Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2018 Vol. 26 No 4

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

A.V. KALASHNIKOV 1, A.A. VOROBYEV 2, D.SH. SALIMOV 3, S.A. KALASHNIKOVA 1, S.SH. AIDAEVA 1

STIMULATION OF ADHESIOGENESIS IN CHRONIC PLEURAL EMPIEMA

Pyatigorsk Medical and Pharmaceutical Institute 1, Pyatigorsk
Volgograd State Medical University 2, Volgograd
Central Military Clinical Hospital named after P.V. Mandryk 3, Moscow,
The Russian Federation

Objective. To substantiate stimulation of adhesiogenesis in the treatment of chronic pleural empyema.
Methods. The results of stimulation of adhesiogenesis in the pleural cavity for the treatment of residual cavities against the background of chronic pleural empyema in 270 nonlinear white male rats divided into 3 groups of 90 animals in each were analyzed. Chronic pleural empyema followed by formation of a residual cavity was modeled by weekly intrapleural injection of 1 billion E. coli suspension during two months. In the control group, no treatment was performed. In the comparison group, doxycycline was administered intracavitary at a rate of 40 mg/kg of body weight, in the experimental group – intracavitary injection of platelet-rich plasma (PRP) was performed The effectiveness of treatment was assessed by changes in biochemical markers of endogenous intoxication, general microbial contamination of pleural exudate. When revising the residual cavity, its volume, intensity of adhesion, histopathography of pleural adhesions with subsequent histological examination were determined.
Results. It was established that stimulation of adhesion using PRP against the background of chronic pleural empyema significantly reduces the severity of endogenous intoxication (by 1.2 times). The number of microorganisms colonizing the pleural cavity in the rats of the experimental group was also significantly less than in the control group, but higher than in the rats of the comparison group. In the study of pleural adhesions in the rats of the experimental group on the 20th day, together with adhesions between the visceral and parietal pleura, multiple interlobar adhesions of different degree of maturity were determined. The technique of PRP injection proved to be more effective method of stimulating adhesion formation in the pleural cavity, so by the end of the experiment obliteration of residual cavities had been recorded in 41.1% of cases, the mature connective tissue was histologically determined.
Conclusions. The method of stimulating adhesiogenesis in the treatment of residual pleural cavities in case of chronic pleural empyema with the use of PRP is pathogenetically substantiated and effective.

