The difficulties in diagnostics and treatment tactics of postresection tuberculous pleural empyema with bronchopleural fistula
Giller D.B., Kesaev O.SH., Koroev V.V., SHilova M.V., Ratobyl'skij G.V., Imagozhev YA.G., Nematov O.N., Shechter A.I.
Purpose. Surgeons all over the world think that bronchopleural complications are the main reason for the most part of insufficient and lethal outcomes of tuberculosis surgery treatment. Bronchopleural complications requires a complex, multi-stage surgical treatment. The main role in the choice of treatment tactics belongs to x-ray methods. Results. Authors offer a variant of a surgical tactic, based on preoperational x-ray diagnostic, which was used in cases of long presence postoperational tuberculosis empyema with bronchopleural fistula. Postoperational complications weren’t noticed after performing thoracomioplasty. Discussion. Postresectional empyema treatment, especially complicated with bronchopleural fistula, is a difficult problem for thoracic surgery. There are many ways to reduce postoperstional cavity and ‘close” bronchopleural fistula. However, all of them are highly traumatic and have a risk of intra- and postoperative complications. Conclusion. CT scans play a leading role in assessing the prevalence of the process and the choice of surgical treatment tactics. It allows to evaluate the size and location of the cavity, the degree of rigidity of the chest and lung by the thickness of fibrous layers, determine the presence of bronchopleural communication by the presence of air in the residual cavity. |
1- I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia. 2- National Medical Research Center of Phthisiopulmonology and Infectious Diseases. Moscow, Russia. 3- Republican Center of Phthisiopulmonology. Republic of Ingushetia, Russia. 4- Republican Specialized Scientific and Practical Medical Center of Phthisiology and Pulmonology of the Ministry of Health. Republic of Uzbekistan. |
Keywords: tuberculosis, pleural empyema, VATS, pleurectomy.
Corresponding author: Giller D.B., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Giller D.B., Kesaev O.SH., Koroev V.V., SHilova M.V., Ratobyl'skij G.V., Imagozhev YA.G., Nematov O.N., Shechter A.I. The difficulties in diagnostics and treatment tactics of postresection tuberculous pleural empyema with bronchopleural fistula. REJR 2019; 9(3):209-214. DOI:10.21569/2222-7415-2019-9-3-209-214.
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Received: 01.07.19 Accepted: 22.08.19