pmjТихоокеанский медицинский журналPacific Medical Journal1609-1175TGMU10.17238/PmJ1609-1175.2019.2.84-87pmj-360Research ArticleМЕТОДИКАMETHODSНедостаточность аэростаза аппаратного шва легкого: профилактика и лечение осложненийAEROSTASIS INSUFFICIENCY OF A MACHINE STITCH OF A LUNG: PREVENTION AND TREATMENT OF COMPLICATIONSШаповаловА. С.ShapovalovA. S.

врач торакального отделения 

690041, г. Владивосток, ул. Пятнадцатая, 2

2 Pyatnadtsataya St. Vladivostok 690041 Russian Federation

poison283@mail.ruПолежаевА. А.PolezhaevA. A.

690002, г. Владивосток, пр-т Острякова, 2

2 Ostryakova Ave. Vladivostok 690002 Russian Federation

БеловС. А.BelovS. A.

690041, г. Владивосток, ул. Пятнадцатая, 2

 

2 Pyatnadtsataya St. Vladivostok 690041 Russian Federation

Приморский краевой противотуберкулезный диспансерРоссияPrimorskiy Regional Tuberculosis DispensaryRussian FederationТихоокеанский государственный медицинский университетРоссияPacific State Medical UniversityRussian Federation201928062019028487Copyright © Шаповалов А.С., Полежаев А.А., Белов С.А., 20192019Шаповалов А.С., Полежаев А.А., Белов С.А.Shapovalov A.S., Polezhaev A.A., Belov S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tmj-vgmu.ru/jour/article/view/360

Цель: оценка эффективности различных методов дополнительного аэростаза в торакальной хирургии. При возникновении устойчивых к лечению остаточных воздушных полостей, ассоциированных с недостаточностью аэростаза, целесообразно их устранение путем апозиции висцеральной плевры к париетальной или иной транспонированной ткани. Материал и методы. Проведено сравнение эффективности методов комбинированного аэростаза по результатам хирургического лечения 227 больных торакального профиля (у 97,3 % – туберкулез), в возрасте от 18 до 65 лет. Эффективность остеопластической торакопластики сетчатым имплантом изучена по результатам хирургического лечения 80 пациентов, в возрасте от 18 до 57 лет. Результаты. Наибольшую суточную аэростатическую эффективность продемонстрировала комбинация аппаратного шва легкого с дополнительной герметизацией латексным клеем. Худшая эффективность наблюдалась при дополнительном укреплении механического шва легкого ручным швом. В то же время, применение дополнительно к ручному шву клея вело более чем к двукратному увеличению суточной аэростатической эффективности. Заключение. Дополнительная обработка линии резекции легкого латексным клеем, способствующим повышению эффективности аэростаза. Остеопластическая торакопластика сетчатым имплантом препятствует образованию легочной грыжи, а также снижает интенсивность и длительность болевого синдрома в послеоперационном периоде.

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.

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The authors declare that there are no conflicts of interest present.