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Khirurgii

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Year 2019 Vol. 27 No 4

CASE REPORTS

E.V. KRASNIKOVA, L.A. POPOVA, R.V. TARASOV, V.K. ALIEV, JU.V. TUROVTñEVA, À.S. IBRIEV, S.S. SADOVNIKOVA, M.A. BAGIROV

A ÑASE OF BILATERAL SILICONE PLOMBAGE AND VALVE BRONCHOBLOCATION IN A PATIENT WITH WIDESPREAD FIBRO-CAVERNOUS DRUG RESISTANT TUBERCULOSIS OF THE OPERATED LUNG

Central Tuberculosis Research Institute, Moscow,
The Russian Federation

A case report describes a patient with chronic bilateral drug resistant lung tuberculosis, who had previously undergone an ineffective resection of one lung. For the first time bilateral extrapleural pneumolysis surgery with silicone plombage has been performed. From the side of the operated lung the effect of collapse was boosted by installation of an endobronchial valve. This case demonstrates a typical situation of chronization of the destructive process due to a long-term treatment without taking into account the data of drug sensitivity of mycobacterium tuberculosis and performing surgery without combination with adequate chemotherapy. Resection surgery is ineffective due to the limitation of functional reserves of the patient. The combination of collapse-forming surgical and endoscopic techniques aimed to form compression and artificial atelectasis are being worked out contributing to the preservation of the entire volume of lung tissue and the healing of cavities. Traditional thoracoplasty is traumatic enough, especially in patients with low respiratory reserves and leads to a significant cosmetic damage. The clinic of Central Tuberculosis Research Institute has experience in performing effective and low-traumatic surgery of extrapleural silicone plombage. An indwelling silicone implant is not rejected by human body, provides a high compression effect and does not lead to cosmetic damage.
The use of the collapse-forming techniques led to clinical recovery of the patient, what was proved by the long-term examination data.

Keywords: tuberculosis, multidrug-resistant tuberculosis, collapse surgery, extrapleuralpneumolysis with silicone plombage, bilateral silicone plombage, operated lung
p. 461-468 of the original issue
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Address for correspondence:
107564, The Russian Federation,
Moscow, Yauz Alley Str., 2,
Central Tuberculosis Research Institute,
Surgery Department.
Tel.mobile +7(916) 573-29-76,
e-mail: el.krasn@gmail.com,
Elena V. Krasnikova
Information about the authors:
Krasnikova Elena V., PhD, Senior Researcher of the Surgery Department, Head of the Operative Unit of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0002-5879-7062
Popova Lydi A., PhD, Senior Researcher of the Functional Diagnostic Unit of the Clinical-Diagnostic Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0003-4571-8772
Aliev Vilayat K., Junior Researcher of the Surgery Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0002-0105-1980
Tarasov Ruslan V., Laboratory Assistant Researcher of the Surgery Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0001-9498-1142
Turovtceva Julia V., Physician of the Endoscopy Unit of the Clinical Diagnostic Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0002-7943-7285
Ibriev Adam S., Physician of the First Surgery Unit of the Surgical Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0002-9712-4442
Sadovnikova Svetlana S., MD, Head of the First Surgery Unit of the Surgical Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0002-6589-2834
Bagirov Mamed A., MD, Professor, Head of the Surgical Department of Central Tuberculosis Research Institute, Moscow, Russian Federation.
https://orcid.org/0000-0001-9788-1024
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