METHOD OF TREATING PRIMARY BRONCHUS STUMP WHEN PERFORMING PNEUMONECTOMY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to surgery, and can be used for treatment of primary bronchus stump when performing pneumonectomy. Essence of method lies in thoracotomy, exposing lung from adhesions, sewing of primary bronchus by sewing apparatus in distal part and its transaction at maximally possible distance from trachea in immediate proximity to lung, which is removed after that. Then by pulling long bronchus stump, region of trachea bifurcation is exposed from mediastinum, mediastinal lymph nodes are removed, peribronchial arteries are tied and transected over or at the level of bronchus orifice. 8-shaped suture is applied on membranous part and portion excision of bronchus stump from cartilage part of trachea bifurcation is performed by successive dissection of cranial and opposite walls of bronchus orifice on inter-cartilage segment between carina and first cartilage semicircle of stump with application of single retension sutures up to the middle of cartilage part of bronchus orifice, where 2-3 mm-wide bridge is left, on which separate retension sutures are applied. Ligatures are pulled, which gives bifurcation defect chink-shaped form, after which part of threads are tied on dorsal side, the remaining part of stump is cut off completely, non-through not more than 1 mm deep incision of distal trachea cartilage is performed on the formed line of trachea bifurcation cartilages kink. After that all remaining on dorsal side threads are tied, and from incision side, shock-absorbing interrupted suture is applied, which fixes deformation of respective bifurcation cartilage. Then threads are tied on ventral side of defect, pulled, exposing part of trachea from mediastinum, and contralateral lymph nodes are removed, threads are cut off, thoracic wound is sewn layer-by-layer.;EFFECT: minimising risk of developing insufficiency of primary bronchus stump and connected with it post-operation complications, ensuring reliable hemostasis of peribronchial arteries, reduction of probability of post-operation bleeding.;1 ex, 3 dwg