Repeated operations on the lungs and pleura in tuberculosis]

Reoperations were performed on 71 patients for tuberculosis of the lungs and pleura at the Phthisiosurgical Department of the Kostroma Regional Antituberculotic Clinic from 1971 to 1990. A total of 159 operative interventions were carried out. Among the indications for repeated operations were complications in the early postoperative period, recurrence, reactivation, and progress of the tuberculous process in the lung which had been operated on, tuberculous empyema of the pleura with a bronchopleural fistula, empyema of the residual pleural cavity and a bronchial fistula forming in the late-term periods after the first operation. Operative interventions were undertaken for the second time for tuberculosis of the lung on which the first operation was conducted in chronic abscess. Finally, operations were repeated for other reasons (excision of a ligature fistula, resection of the ribs for osteomyelitis, etc.). Reoperations on 23 patients who had undergone surgery for recurrence or exacerbation of a tuberculous process in the lung consisted in removal of areas of pulmonary tissue remaining after the first operation, they were of the type of pulmonectomy. This is a technically difficult intervention due to the presence of marked cicatricial adhesions in the pleural cavity and changed topography of the thoracic organs and tissues of the thoracic wall. The results of the reoperations were good.     

Types of microflora in acute suppurative-destructive diseases of the lungs and pleura

By means of the modern bacteriologic methods, including gas-liquid chromatography, the microflora of the sputum, bronchial contents, pus from the abscess cavities and pleura in 106 patients with acute purulent destructive diseases of the lungs and pleura was studied.     

Repeated radical operations after surgical interventions in diseases of the lungs and pleura

The article elucidates the authors' experience with 144 repeated radical operations on lungs and pleura (89 out of them were resections of lungs). Recovery was achieved in 89,4% of patients subjected to a repeated resection of lung. Lethal outcomes were in 7% of cases.     

Use of polymer hemostatic cotton and plate in surgery of the lungs and pleura

The article discusses the efficacy of using polymeric hemostatic wool and plate in operations on the lungs and pleura in experiments. From the results of experimental studies the authors concluded that a biodegradable polyamide based on hexamethylenediamine and derivatives of amino acids in a model of parenchymatous-capillary bleeding from the lungs and pleura is an effective hemostatic. The authors recommend these polymers for use in the clinic.     

Aggregative properties of the erythrocytes in acute suppurative-destructive diseases of the lungs and pleura

The investigation of aggregation properties of erythrocytes in 218 patients with acute pyo-destructive diseases of lungs and pleura at different stages of the conservative and operative treatment has revealed a pronounced hyperaggregation of erythrocytes. The aggregation mechanisms are to be studied and new methods of correction of the aggregation properties of blood red cells are to be searched for.     

Surgical treatment of acute suppurative destructive lesions of the lungs and pleura in sepsis

Eleven patients with metastatic acute purulent-destructuve processes in the lungs and pleura in sepsis were operated on. Fifteen operations were performed: 3 lobectomy, 1 pneumonectomy, 8 drainages of the pleural cavity with its sanitation, 1 drainage of a pulmonary abscess with thoracocentesis and 1 thoracotomy. Sepsis was treated by complex methods. Nine patients were discharged in a good condition. Two patients died.