METHOD OF MEDIASTINAL LYMPHADENECTOMY DURING SURGICAL TREATMENT OF COMMON TYPES OF PULMONARY TUBERCULOSIS

摘要

FIELD: medicine.;SUBSTANCE: if the main destructive disease is completely localised in the left lung, pneumonectomy and lymphadenectomy are done for pretracheobronchial, subaortic, bifurcational, perioesophageal and lymph nodes of the pulmonary ligament. If the destructive disease is localised in parts of the lung, the parts are resected and lymphadenectomy of the corresponding groups of lymph nodes is done. If the destructive disease is in the upper part of the left lung, pretracheobronchial, subaortic and bifurcational nodes are removed, and if in the lower part of the left lung - bifurcational, perioesophageal and lymph nodes of the pulmonary ligament are removed. If the main destructive disease is completely localised in the right lung, pretracheobronchial, bifurcational, perioesophageal and lymph nodes of the pulmonary ligament are removed. If the upper part of the right lung is affected pretracheobronchial and bifurcational nodes are removed. If the middle part of the right lung is affected, bifurcational and perioesophageal nodes are removed. If the lower part of the right lung is affected bifurcational pretracheobronchial and lymph nodes of the pulmonary ligament are removed. During lymphadenectomy mediastinal pleura is dissected around the root of the lung on the transitory fold. Affected lymph nodes are bluntly and sharply separated from the surrounding cellular tissue at the boundary of their capsules. Blood and lymphatic vessels in the lymph node are tied up and transacted or destroyed through electrocoagulation. The lymph nodes are removed. After that the mediastinal pleura is tightly sewn above the bed of removed lymph nodes for better hemostasis. The pleural cavity is drained and the pleural incision is sewn layer-by-layer.;EFFECT: reduced postoperative complications, prevention of relapses of a specific process.;2 tbl, 2 ex