POSSIBILITIES TO IMPROVE TREATMENT RESULTS IN PATIENTS WITH CHRONIC PLEURAL EMPYEMA ACCOMPANIED BY BRONCHOPLEURAL FISTULAS
Journal: Journal of the Grodno State Medical University (Vol.22, No. 2)Publication Date: 2024-05-17
Authors : D. S. Vakulich A. S. Karpitsky A. M. Shestiuk;
Page : 147-153
Keywords : bronchopleural fistula; empyema; intrathoracic negative pressure therapy; endobronchial valve;
Abstract
Background. Treatment of pleural empyema in combination with bronchial fistula is aggravated by severe purulent-resorptive intoxication, which often leads to long periods of treatment with chronicity of the process and is still considered an urgent problem of modern pulmonology and thoracic surgery. Objective. To analyze the results of treatment of patients with chronic pleural empyema accompanied by bronchopleural fistulas using controlled vacuum aspiration, including in combination with the installation of a reverse endobronchial valve. Material and methods. The results of treatment of 38 patients with chronic pleural empyema in combination with bronchopleural fistula using controlled vacuum aspiration technology, including implantation of an endobronchial blocker in 15 of them were analyzed. Results. A method of hybrid surgical treatment of pleural empyema based on application of vacuum aspiration with implantation of an endobronchial blocker was developed. The technique of using adjustable vacuum aspiration in combination with endobronchial blocker implantation provides long-term and adequate blocking of the fistula-bearing bronchus without the risk of pneumonic complications in the blocked part of the lung. Vacuum aspiration based on the creation of local negative pressure accelerates the healing process of empyema cavity and eliminates intoxication syndrome, while their combination makes it possible to reduce the average duration of unstable pneumostasis from 295 days to 3 days, to shorten the total duration of treatment measures almost 4 times as well as to decrease mortality (from 6.2% in the comparison group to 0% in the main group). Conclusions. The use of endobronchial blocking in combination with vacuum aspiration of contents from the purulent cavity for the treatment of patients with chronic pleural empyema reduces the average duration of pneumostasis stabilization, the total duration of therapeutic measures as well as mortality.
Other Latest Articles
- SOLUBILITY AND BIOMINERALIZATION ABILITY OF PMMA BONE CEMENT NANOCOMPOSITE FILLED WITH 40% NANOHYDROXYAPATITE FOR USE AS ROOT-END FILLING MATERIAL
- CURRENT TRENDS IN ANTIBIOTIC RESISTANCE OF PATHOGENIC MICROORGANISMS IN SURGICAL PATIENTS
- THE POTENTIAL OF USING THE DYNAMICS OF ELECTROCARDIOGRAPHIC PARAMETERS IN DETECTING CARDIOTOXICITY 12 MONTHS AFTER THE END OF CHEMOTHERAPY FOR BREAST CANCER WITH DOXORUBICIN
- A STUDY TO ASSESS THE EFFECTS OF CYBER ADDICTION ON THE SELECTED PSYCHOSOCIAL BEHAVIOUR OF NURSING STUDENTS AT SELECTED NURSING COLLEGES, CHENNAI
- READINESS OF HALAL MANAGEMENT STUDENTS FOR EMPLOYABILITY
Last modified: 2024-05-20 20:24:16