Surgical significance of the endothoracic fascia. The anatomic basis for empyemectomy and other extrapleural technics.
Attention if directed to explanation of the endothoracic fascia in several operations described by pioneer thoracic surgeons. The extrapleural plane was extensively and successfully employed in a number of these operations. Re-emphasis of its use seems advisable even today when open thoracotomy is the rule rather than the exception. In selected cases the extrapleural plane can and should be dissected in the aggressive management of relatively localized empyema, with complete enucleation of the infected sac (empyemectomy). This operation can reduce morbidity and prevent prolonged external drainage. The surgical advantage of the extrapleural plane is also apparent in complete parietal pleurectomy for effective palliation of repeated fluid formation. Other instances of intrathoracic disease are mentioned for which dissection in the extrapleural plane can be a safe and time-saving method of treatment. The anatomic considerations relating to the rapid, safe, and effective dissection of the major hilar vessels are also emphasized.
D000328:Adult; D002283:Carcinoma, Bronchogenic / Q000601:surgery; D004653:Empyema / Q000601:surgery*; D005205:Fascia / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008168:Lung / Q000098:blood supply; D008175:Lung Neoplasms / Q000601:surgery; D008722:Methods; D010994:Pleura / Q000601:surgery; D013903:Thoracic Surgery; D013909:Thorax / Q000601:surgery*