Early thoracotomy and decortication for nontuberculous XXXX in adults with and without underlying disease. A twenty-five year review.

@entity1 @entity3509
The present review deals with 63 adult @entity1 having acute nontuberculous @entity3509 treated by early thoracotomy and decortication, during the period from 1955 through 1979. Group I (38 @entity1 ) had postpneumonic @entity3509 , but no underlying disease. Group II (25 @entity1 ) had acute @entity3509 and one or more serious associated diseases. Positive cultures were present in 45 of 63 @entity1 (71.4%). Most surgeons have customarily recommended conservative management, especially for @entity1 in Group II, because of the supposedly "high risk" involved in decortication. Consequently, the mortality is extremely high. The @entity3509 must be cured; a "well drained" or "controlled" @entity3509 will not suffice. The severely ill @entity1 can better withstand the ordeal of a major operation than the deleterious effects of a lingering @entity3509 . The critically ill @entity1 is best managed by the primary procedure of open thoracotomy and decortication. The author's experience confirms that such @entity1 can expect an outlook (8% mortality) approaching the zero mortality of Group I @entity1 .
