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September 1949


Arch Surg. 1949;59(3):705-709. doi:10.1001/archsurg.1949.01240040713029

THE OPERATION of extrapleural pneumonolysis for tuberculosis was apparently first performed by Tuffier in 1891.1 In its various modifications this operation has enjoyed several periods of popularity, only to suffer ensuing periods of disrepute. In the armamentarium of conservative thoracic surgeons it has come to occupy a definite, though minor, place in their treatment of pulmonary tuberculosis. For the most part, its use should be confined to cases in which thoracoplasty cannot or should not be done. Literally scores of various and different substances have been used to fill the artificially created, unnatural extrapleural space. The recent introduction of comparatively nonirritating plastic compounds, particularly lucite (an acrylic resin, methyl methacrylate) in the form of spheres, has again brought this operation into focus.2 However, the use of lucite spheres has been condemned by Trent,3 Murphy4 and others. The relative hardness of the spheres has caused them to

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