ABSTRACT
Videothoracoscopy constitute a secure miniinvasive method of diagnosis of intrathoracic lymphadenopathy syndrome. Pulmonary hemorrhage and injury constitute intraoperative videothoracoscopic complications, and pulmonary collapse, hemorrhage, purulent complications postoperative complications. Satisfactory intraoperative visualization, guaranteeing optimal position of the patient's body on operative table and sufficient pulmonary collapse on the intervention side, application of medical аlphacyanacrylate adhesive with hemostatic sponge for hemostasis in a biopsy zone, systemic application of antibiotics constitute the main prophylactic methods for videothoracoscopic complications and optimization of conditions for videothoracoscopic biopsy of intrathoracic lymphatic nodes. Application of the methods proposed have permitted to reduce the intraoperative complications rate from 19.2 tо 2.8%, and a postoperative one from 23 tо 2.8%.
Subject(s)
AIDS-Related Complex/surgery , Biopsy/adverse effects , Hemorrhage/prevention & control , Lymph Nodes/surgery , Thoracic Surgery, Video-Assisted/methods , AIDS-Related Complex/drug therapy , AIDS-Related Complex/pathology , Adult , Anti-Bacterial Agents/therapeutic use , Biopsy/instrumentation , Biopsy/methods , Bucrylate/therapeutic use , Female , Hemorrhage/physiopathology , Humans , Intraoperative Complications/prevention & control , Lung/blood supply , Lung/pathology , Lung/surgery , Lymph Nodes/blood supply , Lymph Nodes/pathology , Male , Middle Aged , Postoperative Complications/prevention & control , Retrospective Studies , Thoracic Surgery, Video-Assisted/instrumentation , Thorax/blood supply , Thorax/pathology , Tissue Adhesives/therapeutic useABSTRACT
Enhancement of rate of the intrathoracic lymphadenopathy syndrome (ILS) revealing have caused a necessity to find out the informative, secure and miniinvasive method of its diagnosis. There was established, that sensitivity, specificity and accuracy of videothoracoscopic (VTS) biopsy of intrathoracic lymph nodes (ILN) have constituted, accordingly, 96.0, 98.1 and 97.1%, and of videoassisted thoracoscopy (VATS) - 93.8, 93.6 and 93.5%. Low frequency of intraoperative and postoperative complications (accordingly 4.4 and 7.7%), small intraoperative blood loss (29 ml), short duration of operative intervention (45 min), rapid rehabilitation of patients postoperatively (10.6 days) witnesses about expediency of application of a VTS biopsy and VATS as a safe and miniinvasive procedures in ILS.
Subject(s)
Blood Loss, Surgical/prevention & control , Lymph Nodes/surgery , Lymphatic Diseases/diagnosis , Postoperative Complications , Thoracic Surgery, Video-Assisted/methods , Adult , Female , Humans , Lymph Nodes/pathology , Lymphatic Diseases/pathology , Lymphatic Diseases/surgery , Male , Middle Aged , Postoperative Period , Syndrome , Time FactorsABSTRACT
During 2006-2012 years different types of parietal pleurectomy (PE) with lung decortication (LD) were performed for 135 patients. Among them: 42 (31.1%)--had standart PE with LD (with performing usual thoracotomy); 34 (25.2%)--had video-assisted thoracic surgery (VATS) PE with LD; 36 (26.7%)--videothoracoscopy (VTS) PE with LD; 23 (17.0%)--standart PE with LD combined with lung resection. Common effectiveness of surgical treatment was 96.3%, mortality level--1.5%, postoperative complication level--8.9%. On the early stage of pleural diseases VATS PE with LD and VTS PE with LD are more preferable. To unclear and difficult cases for performing standart PE with LD we consider that operation should begin by VTS pleural space investigation. In some cases minithoracotomy is possible with performing VATS PE with LD or standart PE with LD (performing usual thoracotomy).
