Evaluation of the results of applying the early installation of the bronchial valve, prolonged air leakage in the early postoperative period in patients with bullous emphysema

The material was collected in the course of a retrospective study of the medical documentation of the Department of thoracic surgery of the SBU NSO state Novosibirsk regional clinical hospital. During the period from 2009 to 2017, 140 patients with bullous lung emphysema were included in the study, who underwent bull excision or apparatus resection of the lung area and Subtotal parietal pleurectomy. The patients ' age ranged from 15 to 60 years and averaged 29.46 years(Me 27 (23.0;34.0)). At the same time, 108 patients, which accounted for more than 70% were patients aged 21 to 40 years, i.e. the most able-bodied age. One of the serious complications in the postoperative period was air leakage through pleural drains. Proposed and implemented in the practice of the surgical thoracic Department method of early (2-3 days postoperative) drug resistant patients with discharge air and the analysis of the results of this method in comparison with late (more than 3 days since the operation) bronchomalacia. To do this, patients were divided into 2 groups. The first group included 11 patients to whom the bronchoblocker was installed later than 3 days after the intervention. The second group included 21 patients who had the blocker installed on 2-3 days of the postoperative period. There were no statistically significant differences between the groups by age, sex, method of influence on the bullous-altered fragment of pulmonary tissue (p>0.05).

спонтанный пневмоторакс, эндоскопические методы лечения в торакальной хирургии, длительная утечка воздуха, бронхоблокация, spontaneous pneumothorax, endoscopic treatment of thoracic surgery, prolonged air leakage, bronchomalacia

1. Акопов А.Л., Агишев А.С. Видеоторакоскопическая костальная плеврэктомия при первичном и вторичном пневмотораксе//Хирургия. Журнал им. Н.И. Пирогова. 2012. (11). 15-18.

2. Восканян Э.А., Калашников А.В., Маршалкин С.М., Тулюбаев И.Н., Скрипко В.В. Лечебная тактика спонтанного пневмоторакса в общехирургическом стационаре//Лечебная национальный хирургический конгресс совместно с xx юбилейным съездом роэх 4-7 апреля 2017 Москва: Альманах Института хирургии им. А.В. Вишневского. 2017. (1). 1430.

3. Голомидов А.Н, Каракаш Д.М., Кондратюк Э.Р.Роль видеоторакоскопии в ургентной торакальной хирургии//Национальный хирургический конгресс совместно с xx юбилейным съездом роэх 4-7 апреля 2017. Москва: Альманах Института хирургии им. А.В. Вишневского. 2017. (1). 215-216.

4. Жестков К.Г., Поддубный В.В., Багателия З.А., Хадиков К.О. Скрипко Выбор метода облитерации плевральной полости при эмфиземе легких// Национальный хирургический конгресс совместно с xx юбилейным съездом роэх 4-7 апреля 2017. Москва: Альманах Института хирургии им. А.В. Вишневского. 2017. (1). 1503-1504.

5. Пландовский А.В. Выбор рациональной хирургический такткики у пациентов со спонтанным пнев-мотораксом//Военная медицина. 2012. (22). 90-94.

6. Погодина А.Н., Воскресенский О.В., Николаева Е.Б., Бармина Т.Г., Паршин В.В. Современные подходы к лечению спонтанного пневмоторакса и спонтанной эмфиземы средостения//Практическая пульмонология. 2011. (1). 45-51.

7. Blau MB, Weinlich M, Lauchart W, Piatek S, Walcher F. Air Repatriation With a Medium-sized Pneumothorax Without Thoracic Tube: A Special Case of a Repatriation Accompanied by an Experienced Surgeon. Air Med J. 2017. (5). 268-271.

8. Fernandes P, Lareiro S, Monteiro JP, Simoes Costa S, Rijo D, Vouga L, Miranda J, Guerra M. Surgical management of primary spontaneous pneumothorax: 11-years experience. Rev Port Cir Cardiotorac Vasc. 2016. (3-4). 119-124.

9. Gilbert CR, Toth JW, Osman U, ReedMF. Endobronchial valve placement as destination therapy for recurrent pneumothorax in the setting of advanced malignancy. Respir Care. 2015. (3). 46-8.

10. Huang Y, Huang H, Li Q, Browning RF, Parrish S, Turner JF Jr, Zarogoulidis K, Kougioumtzi I, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Courcoutsakis N, Madesis A, Diplaris K, Karaiskos T, Zarogoulidis P. Approach of the treatment for pneumothorax.J Thorac Dis. 2014. (Suppl 4). 416-20.

11. Keshishyan S, Revelo AE, Epelbaum O. Bronchoscopic management of prolonged air leak. J Thorac Dis. 2017. (Suppl 10). 1034-1046.

12. Okubo T, Kawada M, Suzuki Y, Kawarada Y, Kitashiro S, Okushiba S Successful Treatment of a Giant Emphysematous Bulla with Intracavity Drainage and Bronchial Occlusion in a Patient Receiving Home Oxygen Therapy]. Kyobu Geka. 2015. (6). 403-5.

13. Park CB, Moon MH, Jeon HW, Cho DG, Song SW, Won YD, Kim YH, Kim YD, Jeong SC, Kim KS, Choi SY. Does oxygen therapy increase the resolution rate of primary spontaneous pneumothorax? J Thorac Dis. 2017. (12). 5239-5243.

14. Parrish S, Browning RF, Turner JF Jr, Zarogoulidis K, Kougioumtzi I, Dryllis G, Kioumis I, Pitsiou G, Machairiotis N, Katsikogiannis N, Tsiouda T, Madesis A, Karaiskos T, Zarogoulidis P The role for medical thoracoscopy in pneumothorax.J Thorac Dis. 2014. (Suppl 4). 383-91.

15. Pompili C, Salati M, Brunelli A. Chest Tube Management after Surgery for Pneumothorax. Thorac Surg Clin. 2017. (1). 25-28.

16. Riber SS, Riber LP, Olesen WH, Licht PB. The influence of chest tube size and position in primary spontaneous pneumothorax. J Thorac Dis. 2017. (2). 327-332.