METHOD FOR RIGHT-SIDE PULMONECTOMY ACCOMPANIED WITH TRACHEAL BIFURCATION RESECTION IN PULMONARY CANCER CASES

摘要

FIELD: pulmonology. SUBSTANCE: first patient is subjected to complete median sternotomy, pulmonectomy and tracheal bifurcation resection, followed by opening pleural cavity by dissecting mediastinal pleura to separate left pulmonary artery from left main bronchus. Next entire bronchus is displaced into left pleural cavity and positioned in front of left pulmonary artery and aortic arch, followed by forming tracheobronchial anastomosis to the left or above aortic arch. Finally, left pulmonary ligament is cut out, followed by pulmonopexy of superior lobe of left lung to pleural cavity cupola. Proposed method makes it possible to surgically treat patients affected with pulmonary cancer in its central forms and right-side localization. Proposed procedure sharply decreases degree of tension in tracheobronchial anastomosis and fully rules out considerable inflexion of left main bronchus and left pulmonary artery, which are observed during surgical intervention by conventional methods and are often accompanied by further development of stenosis in anastomosis area, its incompetence, arrosion-caused hemorrhage and progressive pulmonary hypertension. EFFECT: method makes it possible to treat surgically cases considered hitherto inoperable; postoperative complications are greatly relieved or altogether ruled out.