Year 2014 Vol. 22 No 6




ME The 9th City Clinical Hospital: 1,
SE Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov 2,
ME City Clinical Pathologoanatomic Bureau 3,
The Republic of Belarus

Objectives. To evaluate comparatively standard and original methods of the left atrium (LA) resection in pneumonectomy performed for the locally advanced lung cancer invading neighboring left atrium.
Methods. The study was performed in 32 adult cadavers. A comparison of LA wall areas excluded by vascular clamp in the application of traditional and developed ways of LA resection has been conducted.
Results. A new LA resection technique has been designed based on possibility of LA wall mobilization on the beating heart up to the mitral valve annulus by transection of fetal dorsal mesocardium remnant and dissection of the friable tissues between anterior wall of LA on the one side and pulmonary trunk and ascending aorta on the other. After the main stem bronchus and pulmonary artery transsection the vascular clamp should be applied to the approximated anterior and posterior walls of LA and located in transverse plane. One of the branches of the vascular clamp is placed along the vena cordis magna, the coronary sinus and the other is applied along the mobilization line limit of anterior wall. This technique has not accompanied by deformity of the orifice area of the opposite pulmonary veins. The worked out method permits to augment the exclusion area of the posterior wall of LA at the right sided pneumonectomy by 115,8% (on the average) and at the left sided - by 117,7% (on the average) in comparison with a standard method.
Conclusion. The developed technique of LA resection has the advantage of exclusion of a larger portion of the posterior LA wall compared to the conventional one that promotes security elevation and radicality of surgical intervention in cases of advanced lung carcinoma to the posterior wall of LA.
The designed method of the LA resection can be an alternative to its resection under conditions of the artificial blood circulation and thereby substantially reduce the cost of treatment.

Keywords: locally advanced lung cancer, left atrium, resection
p. 671-677 of the original issue
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Address for correspondence:
220116, Respublika Belarus,
g. Minsk, ul. Semashko, 8,
UO 9-ya gorodskaya klinicheskaya bolnitsa,
torakalnoe otdelenie,
tel. office: 375 17 376-81-28,
Yeskov Sergey Aleksandrovich
Information about the authors:
Yeskov S.A. A head of the thoracic department of ME The 9th City Clinical Hospital.
Zharkov V.V. MD, professor, a chief researcher of the thoracic oncopathology department with anesthesia group of SE Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N.Alexandrov.
Martynov Y.P. An intern of ME The 9th City Clinical Hospital.
Erokhov V.V. A surgeon of ME The 9th City Clinical Hospital.
Yudina O.A. PhD, an associate professor, a head of the general pathology department of ME City Clinical Pathologoanatomic Bureau.
Kashanski R.V. A pathologist of the general pathology department of ME City Clinical Pathologoanatomic Bureau.
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