Оne-staged bilateral pulmonary resection for tuberculosis

Keywords: pulmonary tuberculosis; one-staged bilateral pulmonary resection; minithoracotomy with videoassistance

Abstract

Objective: enhancement of efficacy of surgical treatment of bilateral pulmonary tuberculosis.

Маterials and methods. Results of operative treatment of 53 patients, suffering bilateral pulmonary tuberculosis, were analyzed. In 28 of them videoassisted thoracoscopic one-staged bilateral pulmonary resection (the main group), and in 25 – bilateral pulmonary resection, using transsternal access (comparison group), were done.

Results. While enhancement of operative access the blood loss have increased also. Positive trustworthy correlational connection between value of the blood loss and volume of exudation on the first day postoperatively was noted. In accordance to the data of studying of the external respiratory function indices in 2 mo postoperatively in patients of both groups a moderate disorder of the respiration biomechanics in accordance to type of isolated obstruction of peripheral respiratory ways, reduction of ratio and pulmonary vital capacity of the forced expiration volume during first second due to reduction of the pulmonary tissue volume were revealed. Bronchial passability on the level of maximal volume velocity was not changed. Total restoration of the external respiration function was noted in the main group only.

Conclusion. Application of video-assisted thoracoscopic pulmonary resection have permitted to reduce traumatism of the operative intervention, severity of  the external respiratory function disorders, the blood loss - in 1,5 times, the rate of postoperative morbidity in 1,6 times.

Author Biographies

І. V. Коrpusenko, Dnipropetrovsk Medical Academy, Dnipro

Korpusenko Igor Vasilevich, MD, PhD, associate professor
Department of the surgical chair № 2
Dnepropetrovsk Medical Academy
Volodymyr Vernadsky str., 9, Dnipro, Dnipropetrovsk region, 49000
(056) 713-52-57
korpus@optima.com.ua

Yu. F. Savenkov, Dnipropetrovsk Regional Clinic-Treatment Complex «Phthisiatry» of the Dnipropetrovsk Region, Dnipro

Savenkov Yuri Fedorovich, MD, PhD,  
Head Department of Pulmonary Surgery
Dnipropetrovsk Regional Clinical Therapeutic and Prophylactic
Bekhterev str., 12, Dnipro, Dnipropetrovsk region, 49000
(056) 753-44-33
dr.bakulin@gmail.com

References

1. Melnik VM, Novozhilova ІO, Matusevich VG, Prikhodko AM. The effectiveness of treatment of patients with multidrug-resistant tuberculosis in Ukraine. Analysis of official statements. Ukr pulmonol zhurnal. 2014;(2):36–9. [In Ukrainian].

2. Kilani T, Boudaya MS, Zribi H. Surgery for thoracic tuberculosis. Rev Pneumol Clin. 2015;(2–3):140–158. doi: 10.1016/j.pneumo.2014.03.005

3. Madansein R, Parida S, Padayatchi N. Surgical treatment of complications of pulmonary tuberculosis, including drug–resistant tuberculosis. Int J Infect Dis. 2015;(3):61–7. doi: 10.1016/j.ijid.2015.01.019.

4. Roberts-Witteveen A, Reinten T, Christensen A, Sintchenko V, Seale P, Lowbridge C. Multidrug-resistant tuberculosis in New South Wales, Australia, 1999-2010: a case series report. Int J Tuberc Lung Dis. 2015 Jul;19(7):850-6. doi: 10.5588/ijtld.14.0575.

5. Duzhiy ІD, Kravets OV. To surgical treatment regarding widespread drug-resistant pulmonary tuberculosis. Ukr pulmonol zhurnal. 2014;(1):39. [In Ukrainian].

6. Obremskaya OK, Opanasenko NS, Klimets EV. Features of preoperative preparation and postoperative management of pulmonary and fisiopatolygica patients with comorbidity. Ibid:57–8. [In Russian].

7. Ivanov AV, Svintsov AE, Mokhirev AI. Simultaneous bilateral resection of the lungs from one-sided intercostal-mediastinal access in patients with tuberculosis. Tuberkulez v Rossii. Materialy VIII Ros. s"ezda ftiziatrov. Moskva; 2007:468–9. [In Russian].

8. Porkhanov VA, Marchenko LG, Polyakov IS. Surgical treatment of bilateral pulmonary tuberculosis. Problemy tuberkuleza. 2002;(4):22–5. [In Russian].

9. Abbo O, Guatta R, Pinnagoda K. Bilateral anterior sternothoracotomy (clamshell incision): a suitable alternative for bilateral lung sarcoma metastasis in children. World J Surg Oncol. 2014;(12):144–9. doi.org/10.1186/1477-7819-12-233

10. Giller DB, Tokaev KV, Bagirov MA. Immediate results of videotorakoscopic and video-aspiratorocoscopic resections of the lungs and pneumonectomies in patients with pulmonary tuberculosis. Problemy tuberkuleza. 2006;(8):38–42. [In Russian].
Published
2018-01-28
Section
General Problems of Surgery