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We have been prompted to present this paper by our observations following phrenicectomy of the unusually rapid decrease in size or the disappearance of unmistakably diagnosed cavities, more than 3 cm. in diameter that were of long standing in pulmonary tuberculosis and had otherwise resisted every attempted form of therapy.
We consider the indications for phrenicectomy to be, in general:
Unilateral pulmonary tuberculosis, ulcerative and fibrocaseous, not acutely progressive, having a tendency to retraction and scarring, in which pneumothorax is not practicable. This operation is not to be used in place of pneumothorax.
Bilateral tuberculosis which does not admit of the risk of pneumothorax or thoracoplasty, in which extensive disease on one side can be active and on the other side stationary or slightly active; this is more particularly true when the lesion on the less involved side is being fed by an upper lobe cavity of the other lung.
MAYER E, LEETCH H. CAVITIES IN PULMONARY TUBERCULOSIS: RAPID CONTRACTION OF UPPER AND LOWER LOBE CAVITIES WITH PHRENICECTOMY. JAMA. 1929;93(4):272–276. doi:10.1001/jama.1929.02710040024008
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