PAEDIATRIC SURGERY.UKRAINE.2018.4(61):51-54; doi 10.15574/PS.2018.61.51

Korpusenko I. V., Savenkov Y. F.
SE «Dnipropetrovsk Medical Academy of Health Ministry of Ukraine», Dnipro
Dnipropetrovsk Regional Communal Clinical Treatment and Prevention Association «Phthisiology», Dnipro, Ukraine

Objective: to improve surgical treatment efficiency in patients with limited bilateral destructive pulmonary tuberculosis.

Materials and methods. The outcomes of 80 simultaneous bilateral lung resections in patients with limited destructive tuberculosis were evaluated depending upon the types of surgical access which were as follows: video-assisted thoracic surgery (VATS) resection (28 patients), transsternal access (25), and routine thoracotomy (27 cases).

Results and conclusions. When performing simultaneous bilateral VATS resection, intraoperative blood loss decreased by 1.8 times as compared with the routine thoracotomy and 1.5 times as compared with the sternotomy. The risk of postoperative complications after VATS resection decreased by 1.6 times. The use of bilateral VATS resection may significantly reduce the surgical injury in comparison with traditional approaches, better visualise resection area due to the optical magnification and perform a more radical resection of a tuberculous lesion with meticulous haemo- and aerostasis, reduce lung tissue deformation.

Key words: destructive tuberculosis, simultaneous bilateral lung resection, videomonitoring.

References

1. Giller DB, Tokaev KV, Bagirov MA. (2006). Immediate results of videotorakoscopic and video-aspiratorocoscopic resections of the lungs and pneumonectomies in patients with pulmonary tuberculosis. Problemy tuberkuleza. 8: 38–42.

2. Duzhiy ІD, Kravets' OV. (2014). To surgical treatment regarding widespread drug-resistant pulmonary tuberculosis. Ukr. pul'monol. zhurnal. 1: 39.

3. Ivanov AV, Svintsov AE, Mokhirev AI. (2007). Simultaneous bilateral resection of the lungs from one-sided intercostal-mediastinal access in patients with tuberculosis. Tuberkulez v Rossii. Materialy VIII Ros. s’ezda ftiziatrov: 468–469.

4. Mel'nik VM, Novozhilova ІO, Matusevich VG, Prikhod'ko AM. (2014). The effectiveness of treatment of patients with multidrug-resistant tuberculosis in Ukraine. Analysis of official statements. Ukr. pul'monol. zhurnal. 2: 36–39.

5. Obremskaya OK, Opanasenko NS, Klimets EV. (2014). Features of preoperative preparation and postoperative management of pulmonary and fisiopatolygica patients with comorbidity. Ukr. pul'monol. zhurnal. 1: 57–58.

6. Porkhanov VA, Marchenko LG, Polyakov IS. (2002). Surgical treatment of bilateral pulmonary tuberculosis. Problemy tuberkuleza. 4: 22–25.

7. Abbo O, Guatta R, Pinnagoda K. (2014). Bilateral anterior sternothoracotomy (clamshell incision): a suitable alternative for bilateral lung sarcoma metastasis in children. World J Surg Oncol. 12: 144–149. https://doi.org/10.1186/1477-7819-12-233; PMid:25064077 PMCid:PMC4118191

8. Kilani T, Boudaya MS, Zribi H. (2015). Surgery for thoracic tuberculosis. Rev Pneumol Clin. 2–3: 140–158. https://doi.org/10.1016/j.pneumo.2014.03.005; PMid:24894967

9. Madansein R, Parida S, Padayatchi N. (2015). Surgical treatment of complications of pulmonary tuberculosis, including drug-resistant tuberculosis. Int J Infect Dis. 3: 61–67. https://doi.org/10.1016/j.ijid.2015.01.019; PMid:25809758

10. Roberts–Witteveen A, Reinten T, Christensen A. (2015). Multidrugresistant tuberculosisin New South Wales, Australia, 1999–2010: a case series report. Int J Tuberc Lung Dis. 19: 850–856. https://doi.org/10.5588/ijtld.14.0575; PMid:26056113

Article received: Jul 15, 2018. Accepted for publication: Nov 15, 2018.