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October 15, 1955


JAMA. 1955;159(7):682. doi:10.1001/jama.1955.02960240048012

There have been essentially four surgical procedures recommended for the treatment of bronchial asthma. First, there is the removal of localized destroyed areas of lung plusneurectomy.1 Next, there has been the treatment of patients proved to be essentially totally epinephrineresistant by carrying out an upper dorsal sympathectomy, unilateral or bilateral, in order to resensitize the patient to the effect of his own circulating epinephrine. This was described in detail by Carr.2 Pulmonary vagotomy is recommended by Rienhoff and Gay.3 Blades4 described a combined denervation procedure removing the pulmonary plexus incorporating excision of both sympathetic and parasympathetic pulmonary denervation.

Follow-up studies on the long-term results of surgical treatment for asthma have been generally disappointing. Long-term follow-up of postganglionic dorsal sympathectomy in the patients proved preoperatively to be distinctly epinephrine-resistant has shown satisfactory persistent response to the surgical procedure.5 Vagotomy alone and combined denervation in the form