Segmental resection for pulmonary diseases.

Abstract

Pulmonary resections have been performed successfully for many years, but until 1933 the techniques remained crude and the operations extremely hazardous according to present standards. Staged operations, use of tourniquets and clamps and destruction of lung tissue with cautery all resulted in prolonged morbidity and a mortality horrifying to the surgeon of today. In 1933 Rienhoff1first described the technique of individual isolation and closure of the bronchus and blood vessels at the hilus. This technique, now used in practically all pulmonary resections, has done more than anything else to reduce the operative complications and mortality of these procedures. In 1932 Graham and his colleagues2collected a series of 212 lobectomies in which the operative mortality was 34 per cent. By 1947 Kay and associates3were able to report 258 consecutive cases of lobectomy for bronchiectasis with only one death, and Jones4presented a series of