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Khirurgii

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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.

Keywords: bilateral pulmonary tuberculosis, operative treatment, thoracoplasty, mini-access
p. 37-43 of the original issue
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Address for correspondence:
49044, Ukraina,
g. Dnepropetrovsk, ul. Dzerzhinskogo, d. 9,
GU "Dnepropetrovskaya meditsinskaya akademiya MZ Ukrainyi," kafedra khirurgii ¹ 2,
Tel.: 38(056)31-22-72,
e-mail: korpus_i@hotmail.com,
Korpusenko Igor Vasilevich
Information about the authors:
Korpusenko I.V. PhD, an associate professor of the surgical chair ¹ 2 of SE "Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine".
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