Keywords: stimulation of adhesion, chronic pleural empyema, residual pleural cavity, PRP-therapy, pleural cavity adhesions, platelet-rich plasma, thoracic surgery
p. 412-420 of the original issue
References
  1. Sakakura N, Mizuno T, Kuroda H, Sakao Y, Uchida T. Surgical treatment of empyema after pulmonary resection using pedicle skeletal muscle plombage, thoracoplasty, and continuous cavity ablution procedures: a report on three cases. J Thorac Dis. 2016 Jun;8(6):1333-39. doi: 10.21037/jtd.2016.04.04
  2. Botianu PV, Botianu AM, Bacarea VC. Muscle flaps and thoracomyoplasty as a re-redo procedure for postoperative empyema. Thorac Cardiovasc Surg. 2016 Apr;64(3):252-57. doi: 10.1055/s-0034-1387820
  3. Zurek W, Makarewicz W, Bobowicz M, Sawicka W, Rzyman W. The treatment of chronic pleural empyema with laparoscopic omentoplasty. Initial report. Wideochir Inne Tech Maloinwazyjne. 2014 Dec;9(4):548-53. doi: 10.5114/wiitm.2014.45129
  4. Zhestkov KG, Barskii BG, Atiukov MA, Pichurov AA. Natsional’nye klinicheskie rekomendatsii po lecheniiu spontannogo pnevmotoraksa [Elektronnyi resurs]. Moskva, RF; 2014. 23 p. Available from: http://www.volgmed.ru/uploads/files/2013-10/23432-nacionalnye_klinicheskie_re-komendacii_po_diagnostike_i_lecheniyu_spontannogo_pnevmotoraksa_proekt_rossijskoe_obcshestvo_hirurgov.doc (in Russ.)
  5. MacDuff À, Arnold À, Harvey J. Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010. Thorax. 2010 Aug;65;2:ii18-31. doi: 10.1136/thx.2010.136986
  6. Song KS, Keum D, Kim JB. Chemical pleurodesis using doxycycline and viscum album extract. Korean J Thorac Cardiovasc Surg. 2017 Aug;50(4):281-86. doi: 10.5090/kjtcs.2017.50.4.281
  7. Thomas R, Piccolo F, Miller D, MacEachern PR, Chee AC, Huseini T, Yarmus L, Bhatnagar R, Lee HJ, Feller-Kopman D, Maskell NA, Tremblay A, Lee YCG. Intrapleural fibrinolysis for the treatment of indwelling pleural catheter-related symptomatic loculations: a multicenter observational study. Chest. 2015 Sep;148(3):746-51. doi: 10.1378/chest.14-2401
  8. Boshuizen RC, Vd Noort V, Burgers JA, Herder GJM, Hashemi SMS, Hiltermann TJN, Kunst PW, Stigt JA, van den Heuvel MM. A randomized controlled trial comparing indwelling pleural catheters with talc pleurodesis (NVALT-14). Lung Cancer. 2017 Jun;108:9-14. doi: 10.1016/j.lungcan.2017.01.019
  9. Akhmerov RR, Zarudii RF, Aminova ZM, Emelin AL, Ovechkina MV. Primenenie trombotsitarnoi autoplazmy pri lechenii gonartrozov i koksartrozov. Prakt Meditsina. 2013; (1-2-2):17-20. https://cyberleninka.ru/article/n/primenenie-trombotsitarnoy-autoplazmy-pri-lechenii-gonartrozov-i-koksartrozov (in Russ.)
  10. Fernández-Barbero JE, Galindo-Moreno P, Avila-Ortiz G, Caba O, Sánchez-Fernández E, Wang HL. Flow cytometric and morphological characterization of platelet-rich plasma gel. Clin Oral Implants Res. 2006 Dec;17(6):687-93. doi: 10.1111/j.1600-0501.2006.01179.x
  11. Jhang JF, Wu SY, Lin TY, Kuo HC. Repeated intravesical injections of platelet-rich plasma are effective in the treatment of interstitial cystitis: a case control pilot study. Low Urin Tract Symptoms. 2017 Dec 19. doi: 10.1111/luts.12212
  12. Cieslik-Bielecka A, Skowroński R, Jędrusik-Pawłowska M, Pierchała M. The application of L-PRP in AIDS patients with crural chronic ulcers: a pilot study. Adv Med Sci. 2017 Nov 6;63(1):140-46. doi: 10.1016/j.advms.2017.10.002
  13. Vorob’ev AA, Beburishvili A.G. Khirurgicheskaia anatomiia operirovannogo zhivota i laparoskospicheskaia khirurgiia spaek: monogr. Volgograd, RF: Izdatel’; 2001. 230 p. (in Russ.)
  14. Korymasov EA, Iablonskii PK, Sokolovich EG, Lishenko VV, Motus IIa, Skriabin SA. Natsional’nye klinicheskie rekomendatsii «Empiema plevry» [Elektronnyi resurs]. 2015. 33 s. Available from: http://zodorov.ru/nacionalenie-klinicheskie-rekomendacii-empiema-plevri-rabochay.html (in Russ.)
  15. Achkasov EE, Bezuglov EN, Ul’yanov AA, Kurshev VV, Repetyuk AD, Egorova ON. Application platelet-rich plasma in clinical practice. Biomeditsina. 2013. (4):46-59. https://cyberleninka.ru/article/n/primenenie-autoplazmy-obogaschennoy-trombotsitami-v-klinicheskoy-praktike (in Russ.)
Address for correspondence:
357532, The Russian Federation,
Pyatigorsk, Kalinin Ave., 11,
Pyatigorsk Medical and Pharmaceutical Institute,
Department of Morphology,
Tel.: +7 928-335-94-30,
e-mail: kalashnikova-sa@yandex.ru,
Svetlana A. Kalashnikova
Information about the authors:
Kalashnikov Anton V., PhD, Associate Professor, Acting Head of the Department of Surgical Disciplines, Pyatigorsk Medical and Pharmaceutical Institute, Branch of Volgograd State Medical University, Pyatigorsk, Russian Federation.
https://orcid.org/0000-0002-9801-5977
Salimov Dmitriy Sh., PhD, Surgeon, II Surgical Department of the General Surgery Center, Central Military Clinical Hospital named after PV. Mandryk, Moscow, Russian Federation.
http://orcid.org/0000-0001-8647-1505
Vorobyev Alexander A., MD, Professor, Head of the Department of Operative Surgery and Topographic Anatomy, Volgograd State Medical University, Volgograd, Russian Federation.
https://orcid.org/0000-0001-8378-0505
Kalashnikova Svetlana A., MD, Associate Professor, Head of the Department of Morphology, Pyatigorsk Medical and Pharmaceutical Institute, Branch of Volgograd State Medical University, Pyatigorsk, Russian Federation.
http://orcid.org/0000-0002-7688-9366
Aidaeva Salihat Sh., Postgraduate Student of the Department of Morphology, Pyatigorsk Medical and Pharmaceutical Institute, Branch of Volgograd State Medical University, Pyatigorsk, Russian Federation.
https://orcid.org/0000-0003-1216-4590
Contacts | ©Vitebsk State Medical University, 2007-2023