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January 30, 1967

Pneumothorax During Surgery

Author Affiliations

Brookline, Mass

JAMA. 1967;199(5):343. doi:10.1001/jama.1967.03120050085026

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To the Editor:—  In the ANESTHESIA PROBLEM OF THE MONTH (198:655, 1966), "Pneumothorax During Surgery," a description is given of a bilateral pneumothorax occurring as surgery was beginning. Obviously, from the protocol, no definitive surgery had been initiated when the pneumothorax occurred.This case was very splendidly handled; however, I wonder about the judgment displayed in going ahead with the surgery after the very major complication of bilateral pneumothorax had occurred.It seems to me that sounder judgment would have been to consider the tracheostomy as a first stage, to treat the pneumothorax, and then, returning at a later date, to perform the definitive surgery as the second stage of the operation.I should appreciate Dr. Hamilton's comments.