosing plexus on the posterior surface of the hilus of the lung. By resection of this plexus it is therefore possible to

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