Attinger B, Jaggi F, Haag M, Bilfinger T, Geroulanos S
Departement Chirurgie, Universitätsspital Zürich.
Schweiz Rundsch Med Prax. 1993 Apr 13;82(15):435-40.
In 1883 Krönlein resected a sarcoma of the ribs in an 18 year old female. Six months later he reoperated the patient for a local recurrency. At the second operation which necessitated a wide exposure of the thoracic cavity he deliberately removed a pulmonary metastasis about the size of a walnut. Two years later a new recurrence had to be resected. The three interventions led to a survival of 7 years. The patient succumbed to a further recurrence in 1890. Krönleins operation opened two new chapters in surgery, pulmonary interventions in general and in particular surgery of pulmonary metastasis. Surgery of lungs was not a topic of that era, particularly since some incisions for abscesses and resections of pulmonary parenchyma had not been successful. By limiting the indication to patients with sufficient pulmonary function and by following the successful pneumonectomy experiments in animals Krönlein favored pulmonary resection. The success of this intervention confirmed these considerations especially since it lasted for years. It was followed in 1885 by a pulmonary resection by G. Ruggi in Bologna. Surgery of the lung, however, came in general use only 50 years later.
1883年,克勒莱因切除了一名18岁女性的肋骨肉瘤。六个月后,他再次为该患者进行手术,以处理局部复发问题。在第二次手术中,由于需要广泛暴露胸腔,他特意切除了一个核桃大小的肺转移瘤。两年后,不得不再次切除新出现的复发肿瘤。这三次手术使患者存活了7年。该患者于1890年因进一步复发而死亡。克勒莱因的手术开创了外科手术的两个新篇章,即一般的肺部手术,尤其是肺转移瘤手术。肺部手术在那个时代并非热门话题,特别是因为一些用于治疗脓肿和切除肺实质的切口并不成功。通过将适应症限制于肺功能良好的患者,并借鉴动物实验中成功的肺切除术经验,克勒莱因倾向于进行肺切除术。这次手术的成功证实了这些考虑,尤其是因为患者存活了数年。1885年,博洛尼亚的G. 鲁吉进行了一次肺切除术。然而,肺部手术直到50年后才普遍应用。