Transsternal occlusion of main bronchi fistulae after pneumonectomy

Pоrkhanov, V. A.; Polyakov, I. S.; Kononenko, V. B.; Lyubavin, A N; Коваленко, А. Л.; Барышев, А. Г.; Sitnik, S D; Zhikharev, V. A.

doi:10.17116/hirurgia202010111

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…Бронхиальный свищ (БС) представляет собой патологический процесс, при котором образуется сообщение между бронхиальным деревом и плевральной полостью [1]. БС обычно возникает в результате резекции легкого, причем частота колеблется от 4,5 до 20 % после пневмонэктомии [2], а смертность, связанная с БС, составляет от 16,0 до 71,2 % [3][4][5].…”

Section: Introductionunclassified

Possibilities of cell therapy in thoracic surgery

Polyakov,

Porhanov,

Kovalenko

et al. 2023

The Scientific Notes of the Pavlov university

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Introduction. Bronchial fistula often occurs after lung surgery. This is an extremely severe complication with high mortality. Despite the variety methods for the treatment of bronchial fistula, the results are not always effective. In our paper, we presented a method of preventing the development of bronchial fistula based on the cell therapy. The objective of the study was to evaluate the effects of the cell therapy on the regeneration of damaged bronchial tissue in an experiment on non-human primates. Methods and materials. The study was performed on 6 non-human primates. Laboratory animals were divided into 2 groups: experimental and control. The left pneumonectomy with the formation of a stump of the main bronchus was done in each primate. In the experimental group, a regenerative product was introduced into the stump; in the control group, 0.9 % NaCl solution was used. The regenerative product consisted of autologous platelet-rich plasma activated by thermal lysis and the suspension of the xenogeneic fibroblast’s culture. The primates were observed for 7, 14 and 21 days, the peripheral blood was taken to study the dynamics of biologically active substances. A histological examination of the autopsy material was performed at the end of the follow-up time. Results. On the early postoperative period, a typical inflammatory reaction was observed and resulted by the intraoperative tissue damage. Then the morphological changes were different in both group. The inflammatory were mild, the restoration of the natural function of the mucous membrane and the formation of scar tissue were earlier in the experimental group than in the control group. An analysis of the dynamics of plasma mediators in the postoperative period revealed an earlier dominance of regenerative processes in the experimental group. Conclusion. The results of the study showed that the cell therapy stimulates the tissue regeneration, thereby preventing the failure of the bronchial stump suture.

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Section: Introductionunclassified

Possibilities of cell therapy in thoracic surgery

Polyakov,

Porhanov,

Kovalenko

et al. 2023

The Scientific Notes of the Pavlov university

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The use of diaphragmatic flap for the main bronchus stump reinforcement in right-sided pneumonectomy performed for destructive pulmonary tuberculosis with drug resistance of <i>Mycobacterium tuberculosis</i>

Avetisyan

Serezvin

Kudriashov

et al. 2022

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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INTRODUCTION. Drug-resistant tuberculosis with subtotal and total lesion of one of the lungs is the most common indication for pneumonectomy. This operation is accompanied by a high risk of postoperative complications, among which the most dangerous is pleural empyema with bronchopleural fistula. In this regard, the prevention of this complication is an extremely important task.The OBJECTIVE was to study the results of using a diaphragmatic flap to prevent the development of right main bronchus stump insufficiency with bronchopleural fistula in patients with destructive pulmonary tuberculosis. METHODS AND MATERIALS. A retrospective study was carried out for the period from 2015 to 2019. The study included 13 patients who underwent right-sided pneumonectomy with diaphragmoplasty of the right main bronchus stump. Indications for diaphragmoplasty were: persistent bacterial excretion at the time of surgery, pre-existing bronchopleural fistula, intraoperative pleural contamination, progressive course of a specific process.RESULTS. The postoperative period was smooth in 10 (77 %) patients. Postoperative complications developed in 3 (23 %) patients: in 1 (7.7 %) case, there was right main bronchus stump insufficiency with bronchopleural fistula and in 2 (15.3 %) cases, there were right main bronchus stump insufficiency without bronchopleural fistula. A satisfactory immediate result was achieved in 12 (92.3 %) patients.CONCLUSION. The diaphragmatic flap is a reliable material for plasty of the right main bronchus stump in order to prevent the formation of bronchopleural fistula in destructive pulmonary tuberculosis.

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Cell Therapy for Upper Respiratory Tract Fistulas

Polyakov,

Porhanov,

Kovalenko

et al. 2023

Innovacionnaâ medicina Kubani

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Fistulas of various etiologies are one of the severe and life-threatening diseases of the upper respiratory tract. The most common cause is bronchial stump failure after pulmonary resection, usually pneumonectomy. The incidence and mortality of this complication is 3 %-4 % and 12.5 %-71.2 %, respectively. Despite the fact that many devices and methods have been described to date, it is usually treated with surgical closure. Standard surgical approaches are associated with significant morbidity and mortality and are not reliably successful. In recent years, cell therapies aimed to stimulate tissue healing rose to prominence and can be considered a potential treatment method. We review current trends in bronchopleural fistula treatment using cell therapy and report cases of the bronchopleural fistula treatment according to the research protocol developed in our clinic. Although clinical experience is quite limited owing to a small number of patients in the most studies, the information on safety and tolerance can help plan future larger trials with innovative methods to further improve clinical results.

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Transsternal occlusion of main bronchi fistulae after pneumonectomy

Cited by 4 publications

References 16 publications

Possibilities of cell therapy in thoracic surgery

Possibilities of cell therapy in thoracic surgery

The use of diaphragmatic flap for the main bronchus stump reinforcement in right-sided pneumonectomy performed for destructive pulmonary tuberculosis with drug resistance of <i>Mycobacterium tuberculosis</i>

Cell Therapy for Upper Respiratory Tract Fistulas

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