Novosti
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This journal is indexed in Scopus |
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Year 2015 Vol. 23 No 4
GENERAL & SPECIAL SURGERY
I.V. KORPUSENKO
THE RESULTS OF MINIMALLY INVASIVE SURGICAL TECHNIQUES IN TREATMENT OF PATIENTS WITH BILATERAL DESTRUCTIVE PULMONARY TUBERCULOSIS
SE "Dnepropetrovsk Medical Academy of the Ministry Health of Ukraine"
Ukraine
Objectives. To improve the surgical treatment efficacy in patients with bilateral destructive forms of pulmonary tuberculosis using new minimally invasive surgical techniques.
Methods. In the thoracic department of Dnepropetrovsk regional public clinical therapeutic and prophylactic association "Phthisiology" 259 clinical records of patients with bilateral destructive pulmonary tuberculosis treated in the period from 2008 up to 2013 have been studied. Patients were divided into 2 groups: the main group (n=129) – the patients who underwent minimally invasive surgery and the control group (n=130) those, who underwent standard surgical approach; 85 of them represented retrospective analysis of clinical records and 45 patients had contraindications for video-assisted surgeries (adhesive process in the pleural cavity). Each group was divided into 3 subgroups: the 1st – radical bilateral simultaneous and staged lung resection, the 2nd – single- or double-sided collapse surgery; the 3rd – patients with fibro-cavernous pulmonary tuberculosis who underwent pleuropneumonectomy.
Results. In minimally invasive interventions the intraoperative complications were occurred in 2 (1,6%) patients and in 7 (5,3%) patients – in the control group. The average postoperative blood and plasma loss in the main group was 394,2±18,7 ml which was 1,4 folds lower than similar indices in the control group 550,8±21,4 ml. Postoperative complications were registered in 13 (10,1%) of patients of the main group and in 32 (24,6%) – in control group. Postoperative mortality rate was 1 (0,8%) in the main group and 7 (5,4%) in the control group. As a result of the surgery and subsequent treatment the cessation of bacterial excretion and closure of cavernous lesions have been achieved in 113 (87,5%) patients of the main group compared with 82 (63,0 %) – in the control group.
Conclusion. The use of minimally invasive surgical techniques in patients with bilateral destructive pulmonary tuberculosis thought to be improved the clinical efficacy of treatment by 1,4 folds.
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49044, Ukraine, g. Dnepropetrovsk,
ul. Dzerzhinskogo, d. 9,
GU "Dnepropetrovskaya meditsinskaya akademiya
MZ Ukrainyi",
kafedra khirurgii ¹2,
tel.: + 38(056)31-22-72,
e-mail: korpus_i@hotmail.com,
Korpusenko Igor Vasilevich
Korpusenko I.V. PhD, an associate professor of the surgery chair ¹ 2 of SE "Dnepropetrovsk Medical Academy of the Ministry Health of Ukraine".
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