Ann Thorac Surg 1997;64:224-225
© 1997 The Society of Thoracic Surgeons
Invited Commentary
Invited Commentary
Marvin Pomerantz, MD
General Thoracic Surgery Section, Division of Cardiothoracic Surgery, University of Colorado Health Sciences Center, 4200 E 9th Ave, #C310
See also page 220.
Doctor Massard and his colleagues should be complimented on their fine report on a disease process that should disappear by the law of natural attrition. This article most likely represents the last large series concerning long-term complications of extraperiosteal plombage therapy using translucent methyl methacrylate balls. It is perfectly clear that if any complication develops from this form of therapy, operation should be performed expeditiously. It is unreasonable to think that hemoptysis, chronic draining sinuses, or other complications will be cured by conservative management. I would question the routine use of thoracoplasty in these patients. Thoracoplasty can further add to pulmonary embarrassment, and possibly the insertion of muscle flaps to fill the space might be a better alternative in some of the patients. The recommendation of routine ablation of the material in patients without major operative risk might be a little strong. The use of computed tomography to observe movement or change in any manner of the plombage balls might be a way to follow up some of these patients. When there is significant movement or other changes, then I think it is reasonable to proceed with removal if the patient's general health is satisfactory. If there is juxtaposition of the plombage balls to a major vessel, surgical removal of the balls might prevent a catastrophic event.
Once again, this is an excellent article, which, in all likelihood, will be the last definitive report on this entity.
Related Article
-
Long-Term Complications of Extraperiosteal Plombage
- Gilbert Massard, Pascal Thomas, Pierre Barsotti, Pierre Riera, Roger Giudicelli, Eugène Reboud, Georges Morand, Pierre A. Fuentes, and Jean-Marie Wihlm
Ann. Thorac. Surg. 1997 64: 220-225.
[Abstract]
[Full Text]
