Anterior Mediastinal Plastics During Pneumonectomy as Prevention and Treatment of a Mediastinal Hernia in Fibrous Cavernous Pulmonary Tuberculosis Patients

Багиров, М. А.; Krasnikova, Elena; Эргешова, А.Э.; Lovacheva, Olga; Karpina, Natalya; Пенаги, Р.А.

doi:10.21292/2075-1230-2017-95-11-36-40

Cited by 7 publications

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“…После их выполнения происходит смещение органов средостения в сторону оперированного гемиторакса, что ведет к перерастяжению неоперированного легкого и формированию медиастинальной грыжи (МСГ). После пневмонэктомии МСГ не формируется у 82,4% (95%-ный ДИ 59,0-93,8%) пациентов, если выполняется пластика переднего средостения, и лишь у 7,7% (95%-ный ДИ 1,4-33,3%) пациентов, если пластика не используется, p < 0,01 [2] .…”

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“…3) уменьшение объема гемиторакса путем выполнения отсроченной экстраплевральной торакопластики со стороны пневмонэктомии с резекцией одного-пяти ребер [4]; 4) медиастинопластика окружающими тканями путем создания дупликатуры [1,2].…”

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Staged Surgical Treatment of Patients with Destructive Pulmonary Tuberculosis with pre-XDR Using Anterior Mediastinal Plasty

Тарасов

Krasnikova

Лепеха

et al. 2023

Tuberk. bolezni lëgk.

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The presented observation describes an example of effective treatment of the patient with disseminated destructive pulmonary tuberculosis with preXDR. The treatment included staged surgery using the original method of anterior mediastinum plasty with a mesh implant.The treatment resulted in the following outcomes: stabilization of the tuberculous disease, persistent sputum conversion, minimization of overdistension of the only lung, absence of mediastinal pulmonary hernia and no deterioration of respiratory function.

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Staged Surgical Treatment of Patients with Destructive Pulmonary Tuberculosis with pre-XDR Using Anterior Mediastinal Plasty

Тарасов

Krasnikova

Лепеха

et al. 2023

Tuberk. bolezni lëgk.

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“…DOI: 10.24884/0042-4625-2021-180-3-57-60. в в е д е н и е. При разрушенном легком вследствие фиброзно-кавернозного туберкулеза операцией выбора является пневмонэктомия [1,2]. В 7-81,1 % случаев развивается постпневмонэктомический синдром [1], одним из проявлений которого является медиастинальная грыжа (МСГ), выражающаяся в пролабировании перерастянутого единственного легкого в противоположный гемиторакс [1,2].…”

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“…в в е д е н и е. При разрушенном легком вследствие фиброзно-кавернозного туберкулеза операцией выбора является пневмонэктомия [1,2]. В 7-81,1 % случаев развивается постпневмонэктомический синдром [1], одним из проявлений которого является медиастинальная грыжа (МСГ), выражающаяся в пролабировании перерастянутого единственного легкого в противоположный гемиторакс [1,2]. Перерастяжение легкого приводит к прогрессированию туберкулеза в очагах, особенно если они располагаются в сместившихся в противоположный гемиторакс отделах, а смещение трахеи и пищевода -к одышке и дисфагии [3].…”

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Successful treatment of advanced tuberculosis of a single lung with staged correction of post-pneumonectomy syndrome

Тарасов

Krasnikova

Лепёха

et al. 2021

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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An observation from practice is given – surgical treatment of a patient with advanced tuberculosis of a single lung and a pronounced lung displacement. Patient A., 47 years old, after 3 months from the left pneumonectomy for fibrocavernous tuberculosis complained of dyspnea at rest, and dysphagia, underwent CT scan, which showed a pronounced displace ment of a single right lung with tuberculoma to the left. At the first stage of the surgery, the overstretched section of a single lung with tuberculoma was resected, the displaced lung was put back and a hernial orifice was strengthened with a mesh implant. At the second stage, the extrapleural thoracoplasty was made with resection of I–IV ribs from the side of pneumonectomy to reduce the volume of the left hemithorax and prevent relapse of mediastinal hernia. As a result, the patient stopped dyspnea and dysphagia, radiographically a single right lung was visualized in the right hemithorax.

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Patterns of topographic and anatomical changes in body cavities after pneumonectomy

Kagan

Vasyukov

Tretyakov

2022

Issled. prakt. med. (Print)

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Purpose of the study. To study and describe the general patterns of topographic and anatomical changes after pneumonectomies on the basis of this study.Materials and methods. Computed tomograms of the chest of 53 patients (50 men and 3 women) aged 39 to 75 years before and after pneumonectomy (26 on the left, 27 on the right) were examined. Postoperative computed tomography was performed on the 10–12th day after the operation, 6 and 12 months after the intervention. The transverse, anteroposterior and angular displacements of organs and structures of the mediastinum, chest wall, and abdomen were studied. Changes in their skeletotopic and holotopic characteristics were assessed. Calculations of the volumes of the postpneumonectomy space and the remaining lung were performed.Results. Pneumonectomy causes regular, causal topographic and anatomical changes in the abdominal cavity and retroperitoneal space. Displacement of organs and large vessels of the mediastinum after pneumonectomy has a multi-vector character of varying severity. Among the mediastinal organs, the most pronounced changes after pneumonectomy are the heart, which is displaced laterally, posteriorly and upward. Changes in the chest wall after pneumonectomy on the side of the operation are expressed in it, changes in the angles of inclination of the ribs, scoliotic deformity of the thoracic spine. Pneumonectomy leads to the rise of the dome of the diaphragm on the side of the operation to a height of 1–5 ribs with the corresponding topographic and anatomical changes in the abdominal cavity and retroperitoneal space. Anatomical changes in the remaining lung are expressed in a partial decrease in its volume in the early postoperative period, followed by an increase in volume in the long term and the gradual formation of predominantly anterior mediastinal hernia. Postpneumonectomy cavity is reduced in the postoperative period by changing its shape. The general dynamics of changes after pneumonectomies is their occurrence in the early postoperative period, gradual progression during the year and subsequent stabilization.Conclusion. Regular post-pneumonctomic changes in the chest and abdomen must be taken into account when performing surgical interventions and invasive research methods. They can serve as a basis for clinical and functional studies of the abdominal organs in the postoperative period. They should be used in the development of postoperative diagnostic and treatment methods.

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Anterior Mediastinal Plastics During Pneumonectomy as Prevention and Treatment of a Mediastinal Hernia in Fibrous Cavernous Pulmonary Tuberculosis Patients

Cited by 7 publications

References 0 publications

Staged Surgical Treatment of Patients with Destructive Pulmonary Tuberculosis with pre-XDR Using Anterior Mediastinal Plasty

Staged Surgical Treatment of Patients with Destructive Pulmonary Tuberculosis with pre-XDR Using Anterior Mediastinal Plasty

Successful treatment of advanced tuberculosis of a single lung with staged correction of post-pneumonectomy syndrome

Patterns of topographic and anatomical changes in body cavities after pneumonectomy

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