Abstract
Introduction. The large break in thoracic surgery is connected to introduction of fibrobronchoscopic techniques (FBT) with application of various glue compositions and laser in treatment of bronchial stump fistula (BSF).
Materials and methods. In comparative aspect with surgical methods of shelter of BSF the own experience and results of application FBT in treatment of 43 patient with insufficiency of stump of main bronchus after pneumonectomy (PE) is submitted.
Results and discussion. Analized the performance of FBT in liquidation of BSF depending on the party of a defeat. Efficiency of application of FBT in liquidation of BSF has made only 62,8%, morality is marked at 5 (11,4%) patients. The satisfactory results of treatment fistula with application of FBT at the patients after right PE are marked at 58,4% of the patients and at 68,4% after left PE. The basic quantity of unsatisfactory results is a share of the patients, at which the diameter of fistula has made more than 3 mm. So, the number of satisfactory results makes only 33,3%.
The most basic moment is the choice of tactics of surgical intervention with obvious preference of active thoracotomy with obligatory strengthening of BSF. At the sizes of a fistula up to 3MM the priority should be given back to FBT, at an insufficiency last is carried out open surgical intervention. At a diameter of a fistula more 3MM after right-side PE effective there is only active surgical tactics with performance bronchial stump plasty.
Conclusions. The high efficiency of FBT is achieved at treatment of BSF fistulas by diameter up to 3MM at 83,2% of the patients after right PE and at 92,3% of the patients after left PE.
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