Extrapleural pneumothorax

Artificial intrapleural pneumothorax deservedly ranks first among the surgical methods used in the treatment of pulmonary tuberculosis. A simple, easily assimilated technique of its imposition, uncomplicated equipment make it possible to use it in any place where there is a doctor who knows the clinic of pulmonary tuberculosis. Unfortunately, the persistent effect of its use is limited to recent cases, where the spread of the process has not touched the pulmonary pleura, i.e., where there are no adhesions between the pleural sheets. In older lesions, only partial pneumothorax is usually obtained. The collapse of the cavity in these cases is prevented by adhesions or adhesions, and if they are inaccessible to burning out, then the choice remains: either to stop and. etc., or continue blowing, counting on their palliative effect — lowering the temperature, improving the general condition, even if the cavity did not have a tendency to collapse. Persistent continuation of ineffective and. the item is fraught with formidable complications, especially in cases where the cavity is exposed during the act of breathing to stretching by adhesions - "jerking", as is clearly seen during thoracoscopy, or where the cavity is marginal, close to the visceral pleura. The experience of a large number of thoracoscopies convinced us that where there are adhesions that cannot technically be eliminated by burning, the continuation of pneumothorax almost inevitably entails pneumopleuritis. And in the presence of a superficially located cavity, this pleurisy has every chance of becoming purulent immediately or very soon. Marginal caverns in these cases can give even more serious complications - spontaneous pneumothorax, followed by purulent pneumopleuritis in a significant percentage of cases.