Eoentj-six patielits imdenveiit pleirral decortication for chronic enipjenin. All had a conipirted tonigraplij scan of the chest showing 110 marked parencliyiiial destrirctioii. Miiltiple srrbpleirral linear densities perpendicirlar to the pleirra were seeii to varioirs degrees and the siriii of the areas of these densities ivns einlirated for each patient. Tlie thickness of visceral aiid parietal pleura, nodirlarity of the enipjenia wall, preseiice of calcijcation, and hoiiiogeiieity of the inner-content of the eiiipjeiiia were assessed. Tlie degree of liriig reexpansion ivas qiraritijed frorii the ratio of the aerated areas of the afected and irnc;ffected lirrigs on postoperative chest radiography. Sirccessjirl lung ree-xpansion ;vas achieiied in 23 patients. Tlie 3 patierits in ivhorii Iiurg reexpansion failed required a subsequent 1"ieirnioiiecronij. Tlie thickriess of extrapleirral fat arid the siriii of the areas of sirbpleirral linear densities were signijcnntlj higher in these 3 patieiits.In the sirccessjrl decortication gr-airp, the degree of lirrig r-eexpansioii correlated with the sirin of siibpleirral h e a r densities arid with a iioted honiogeiieity of the iniier coiiterit of the enipjenia. Coniputed toniographj appeared to be irsejrl iii deterininiiig the appropriate sirr-gical nietliod of treating cliroiiic enipjenia. A m 1997;5:220-226) Compared to a planned pleuropneumonectomy, pneumonectomy after failure of decortication surgery requires
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