Minimally invasive corrective thoracoplasty in surgical treatment of destructive pulmonary tuberculosis and pleural empyema

Authors

  • YU. F. SAVENKOV Kryvyi Rih Tuberculosis Dispensary of Dnipropetrovsk Regional Council, Dnipro
  • M. V. MOISEIENKO Kryvyi Rih Tuberculosis Dispensary of Dnipropetrovsk Regional Council, Dnipro
  • YU. F. KOSHAK I. Horbachevsky Ternopil National Medical University
  • P. E. BAKULIN Kryvyi Rih Tuberculosis Dispensary of Dnipropetrovsk Regional Council, Dnipro

DOI:

https://doi.org/10.11603/2414-4533.2023.4.14342

Keywords:

minimally invasive thoracoplasty, collapse surgery, destructive pulmonary tuberculosis, pleural empyema, hemithorax correction

Abstract

The aim of the work: to evaluate the results of the application of the developed technique of minimally invasive correction of post-resection hemithorax during the surgical treatment in patients with destructive pulmonary tuberculosis pleural empyema.

Materials and Methods. In the studied group, minimally invasive corrective thoracoplasty was performed on 14 patients with chronic destructive pulmonary tuberculosis 12–14 days after upper lobectomy (9 patients) and after polysegmental resections in 5 patients. The following criteria efficacy evaluation of the developed technique of minimally invasive correction of post-resection hemithorax have been established: a number of pleuropulmonary complications, in particular the presence of the residual pleural cavity and disease recurrences during the postoperative period.

Results and Discussion. When performing a minimally invasive corrective intervention, there is no need to exarticulate the heads of the ribs as the aim of this surgical operation is to create a new vault of the pleural dome with a non-paravertebral center and goes a little more laterally along the scapular line. This significantly reduces the consequent injury due to the surgical intervention. Performing all surgical manipulations under double visual control allows you to safely isolate the apex of the lung in the area of ​​the subclavian vessels and control the quality of hemostasis. The use of a polypropylene mesh with the size of 10 x 15 cm allows you to reliably fix the top of the lung at a new level and prevent it from overstretching. The use of collagen provides you an additional means of the lung apex fixation and fills the newly formed extrapulmonary space. There were no cases of residual pleural cavity or exacerbation of the tuberculosis process during the postoperative period.

References

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Published

2023-12-28

How to Cite

SAVENKOV, Y. F., MOISEIENKO, M. V., KOSHAK, Y. F., & BAKULIN, P. E. (2023). Minimally invasive corrective thoracoplasty in surgical treatment of destructive pulmonary tuberculosis and pleural empyema. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 19–22. https://doi.org/10.11603/2414-4533.2023.4.14342

Issue

No. 4 (2023)

Section

ORIGINAL INVESTIGATIONS

License

Copyright (c) 2023 Ю. Ф. САВЕНКОВ, М. В. МОІСЕЄНКО, Ю. Ф. КОШАК, П. Є. БАКУЛІН

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