Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2015 Vol. 23 No 4

GENERAL & SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2015.4.398   |  

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 394,218,7 ml which was 1,4 folds lower than similar indices in the control group 550,821,4 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.

Keywords: bilateral pulmonary tuberculosis, video-assisted thoracoscopic surgery, minimally invasive method, clinical efficacy, complications, lethality
p. 398-405 of the original issue
References
  1. Ots ON, Agkatsev TV, Perel'man MI. Khirurgicheskoe lechenie tuberkuleza legkikh pri ustoichivosti mikobakterii k khimiopreparatam [Surgical treatment of pulmonary tuberculosis in the drug resistance of mycobacteria]. Problemy Tuberkuleza i Boleznei Legkikh. 2009;(2):42-49.
  2. Petrenko VM, Cheren'ko SO, Litvinenko NA, 1vankova OV, Tarasenko OR. Tuberkul'oz z rozshirenoiu rezistentnstiu do protitubekul'oznikh preparatv: situatsia v Ukran [Tuberculosis with enhanced resistance to anti-TB drugs, the situation in Ukraine]. Ukr Pul'monol Zhurn. 2007;(3):35-39.
  3. Kim HJ, Kang CH, Kim YT, Sung SW, Kim JH, Lee SM, Yoo CG, Lee CT, Kim YW, Han SK, Shim YS, Yim JJ. Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis. Eur Respir J. 2006 Sep;28(3):576-80.
  4. Shiraishi Y, Katsuragi N, Kita H, Tominaga Y, Kariatsumari K, Onda T.Aggressive surgical treatment of multidrug-resistant tuberculosis. J Thorac Cardiovasc Surg. 2009 Nov;138(5):1180-4. doi: 10.1016/j.jtcvs.2009.07.018.
  5. Takeda S, Maeda H, Hayakawa M, Sawabata N, Maekura R.Current surgical intervention for pulmonary tuberculosis. Ann Thorac Surg. 2005 Mar;79(3):959-63.
  6. Feshchenko Iu. Stan nadannia ftizatrichno dopomogi naselenniu Ukrani [The situation with tuberculosis care in Ukraine]. Ukr Pul'monol Zhurn. 2008;(3):7-9.
  7. Duzhii D, Gres'ko Ia, Madiar VV. Ekstraplevral'na torakoplastika al'ternativne operativne vtruchannia pri poshirenomu tuberkul'oz legen' [Extrapleural thoracoplasty - surgery alternative in advanced pulmonary tuberculosis]. Kharkv Khrurg Shkola. 2010;6.1(45):97-100.
  8. Duzhii D. Ekstraplevral'na torakoplastika ta mstse v umovakh epdem tuberkul'ozu [Extrapleural thoracoplasty and its place in tuberculosis epidemy]. Klnch Khrurgia. 2003;(8):38-40.
  9. Porkhanov VA, Marchenko LG, Poliakov IS, Kononenko VB, Bodnia VN, Mezeria AL, Kovalenko AL, Mamelov MIu. Khirurgicheskoe lechenie dvustoronnikh form tuberkuleza legkikh [Surgical treatment of bilateral pulmonary tuberculosis]. Problemy Tuberkuleza. 2002;(4):22-25.
  10. Repin IuM. Lekarstvenno ustoichivyi tuberkulez legkikh: khirurgicheskoe lechenie [Multidrug resistant tuberculosis: a surgical treatment]. Saint-Petersburg, RF: Gippokrat. 2007. 168 p.
  11. Asanov BM, Giller DB, Iangolenko DV, Slobodin DG. Slobodin Ekstraplevral'nyi selektivnyi ballonnyi kollaps legkogo novyi metod khirurgicheskogo lecheniia rasprostranennogo destruktivnogo tuberkuleza legkikh [Extrapleural selective balloon collapsed lung - a new method for the surgical treatment of advanced destructive pulmonary tuberculosis]. Tuberkulez i Bolezni Legkikh. 2011;(4):40-41.
  12. Giller DB. Miniinvazivnye dostupy s ispol'zovaniem endoskopicheskoi tekhniki v torakal'noi khirurgii [Minimally invasive approaches with the use of endoscopic techniques in thoracic surgery]. Khirurgiia. 2009;(8):21-28.
  13. Porkhanov VA, Grebennikov SV, Marchenko LG, Mova VS, Poliakov IS. Khirurgicheskoe lechenie dvukhstoronnikh form tuberkuleza legkikh [Surgical treatment of bilateral pulmonary tuberculosis]. Problemy Tuberkuleza. 1998;(10):36-39.
Address for correspondence:
49044, Ukraine, g. Dnepropetrovsk,
ul. Dzerzhinskogo, d. 9,
GU "Dnepropetrovskaya meditsinskaya akademiya
MZ Ukrainyi",
kafedra khirurgii 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 surgery chair 2 of SE "Dnepropetrovsk Medical Academy of the Ministry Health of Ukraine".
Contacts | ©Vitebsk State Medical University, 2007