Pleuropneumonectomy for the treatment of tuberculosis

The OBJECTIVE was to reduce the risk of complications and mortality after pleuropneumonectomy in patients with pulmonary tuberculosis complicated by pleural empyema.METODS AND MATERIALS. The immediate and long-term results of surgical treatment were analyzed in 910 patients who underwent pneumonecto...

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Main Authors: D. B. Giller, A. A. Popova, V. A. Basangova, G. V. Shcherbakova, S. S. Saenko, O. Sh. Kesaev, V. V. Koroev, I. I. Martel, S. V. Smerdin, A. E. Ergeshov
Format: Article
Language:Russian
Published: Pavlov First Saint Petersburg State Medical University 2024-12-01
Series:Вестник хирургии имени И.И. Грекова
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Online Access:https://www.vestnik-grekova.ru/jour/article/view/2456
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author D. B. Giller
A. A. Popova
V. A. Basangova
G. V. Shcherbakova
S. S. Saenko
O. Sh. Kesaev
V. V. Koroev
I. I. Martel
S. V. Smerdin
A. E. Ergeshov
author_facet D. B. Giller
A. A. Popova
V. A. Basangova
G. V. Shcherbakova
S. S. Saenko
O. Sh. Kesaev
V. V. Koroev
I. I. Martel
S. V. Smerdin
A. E. Ergeshov
author_sort D. B. Giller
collection DOAJ
description The OBJECTIVE was to reduce the risk of complications and mortality after pleuropneumonectomy in patients with pulmonary tuberculosis complicated by pleural empyema.METODS AND MATERIALS. The immediate and long-term results of surgical treatment were analyzed in 910 patients who underwent pneumonectomy between 1984 and 2021. Among these, 342 patients (37.6 %) underwent pleuropneu- monectomy (Group I), while 568 patients (62.4 %) underwent pneumonectomy (Group II). Group I was further divided into two subgroups. Subgroup Ia consisted of 278 patients (main group) who received stump-free suturing of the main bronchus according to D. B. Giller’s method, long-term drainage management of the pleural cavity using an original technique, and the proposed staged surgical tactics. Subgroup Ib comprised 64 patients who were treated using traditional methods for the main bronchus and puncture management of the pleural cavity.RESULTS. Postoperative complications were more frequent after pleuropneumonectomy (PPE); however, the mortality rate in Subgroup Ia and Group II did not significantly differ. In contrast, the hospital mortality rate in Subgroup Ib, which utilized traditional approaches for the treatment of the main bronchus and puncture management of the pleural cavity, was 2.3 times higher than the mortality rate after pneumonectomy (PE). The incidence of complications, mortality, recurrence of tuberculosis, and empyema differed significantly between Subgroups Ia and Ib, with the best outcomes observed in Subgroup Ia. These results are attributed to the applied method of treating the main bronchus, pleural cavity management, and differentiated surgical tactics.
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series Вестник хирургии имени И.И. Грекова
spelling doaj-art-d03f8564603c480a8940952271e0cbb82025-08-20T03:23:23ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252024-12-011835142210.24884/0042-4625-2024-183-5-14-221635Pleuropneumonectomy for the treatment of tuberculosisD. B. Giller0A. A. Popova1V. A. Basangova2G. V. Shcherbakova3S. S. Saenko4O. Sh. Kesaev5V. V. Koroev6I. I. Martel7S. V. Smerdin8A. E. Ergeshov9I. M. Sechenov First Moscow State Medical University (Sechenov University)I. M. Sechenov First Moscow State Medical University (Sechenov University)I. M. Sechenov First Moscow State Medical University (Sechenov University)I. M. Sechenov First Moscow State Medical University (Sechenov University)Regional Clinical Center of PhthisiopulmonologyI. M. Sechenov First Moscow State Medical University (Sechenov University)I. M. Sechenov First Moscow State Medical University (Sechenov University)I. M. Sechenov First Moscow State Medical University (Sechenov University)Moscow Regional Clinical Tuberculosis DispensaryCentral Tuberculosis Research InstituteThe OBJECTIVE was to reduce the risk of complications and mortality after pleuropneumonectomy in patients with pulmonary tuberculosis complicated by pleural empyema.METODS AND MATERIALS. The immediate and long-term results of surgical treatment were analyzed in 910 patients who underwent pneumonectomy between 1984 and 2021. Among these, 342 patients (37.6 %) underwent pleuropneu- monectomy (Group I), while 568 patients (62.4 %) underwent pneumonectomy (Group II). Group I was further divided into two subgroups. Subgroup Ia consisted of 278 patients (main group) who received stump-free suturing of the main bronchus according to D. B. Giller’s method, long-term drainage management of the pleural cavity using an original technique, and the proposed staged surgical tactics. Subgroup Ib comprised 64 patients who were treated using traditional methods for the main bronchus and puncture management of the pleural cavity.RESULTS. Postoperative complications were more frequent after pleuropneumonectomy (PPE); however, the mortality rate in Subgroup Ia and Group II did not significantly differ. In contrast, the hospital mortality rate in Subgroup Ib, which utilized traditional approaches for the treatment of the main bronchus and puncture management of the pleural cavity, was 2.3 times higher than the mortality rate after pneumonectomy (PE). The incidence of complications, mortality, recurrence of tuberculosis, and empyema differed significantly between Subgroups Ia and Ib, with the best outcomes observed in Subgroup Ia. These results are attributed to the applied method of treating the main bronchus, pleural cavity management, and differentiated surgical tactics.https://www.vestnik-grekova.ru/jour/article/view/2456pleuropneumonectomypneumonectomybronchopleural complicationsempyemaresistance of mycobacterium tuberculosis
spellingShingle D. B. Giller
A. A. Popova
V. A. Basangova
G. V. Shcherbakova
S. S. Saenko
O. Sh. Kesaev
V. V. Koroev
I. I. Martel
S. V. Smerdin
A. E. Ergeshov
Pleuropneumonectomy for the treatment of tuberculosis
Вестник хирургии имени И.И. Грекова
pleuropneumonectomy
pneumonectomy
bronchopleural complications
empyema
resistance of mycobacterium tuberculosis
title Pleuropneumonectomy for the treatment of tuberculosis
title_full Pleuropneumonectomy for the treatment of tuberculosis
title_fullStr Pleuropneumonectomy for the treatment of tuberculosis
title_full_unstemmed Pleuropneumonectomy for the treatment of tuberculosis
title_short Pleuropneumonectomy for the treatment of tuberculosis
title_sort pleuropneumonectomy for the treatment of tuberculosis
topic pleuropneumonectomy
pneumonectomy
bronchopleural complications
empyema
resistance of mycobacterium tuberculosis
url https://www.vestnik-grekova.ru/jour/article/view/2456
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AT gvshcherbakova pleuropneumonectomyforthetreatmentoftuberculosis
AT sssaenko pleuropneumonectomyforthetreatmentoftuberculosis
AT oshkesaev pleuropneumonectomyforthetreatmentoftuberculosis
AT vvkoroev pleuropneumonectomyforthetreatmentoftuberculosis
AT iimartel pleuropneumonectomyforthetreatmentoftuberculosis
AT svsmerdin pleuropneumonectomyforthetreatmentoftuberculosis
AT aeergeshov pleuropneumonectomyforthetreatmentoftuberculosis