ANALYSIS OF RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH TUBERCULOUS PLEURAL EMPYEMA
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i1.11077Keywords:
tuberculosis, tuberculosis empyema, videothorcoscopy, video-assisted surgical resection, open pleurectomy with decortication of the lungsAbstract
The aim is to improve the results of minimally invasive surgical treatment of patients with tuberculous pleural empyema.
Material and Methods. A retrospective analysis of 685 cases of pleural tuberculosis in patients who underwent inpatient treatment in the Phthisiosurgical Unit of the Ternopil Regional TB Dispensary was conducted in the last 10 years. Necessary clinical, laboratory, and instrumental studies, including radiological and immunological examination methods, were performed for all patients.
Results and Discussion. The first in Ukraine analysis of the results of surgical treatment of patients with combined forms of pleural TB empyema with the use of standard diagnostic and surgical techniques is presented. The morphological features of stage, localization and diagnostics of pleural TB are analyzed depending on the gender, age, beginning, course and prevalence of suppuration. It is shown leading effect of pleural tuberculosis on the surgical treatment of patients with pleural TB empyema and ways will the improved surgical techniques for minimally invasive thoracic surgery (VTS, VATS) treatment.
Conclusions. The leading influence of the type of tuberculous lesion of the pleura on the operative treatment of patients with tuberculous pleural empyema and the ways of improvement of surgical methods to the minimally invasive thoracosurgical treatment are shown.
References
Ceimach, E.A. (2010). Empiema pleuri. Operativni metody lecheniya. Chast III [Empyema of pleura. Surgical treatment methods. Part III]. Tuberkuloz i bolezni legkikh – Tuberculosis and Lung Diseases, 2, 5-12 [in Russian].
Shipulin, P.P. (2010). Primeneniya raniy dekortikatsii legkogo v lechenii ostroy empiemy pleuri i nagnoivshegosya svernutogo gemotoraksa [The use of early videothoracoscopic lung decortication in the treatment of acute empyema of the pleura and suppurating clotted hemothorax]. Кlinichna khirurhiia – Clinical Surgery, 10, 29-31 [in Russian].
Kariev, T.M., & Sabirov, Sh.Y. (2010). Efektivnost pleurektomii pri tuberkuloznoy empieme pleury [The effectiveness of pleurectomy in tuberculous pleural empyema]. Tuberkulos i bolezni legkikh – Tuberculosis and Lung Diseases, 12, 29-30 [in Russian].
Opanasenko, M.S., Shalahay, S.M., & Klymets, E.V. (2017). Endoskopichni metody likuvannia pidhostrykh i khronichnykh zapalnykh zakhvoriuvan pleury [Endoscopic methods of treatment of subacute and chronic inflammatory diseases of the pleura]. Кlinichna khirurhiia – Clinical Surgery, 1, 39-42 [in Ukrainian].
Duzhii, I.D. (Ed). (2016). Pytannia epidemiolohii empiemy pleury [Issues of epidemiology of pleural empyema]. Ukrainskyi pulmonolohichnyi zhurnal – Ukrainian Pulmonogy Journal, 3, 60-63 [in Ukrainian].
Severgin, V.E. (Ed). (2011). Primineniya endobronkhialnogo rezinevogo klapana "Medlung" u patsientov s khronicheskoy empiemoy pleury i bronkhopleuralnimi svizhami [The use of the Medlung endobronchial rubber valve in a patient with chronic pleural empyema and bronchopleural fistula]. Кlinichna khirurhiia – Clinical Surgery, 4, 71-72 [in Ukrainian].
Opanasenko, M.S., Shalahai, S.M., & Klymets, E.V. (2017). Obhruntuvannia efektyvnosti vykorystannia videoasystovanoho dostupu v khirurhii zapalnykh protsesiv pleury [Substantiation of the efficiency of the use of video-assisted access in surgery of inflammatory processes of the pleura]. Кlinichna khirurhiia – Clinical Surgery, 7, 37-40 [in Ukrainian].
Danielyan, Zh.N. (Ed). (2012). Khirurgicheskoe lechenie posttravmaticheskoy empiemy pleuri [Surgical treatment of post-traumatic pleural empyema]. Khirurgiya imeni N.I. Grekova – Surgery named after N.I. Grekov, 3, 4-10 [in Russian].
Simonets, E.N., Makarov, V.V., & Zhkurat, A.N. (2012). Profilaktika gnoyno-vospalitelnykh oslozhneniy grudnoy stinky u bolnikh s ostroy empiemoy pleury [Prevention of purulent-inflammatory complications of the chest wall in patients with acute pleural empyema]. Zaporozhkiy med. zhurn. – Zaporozhian Medical Jornal, 6, 38-41 [in Ukrainian].
Boyko, V.V., (Ed). (2012). Lechebnaya taktika u bolnykh s mnogokamernoy empiemoy pleury [Therapeutic tactics in patients with multichamber pleural empyema]. Visnyk nevidkladnoi i vidnovnoi medytsyny – Bulletin of emergency and Recovery Medicine, 13, 3, 327-330 [in Ukrainian].
Zharov, Y.K. (Ed). (2013). Empyema necessitates. Khirurhiia imeni N. I. Hrekova – Surgery named after N.I. Hrekov, 172, 2, 57-59.
Subotic, D., Yablonskiy, P., & Sulis, G. (2016). Surgery and pleuro-pulmonary tuberculosis: a scientific literature review. J. Thorac. Dis., 8 (7), E474-E485. DOI: https://doi.org/10.21037/jtd.2016.05.59
Porcel, J.M. (2009). Tuberculous pleural effusion. Lung, 187, 263-70. DOI: https://doi.org/10.1007/s00408-009-9165-3
Ruan, S.Y., Chuang, Y.C., & Wang, J.Y. (2012). Revisiting tuberculous pleurisy: pleural fluid characteristics and diagnostic yield of mycobacterial culture in an endemic area. Thorax, 67, 822-827. DOI: https://doi.org/10.1136/thoraxjnl-2011-201363
Subotic, D., Lardines, D., & Hojski, A. (2018). Minimally invasive thoracic surgery for empyema. Breathe December, 14 (4), 302-319. DOI: https://doi.org/10.1183/20734735.025718
Baumann, M.H., Nolan, R., & Petrini, M. (2007). Pleural tuberculosis in the United States: incidence and drug resistance. Chest, 131, 1125-1132. DOI: https://doi.org/10.1378/chest.06-2352
