[Surgical treatment of bronchopleural complications after lung resection and pleurectomy in patients with tuberculosis].

Autor:	Giller DB; Sechenov First Moscow State Medical University, Moscow, Russia., Kesaev OS; Sechenov First Moscow State Medical University, Moscow, Russia., Koroev VV; Sechenov First Moscow State Medical University, Moscow, Russia., Enilenis II; Sechenov First Moscow State Medical University, Moscow, Russia., Shcherbakova GV; Sechenov First Moscow State Medical University, Moscow, Russia., Romenko MA; Sechenov First Moscow State Medical University, Moscow, Russia., Ratobylsky GV; Sechenov First Moscow State Medical University, Moscow, Russia., Pekhtusov VA; Tambov Regional Clinical Tuberculosis Dispensary, Tambov, Russia., Martel II; Sechenov First Moscow State Medical University, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2021 (11), pp. 39-46.
DOI:	10.17116/hirurgia202111139
Abstrakt:	Objective: To increase an efficiency of surgical treatment of bronchopleural complications after lung resections and pleurectomies through the development of modern indications, treatment strategies, techniques and postoperative management. Material and Methods: We analyzed data in 252 patients with bronchopleural complications after lung resections and pleurectomies. The study included patients who underwent treatment at the Central Research Institute of Tuberculosis for the period 2004-2010, Clinical Hospital of Phthisiopulmonology of the Sechenov First Moscow State Medical University for the period 2011-2017 and Thoracic Center of the Republic of Ingushetia for the period 2015-2019. The study included patients with postoperative pleural empyema divided into two groups: group I - 138 patients with empyema and bronchial fistula; group II - 114 patients with empyema and no bronchial fistula. In the 1 st group, 1 patient had bronchial and esophageal fistulas. Results: At discharge, empyema and bronchial fistula were eliminated in 245 (97.2%) patients of both groups. Overall in-hospital mortality was 1.6% (4 cases). Two (1.4%) patients died within 30 days in group I and 1 (0.9%) patient died in group II. Within 90 days after surgery, another patient died from acute cerebrovascular accident in group I. In long-term period, overall effectiveness of treatment of bronchopleural complications was 97.2% (208 out of 214 cases). Conclusion: The original surgical approach for bronchopleural complications considers timing of postoperative empyema, its spread and duration. This method together with minimally invasive interventions reduces mortality and ensures stable recovery after bronchopleural complications in 97.2% of patients.
Databáze:	MEDLINE
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