Home

Aerostasis insufficiency of a machine stitch of a lung: prevention and treatment of complications

Written by Shapovalov A.S., Polezhaev A.A., Belov S.A.

  UDK: 616.24–089.819.84–06-084.454.1 | DOI: 10.17238/PmJ1609-1175.2019.2.84–87 | Pages: 84–87 | Full text PDF | Open PDF 

Annotation:

Objective: Aerostasis insufficiency of a stitch of a lung remains an unsolved problem of thoracic surgery. When residual air pockets resistant to the treatment and associated with aerostasis insufficiency occur it is rational to remove them with the apposition of visceral pleura to parietal or any other transposed tissue.
Methods: The effectiveness of methods of combined aerostasis was compared based on the results of surgical treatment of 227 thoracic patients (in 97.3 % – tuberculosis), aged from 18 to 65 y.o. The effectiveness of osteoplastic thoracoplasty with a mesh implant was studied based on the results of surgical treatment of 80 patients aged from 18 to 57 y.o.
Results: The combination of a machine stitch of a lung and additional seal with latex glue demonstrated the highest effectiveness. The worst efficiency was observed with additional strengthening of the machine stitch of the lung with manual stitch, at the same time, the use of glue in addition to the manual stitch led to more than double the daily aerostatic efficiency.
Conclusions: Additional processing of the lung resection line with latex glue to improve the effectiveness of aerostasis. Osteoplastic thoracoplasty with a mesh implant prevents the formation of pulmonary hernia, and also reduces the intensity and duration of pain in the postoperative period.

Links to authors:

A.S. Shapovalov1, A.A. Polezhaev2, S.A. Belov1
1 Primorskiy Regional Tuberculosis Dispensary (2 Pyatnadtsataya St. Vladivostok 690041 Russian Federation),
2 Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690002 Russian Federation)


1. Belov A.V. Profilaktika ostatochnoy plevralnoy polosti posle rezektsii legkogo // Kharkiv Surgical School. 2011. No. 2. P. 62–65.
2. Belov S.A., Panchoyan V.M., Bobyreva M.G. [et al.]. Sposob khirurgicheskogo lecheniya tuberkuleza legkikh: Patent Rossii No. 2469661. 2012. Bul. No. 35.
3. Zhestkov K.G., Vishnevsky A.A., Esakov Y.S. Modern methods of preventing insufficiency of aerostasis at resection of the lung // Practical Medicine. 2013. No. 2. P. 9–12.
4. Parshin V.D., Bazarov D.V., Popovich V.K., Dobrovol’skiĭ S.R. Lung volume reduction surgery in patients with diffuse emphysema: indications and the extent of resection // Khirurgia. 2009. No. 4. P. 4–11.
5. Savenkov Yu.F., Belov A.V., Korpusenko I.V. [et al.]. Korrektsiya gemitoraksa v khirurgii tuberkuleza legkikh // Surgery of Ukraine. 2011. No. 4. P. 48–52.
6. Ahmad M., Bilal A., Ullah K. [et al.]. Thoracoplasty, an experience of 513 cases over 12 years period in a developing country // Pakistan Journal of Chest Medicine. 2014. Vol. 20, No. 3. P. 95–98.
7. Ang K., Olland A., Massard G. Management of residual pleural space // Perspectives in Cardiothoracic Surgery: The SCTS-Ionescu University, Vol. 1 / Ed. by P. Modi. London, 2016. P. 131–137.
8. Brunelli A., Xiume F., Al Refai M. [et al.]. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complications: a case-matched analysis // Chest. 2006. Vol. 130, No. 4. P. 1150–1156.
9. Burt B.M., Shrager J.B. The prevention and management of air leaks following pulmonary resection // Thoracic Surgery Clinics. 2015. Vol. 25, No. 4. P. 411–419.
10. Cerfolio R.J., Bryant A.S. The benefits of continuous and digital air leak assessment after elective pulmonary resection: a prospective study // Ann. Thorac. Surg. 2008. Vol. 86, No. 2. P. 396–401.
11. Drewbrook C., Das S., Mousadoust D. [et al.]. Incidence risk and independent predictors of prolonged air leak in 269 consecutive pulmonary resection patients over nine months: A single-center retrospective cohort study // Open Journal of Thoracic Surgery. 2016. Vol. 6, No. 4. P. 33–46.
12. Malapert G., Hanna H.A., Pages P.B. Bernard A. Surgical sealant for the prevention of prolonged air leak after lung resection: Meta-analysis // The Annals of Thoracic Surgery. 2010. Vol. 90, No. 6. P. 1779–1785.
13. Pompili C., Miserocchi G. Air leak after lung resection: pathophysiology and patients’ implications // Journal of Thoracic Disease. 2016. Vol. 8, Suppl. 1. P. S46.
14. Singhal S., Ferraris V.A., Bridges Ch.R. [et al.]. Management of alveolar air leaks after pulmonary resection // The Annals of Thoracic Surgery. 2010. Vol. 89, No. 4. P. 1327–1335.
15. Varela G., Jimenez M.F., Novoa N., Aranda J.L. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy // Eur. J. Cardiothoracic Surg. 2005. Vol. 27, No. 2. P. 329–333.

PUBLISHER: "MEDITSYNA DV"

Founded in 1997  |  Editions in a year: 4, Articles in one issue: 30 |  ISSN of print version: 1609-1175  |  Ind.: 18410 (Agency "Rospechat’")  |  Edition: 1000 c.