"Some of the Forgotten Men in the Field of Thoracic Surgery"

Address by Honored Guest, Mr. Philip Allison, Ch.M., F.R.C.S., Nuffield Professor of Surgery, Oxford, England.

"Observations on a Conservative Approach to Non-Malignant Lesions of the Cardia"

31. Reconstruction of the Trachea.

John M. Keshishian (by invitation), Brian Blades and

Edward J. Beattie, Jr., Washington, D. C.

Recommendations will be made on the clinical application and surgical technique of reconstruction of the trachea. Experiences gained in laboratory experiments on over 100 dogs will be described. Results with prosthetic devices will be reported. A review of the literature touching on both the experimental and clinical status of tracheal reconstruction is made.

Indications for reconstruction of the trachea vary depending on the site of the lesion. Moreover, consideration must be given for the type of lesion: Stenosis due to tuberculosis; involvement with tumor; stenosis resulting from long standing inflammation; stenosis or damage resulting from trauma.

A classification of the various types of tracheal defects will be presented. Selection of cases, preparation for the operation and management in the postoperative phase will be discussed. Several representative cases with accompanying illustrations will demonstrate the magnitude of even the simplest derangement of respiratory physiology. Cases will also be described dealing with the definitive treatment of tumor, trauma and inflammatory stricture of the trachea.

32. The Solitary Pulmonary Nodule -A Ten Year Survey.

Edgar W. Davis, J. Winthrop Peabody, Jr. (by invitation) and

Sol Katz (by invitation), Washington, D. C.

This paper represents the culmination of a study initiated by the senior author in 1946. Over the intervening decade 200 patients with solitary, non-calcified, pulmonary nodules have undergone thoracotomy; another group with single nodules containing radiographic evidence of calcification, therefore presumably benign lesions, have for one reason or another also been resected and are available for comparison. Apparently these two groups comprise the largest personal series of solitary lung tumors so far collected. Not only do they afford an unusual opportunity for correlating roentgenologic impressions with pathologic findings, but permit a statistically significant analysis of the relative frequency and ultimate prognosis of the many different lesions encompassed in this study.

To date the main theme of all papers on this subject pertains to the malignant propensities of the group as a whole and the lack of significant radiographic distinctions between the benign and malignant nodule. Important questions remain unanswered, however. Chief among these are: (1) Survival rates of resected bronchogenic carcinoma presenting as a solitary pulmonary nodule. Resolution of this question is imperative in view of recent indictments of the value of X-ray surveys in influencing the number of long-term survivals; (2) Reliability of calcification as an indication of benignancy. Instances of calcine deposition within proved bronchogenic carcinomas will be presented and attention directed to the importance of the pattern of calcification in determining its significance; (3) Identification of the specific etiology of the various granulomas. One of the most revealing aspects of this study has been the demonstration of Histoplasma, Coccidioides, Crytococcus, etc., in a large percentage of these supposedly non-specific lesions.

7:00 P.M. Cocktails, Banquet and Dancing, Hotel Fontainebleau.

Attendance limited to Members of the Association and their ladies, Invited Speakers and their ladies.

Dinner dress preferred.