Novosti
Khirurgii
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Year 2011 Vol. 19 No 3

GENERAL AND SPECIAL SURGERY

HUDAYBERGENOV SH.N., PAKHOMOV G.L., HAYALIEV R.YA., IRISOV O.T., ESHONKHODZHAYEV O.D.

SURGICAL TACTICS IN PATIENTS WITH BRONсHOPLEURAL FISTULAS AFTER PNEUMONECTOMY

Objectives. To improve the treatment tactics of patients with bronchial fistulas after pneumonectomy.
Methods. The analysis of treatment results in 109 patients with bronchopleural fistulas after pneumonectomy was performed. Primary operations were carried out because of the ontological diseases in 79 (72,5%) cases; in the rest 30 cases (27,5%) - because of the purulent pulmonary diseases.
Results. The patients were divided into 3 groups. 35 patients composed the 1st group, to whom an active tactics of the surgical treatment was applied, that is after state stabilization of patients with purulent complications (thoracoscopy with the drainage) on average after 6,1±1,2 days, they underwent the surgical treatment of fistulas. In 31 patients a delaying surgical tactics was used; in 43 patients endoscopic techniques were used at bronchopleural fistulas (BPF) closure. Use of the active surgical tactics appeared to be the most justified, in 31 (88,6%) patients, good results were registered. Complications were registered in 4 (11,4%) patients, lethality – in 3 (8,6%) cases. Delaying tactics determined satisfactory results only in 21 (67,7%) patients and complicated course – in 10 (32,3%) with lethality in 5 (16,1%) cases. Efficacy of BPF bronchoscopic elimination composed 62, 8% only; lethality outcomes were registered in 5 (11%) cases.
Conclusions. The active surgical tactics is the most justified at the bronchial stump failure after pneumonectomy regardless of the character and the side of the lesion.

Keywords: pneumonectomy, bronchial stump failure, treatment tactics, omenoplastics, lethality
p. 57 – 62 of the original issue
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