Novosti
Khirurgii

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Year 2019 Vol. 27 No 3

GENERAL & SPECIAL SURGERY

S.A. BELOV 1, A.A. GRIGORYUK 2

INFLUENCE OF THORACOPLASTY ON THE EXTERNAL RESPIRATORY FUNCTION

Seaside Regional Antituberculous Dispensary 1,
Pacific State Medical University 2, Vladivostok,
The Russian Federation

Objective. To evaluate the function of external respiration after thoracoplasty using the polypropylene mesh.
Methods. 42 cases of collapse surgical treatment of fibrous-cavernous pulmonary tuberculosis were studied. Patients were divided into 2 groups. The 1st group (n=21) – patients who were performed the author’s method of extrapleural upper-posterior thoracoplasty using the mesh «Surgipro» implant; the 2nd group (n=21) – patients who underwent traditional extrapleural upper-posterior thoracoplasty. The function of external respiration, perfusion of the lungs, dead space ratio and efficiency of surgical method were compared.
Results. Pre-surgery spirographic study revealed the violation of the external respiration function in all patients. There was a change in the gas composition of the blood and ventilation-perfusion relations on the first day after the intervention in both groups. In the second group, there was a significant decrease in lung capacity, forced expiratory volume, the percentage of arterial blood oxygen saturation (p<0.05) and the development of respiratory and metabolic acidosis. In the first group, thoracoplasty using the mesh implant «Surgipro» revealed no violation of the ventilation-perfusion balance and a significant decrease in external respiration compared to the original figures (p>0.05). Clinical and x-ray examination of patients three weeks after the operation indicates that in the group with the use of polypropylene mesh, the occurrence of complications and the preservation of bacterial excretion is much lower. The developed method of extrapleural upper-posterior thoracoplasty using a mesh polypropylene implant can solve the problem of chest reconstruction, reduces the risk of paradoxical breathing and increases the degree of compression necessary to close the defects in the lungs.
Conclusions. Breach of the skeleton of the chest lowers the release of carbon dioxide from the body. The use of the mesh implant in the formation of a new pleural dome reduces the coefficient of dead space and prevents the development of the respiratory imbalance.

Keywords: pulmonary tuberculosis, external respiration, thoracoplasty, polypropylene mesh, implant
p. 264-268 of the original issue
References
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Address for correspondence:
690041, The Russian Federation,
Vladivostok, Pyatnadtsataya Str., 2,
Seaside Regional Antituberculous Dispensary,
4th Pulmonary Surgical Department.
Tel. mobile: +7 914 734-35-74,
e-mail: sur_belove@mail.ru,
Sergei A. Belov
Information about the authors:
Belov Sergei A., PhD, Thoracic Surgeon, 4th Pulmonary Surgical Department, Seaside Regional Antituberculous Dispensary, Vladivostok, Russian Federation.
http://orcid.org/0000-0001-5325-2891
Grigoryuk Alexandr A., PhD, Associate Professor, Institute of Surgery, Pacific State Medical University, Vladivostok, Russian Federation.
http://orcid.org/0000-0002-7957-5872
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