Tuesday Afternoon, April 9, 1963

2:00 P.M. Executive Session (Limited to Active and Senior Members)

Emerald Room

3:00 P.M. Scientific Session: REGULAR PROGRAM

Emerald Room

Address by the President

Julian Johnson, Philadelphia

"A Surgeon and Something More"

Address by Honored Guest

Andrew Logan, F.R.C.S.

Reader in Thoracic Surgery, University of Edinburgh

Surgeon to the Royal Infirmary

Edinburgh, Scotland

"The Surgical Treatment of Carcinoma

of the Esophagus and Cardia"

27. Surgical Experience in the Management of Atypical Myco-bacterial Infections

sam W. law, daniel E. jenkins, irving chofnas, david bahar,

frances whitcomb (all by invitation), H. T. barkley, and

michael E. de bakey) Houston, Texas

Increasing recognition of pulmonary disease due to atypical Mycobacteria has emphasized the need for precise information about the results of treatment of these patients. The frequent drug resistance in these organisms and slow clinical response to chemotherapy in this disease has caused concern about the effects of surgical intervention. During the past ten years, 68 operations have been performed on 64 patients with pulmonary disease caused by atypical Mycobacteria. There were 56 patients with Group I infections, 2 with Group II, 5 with Group III, and one with Group IV infection. The sputum was positive pre-operatively in 47 of the 68 operations. There was no operative mortality. This experience will be evaluated in relation to the species of atypical organism, sputum positivity, surgical specimen positivity, type and duration of chemotherapy, type of operative procedure, and ultimate result. The low complication rate compares favorably with the results of surgery in typical tuberculosis, and with other reports of surgery in atypical infections. In our experience, early surgery can be recommended, and resections of less than a lobe are safe and efficacious.

28. Massive Plombage Thoracoplasty Versus Pneumonectomy in the Treatment of Pulmonary Tuberculosis

Thomas F. Boyd (by invitation), and John W. Strieder, Boston, Mass.

In the surgical treatment of pulmonary tuberculosis, the mortality rate for pneumonectomy is distressingly high, whereas that for plombage thoracoplasty is very low. If sputum conversion and a good clincal status resulted from massive plombage thoracoplasty in those cases which would ordinarily require pneumonectomy, this procedure might supplant pneumonectomy as the surgical operation to be performed for the lung destroyed by tuberculosis. In this study, 28 patients were subjected to massive plombage thoracoplasty (stripping of either 8, 9 or 10 ribs) rather than to pneumonectomy with no operative deaths. At the time of surgery, the oldest patient was 64 years and the youngest 18 years (mean of 41 years). Twenty-four of the 28 had positive sputum at the time of surgery. AH of the patients were followed from 6 to 146 months (mean of 74 months in successful cases) after surgery. In 20 of the 28 patients so treated, sputum conversion and good clinical status were achieved by means of this procedure. Massive plombage thoracoplasty should always be considered before pneumonectomy is selected as the treatment of pulmonary tuberculosis.

Tuesday Evening, April 9, 1963

7:00 P.M. Banquet and Dancing

Emerald Room

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

Dinner dress preferred