Way of unilateral lung resection

 

(57) Abstract:

The invention relates to medicine, namely to lung surgery. Open the pleural cavity. Resetinput easy. Drain the pleural cavity. Sutured the wound in the chest wall. Along with basic operation, at the same time cause irritation of receptors of the pleura and the lung on the opposite side of the introduction into the pleural cavity of the stimulus, or influence the centripetal nerves involved in the innervation of this anatomical region. The method can improve the oxygenation of body tissues.

The invention relates to medicine, namely to lung surgery.

The known method of unilateral partial lung resection [3]: after thoracotomy emit light from cicatrices, perform a partial resection, drain the pleural cavity and sutured the wound in the chest wall.

The disadvantages of this method are significant impairment of pulmonary ventilation due to a sharp decline in the excursions of the diaphragm [2,4,7] and perfusion lung shunting of blood on precapillary level [10,12] on the side of the surgical intervention and, as a consequence, a significant deterioration of gotomenu in the operated leghaemoglobin in the arterial blood is up to 75-78% [13].

The closest to the technical nature of the proposed method is a method of simultaneous bilateral resection of the lung [8]: after Antero-lateral thoracotomy for IV or V Mirabello perform a partial resection of the lung, cut through the mediastinal pleura parallel to the phrenic nerve and in front of him, rasclaat tissue anterior mediastinum, similarly cut contralateral mediastinal the pleura, perform shows resection of the opposite lung, drain the pleural cavity and sutured the wound mediastinum and chest wall.

The disadvantage of this method is that it is designed to provide surgical care exclusively for two-sided nature of pathological changes in the respiratory organs.

There are General characteristics of this method with the stated method, which are expressed as follows.

1. The method used in surgery of the lungs.

2. Carry out simultaneous surgical impact on both the pleural cavity and both lungs, which is accompanied by synchronous transfer irritation of these anatomical areas in the Central nervous system.

3. Achieve full lung ventilation zi perfusion lung [6,9,11], consequently, in the presence of plavalaguna complications - good condition gas exchange, far superior to that in unilateral partial lung resections even smaller [13] that, in the first place, and determines the good results of one-stage bilateral operations on the respiratory obtained as the author of this project, and by other authors [5,8], and, at least, not inferior to the results of the unilateral lung resections of the same volume.

The purpose of this design is to obtain a method of unilateral partial resection of the lung, characterized by a significant improvement in oxygenation of body tissues, especially in the early postoperative period, in comparison with the known analogues, due to the imitation of the operation on the opposite lung.

The proposed method is as follows.

After thoracotomy and pneumonia perform a partial resection of the lung on the affected side and simultaneously cause irritation of receptors of the pleura and the lung on the opposite side of the introduction to the contralateral pleural cavity through a puncture of the chest wall /small wound and/ or tissue of mediastinum emergency razdrai, involved in the innervation of this anatomical region.

The proposed method allows for unilateral partial lung resections imitation simultaneous bilateral surgery on the organs of respiration with more complete pulmonary perfusion and ventilation, including at the expense of sufficient size and consistency of the respiratory movements of both domes of diaphragm, as a result - improved oxygenation of body tissues and increase the results of such interventions, particularly in individuals with a marked reduction in the functional reserve of the respiratory system, and thus to expand the scope of providing surgical care to patients pulmonary profile.

LITERATURE

1. Amosov N. M. Bilateral resection of the lungs of patients with pulmonary tuberculosis//Proceedings of all-Union meeting of surgery and drugs. - M.,1963. - C. 61-65.

2. Amosov N. M., Vinokurov P. H., Kolosov Y. A. Simultaneous bilateral resection of pulmonary tuberculosis//proceedings of the Central Institute of advanced medical. - 1966. - T. 86. - S. 10-15.

3. Bogush L. K., Gromova, L. S., A. Dubrovsky Century, Kibrik B. S., B. N. Streltsov Resection of the lung//Surgical treatment of pulmonary tuberculosis/edited by L. K. of Bogush. - M., 1979. - the GII tuberculosis: Dis. ... candles. the honey. Sciences. - M., 1973. - S. 108.

5. Ivanov A. C. Simultaneous bilateral transactions from transsternal transmediterranea access in patients with tuberculosis of the lungs and intrathoracic lymph nodes: author. dis. ... Dr. med. Sciences. - M.,1983.

6. Ivanov A. C. Simultaneous bilateral transactions from transsternal transmediterranea access in patients with tuberculosis of the lungs and intrathoracic lymph nodes: Dis. ... Dr. med. Sciences. - M., 1983. - S. 11, 170-174, 191-192, 278-280.

7. Nikolaev, I. S., Jagnow C. H. Experience 100 simultaneous bilateral resections of the transsternal transmediterranea access//recent advances in surgery of the lungs and mediastinum. - M.,1985. - So H. - S. 75-78.

8. Svintsov A. E. Simultaneous bilateral lung resection of unilateral mirabellecatering access: author. dis. ... candles. the honey. Sciences. - M., 1997 - (PROTOTYPE).

9. Svintsov A. E. Simultaneous bilateral lung resection of unilateral mirabellecatering access: Dis. ... candles. the honey. Sciences. - M., 1997. - S. 38, 77, 84, 107.

10. Sigayev A. T. Clinical radioisotope studies of patients with pulmonary tuberculosis in pre - and postoperative period: Dis. ... candles. the honey. Sciences. - M., 1974.

11. Mehanicheskij properties of the lungs and capillary blood flow in patients with cavernous tuberculosis before and after partial resections//Problems of tuberculosis. - 1992. - 1-2. - S. 33-36.

13. Soludo M. L., Zislin B. D., Kipiani N. M. Some issues of bilateral resections of the lung TB//TB Issues. - 1965. - 1. - S. 26-31.

Way of unilateral lung resection, including opening the pleural cavity, lung resection, drainage of pleural cavity, suturing wounds of the chest wall, characterized in that along with the main operation at the same time cause irritation of receptors of the pleura and the lung on the opposite side of the introduction into the pleural cavity of the stimulus, or influence the centripetal nerves involved in the innervation of this anatomical region.

 

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FIELD: medicine.

SUBSTANCE: method involves applying one or two parallel through draining tubes having lateral perforations. Flow lavage of the retroperitoneal space with antiseptic solutions is carried out via the perforations at room temperature and cooled solutions are administered concurrently with vacuum suction. Omental bursa is concurrently drained using the two parallel through draining tubes. Flow lavage of the omental bursa is carried out using these tubes.

EFFECT: enhanced effectiveness of treatment in healing pyo-inflammation foci.

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