Novosti
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This journal is indexed in Scopus |
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Year 2015 Vol. 23 No 1
GENERAL AND SPECIAL SURGERY
I.V. KORPUSENKO
APPLICATION OF MINIMALLY INVASIVE EXTAPLEURAL THORACOPLASTY IN PATIENTS WITH BILATERAL TUBERCULOSIS OF THE LUNGS
SE "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine"
Objectives. Increasing of surgical treatment effectiveness in patients with bilateral destructive forms of the pulmonary tuberculosis on the basis of new minimally invasive methods of surgical treatment using video-assisted thoracoscopic support.
Methods. 66 patients with bilateral pulmonary tuberculosis have been operated on (2008-2013 yrs.) in the thoracic unit of Dnepropetrovsk regional municipal clinical therapeutic and preventive association «Phthisiatry”. Patients were divided into 2 groups: the main group (34), who underwent video-assisted extrapleural medical thoracoplasty with collagen sealing and control group (32), who underwent classical extrapleural thoracoplasty by Zauerbruch – Bohush technique.
Results. Application of video-assisted extrapleural medical thoracoplasty with collagen sealing lets to reduce the volume of blood loss by 1,6 folds, amount of exudate in the first day of the postoperative period by 2,3 folds, and to decrease quantity of postoperative complications by 2,5 folds. On the basis of spirography, carried out 60 days after, dynamics of the external respiratory function parameters, performed after minimally invasive extrapleural thoracoplasty, showed the best results caused to a significantly lower respiratory biomechanics changes proportional to the volume of thoracoplasty.
Conclusion. The application of video-assisted extrapleural thoracoplasty with collagen sealing permits to abandon the traumatic access in connection with the visualization of the operating field videothoracoscopically. Fixation of the apex of the lung and tight sealing of the subscapular space with collagen provides the selective collapse of caverns within the resected ribs and prevents reexpansion of the lung apex. In applying video-assisted extrapleural thoracoplasty, biomechanics of respiratory system is disturbed to a much lesser extent.
- Ots ON, Agkatsev TV, Perel'man MI. Khirurgicheskoe lechenie tuberkuleza legkikh pri ustoichivosti mikobakterii k khimiopreparatam [Surgical treatment of pulmonary tuberculosis with mycobacterial resistance to chemotherapeutic drugs]. Problemy Tuberkuleza i Boleznei Legkikh . 2009;(2):42-49.
- Petrenko VM, Cheren'ko SO, Litvinenko NA, Ivankova OV, Tarasenko OR. Tuberkul'oz 13 rozshirenoiu rezistentnostiu do protituberkul'oznikh preparatov: situatsiia v Ukraine [13 tuberculosis enhanced resistance to antituberculosis drugs: situation in Ukraine]. Ukr Pul'monol Zhurn. 2007; (3):35-39.
- Kim HJ, Kang CH, Kim YT, Sung SW, Kim JH, Lee SM, Yoo CG, Lee CT, Kim YW, Han SK, Shim YS, Yim JJ. Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis. Eur Respir J. 2006 Sep;28(3):576-80.
- Shiraishi Y, Katsuragi N, Kita H, Tominaga Y, Kariatsumari K, Onda T. Aggressive surgical treatment of multidrug-resistant tuberculosis. J Thorac Cardiovasc Surg. 2009 Nov;138(5):1180-84.
- Takeda S, Maeda H, Hayakawa M, Sawabata N, Maekura R. Current surgical intervention for pulmonary tuberculosis. Ann Thorac Surg. 2005 Mar;79(3):959-63.
- Feshchenko IuІ. Stan nadannia ftizіatrichnoї dopomogi naselenniu Ukraїni [The situation with TB care in Ukraine]. Ukr Pul'monol Zhurn. 2008;(3):5-8.
- Duzhii ІD, Gres'ko ІIa, Madiar VV. Ekstraplevral'na torakoplastika – al'ternativne operativne vtruchannia pri poshirenomu tuberkul'ozі legen' [Extrapleural thoracoplasty - an alternative to surgery in advanced pulmonary tuberculosis]. Kharkіvs'ka Khіrurg Shkola. 2010;6.1(45):S.97-100.
- Duzhii І.D. Ekstraplevral'na torakoplastika ta її mіstse v umovakh epіdemії tuberkul'ozu [Extrapleural thoracoplasty and its role in epidemic conditions of tuberculosis]. Klіnіch Khіrurgіia. 2003;(8):38-40.
- Porkhanov VO, Marchenko LG. Khirurgicheskoe lechenie dvustoronnikh form tuberkuleza legkikh [Surgical treatment of bilateral pulmonary tuberculosis]. Problemy Tuberkuleza.2002;(4):22-25.
- Repin IuM. Lekarstvenno – ustoichivyi tuberkulez legkikh: khirurgicheskoe lechenie [Drug - resistant pulmonary tuberculosis: surgical treatment]. Saint-Petersburg, RF: Gippokrat; 2007.168 p.
- Asanov BM, Giller DB, Iangolenko DV, Slobodin DG. Ekstraplevral'nyi selektivnyi ballonnyi kollaps legkogo – novyi metod khirurgicheskogo lecheniia rasprostranennogo destruktivnogo tuberkuleza legkikh [Extrapleural selective balloon collapsed of lungs - a new method of surgical treatment of advanced destructive pulmonary tuberculosis]. Tuberkulez i Bolezni Legkikh. 2011;(4):40-41.
- Giller DB. Miniinvazivnye dostupy s ispol'zovaniem endoskopicheskoi tekhniki v torakal'noi khirurgii [Minimally invasive access using endoscopic techniques in thoracic surgery]. Khirurgiia. 2009;(8):21-28.
- Porkhanov VO, Grebennikov SV, Marchenko LG, Poliakov IS, Mova VS. Khirurgicheskoe lechenie dvukhstoronnikh form tuberkuleza legkikh [Surgical treatment of bilateral pulmonary tuberculosis]. Problemy Tuberkuleza. 1998;(1):36-39.
- Bakulіn PЄ, Savenkov IuF. Pat. 31430. Ukraїna, MPK A61V17/22. Sposіb torakoplastiki [A method of thoracoplasty]/ № u200713193; zaiavl. 27.11.07; opubl. 10.04.08, Biul. №17.
49044, Ukraina,
g. Dnepropetrovsk, ul. Dzerzhinskogo, d. 9,
GU "Dnepropetrovskaya meditsinskaya akademiya MZ Ukrainyi," kafedra khirurgii № 2,
Tel.: 38(056)31-22-72,
e-mail: korpus_i@hotmail.com,
Korpusenko Igor Vasilevich
Korpusenko I.V. PhD, an associate professor of the surgical chair № 2 of SE "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine".
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