METHOD OF SURGICAL MANAGEMENT OF PATIENTS WITH DESTRUCTIVE FORMS OF PULMONARY TUBERCULOSIS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to thoracic surgery, and aims at surgical management of the patients suffering destructive forms of pulmonary tuberculosis. Substance of the method involves performing intercostal thoracotomy, extrapleural and/or extrafascial separation of an affected portion of a lung, creating an extrapleural cavity and introducing into the extrapleural cavity of a selective controlled collapsed lung device. After operative wound closure, a balloon of said device is inflated with 1% dioxidine in amount 20-30 ml to ensure collapsed lung in a destruction area. It is combined with selective valvular bronchial blocking by intraoperative insertion of an endobronchial valve in segmental bronchial tubes so that orifice lumens of distal bronchial tubes are visible. The endobronchial valve dimensions are specified to exceed a bronchial lumen diametre in 1.2-1.5 times. After X-ray proved cicatrisation of the destruction area, at first a catheterised balloon is removed from the extrapleural cavity, and then the endobronchial valve is removed from the bronchial tube.;EFFECT: invention allows to reduce length of abacillation, provides destruction area closure, interrupted bacterial discharge, resorption of pericavital infiltration, as well as presents more efficient extrapleural collapsed lung.;1 ex, 5 dwg