METHOD OF CREATING ARTIFICIAL EXTRAPLEURAL CAVITY FROM INTRAPLEURAL ACCESS AND ITS STOPPING AFTER EXTENSIVE LUNG RESECTION IN CASE OF FIBROUS-CAVERNOUS TUBERCULOSIS Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to phthisio-surgery and can be applied in creation of artificial extra-pleural cavity from intrapleural access and its stopping after extensive lung resection in case of fibrous-cavernous tuberculosis. Essence of method lies in preliminary antibacterial therapy during not less than six months because of infiltrative tuberculosis of upper lobe of right or left lung in destruction phase, MBT (+) plus, thoracotomy and performing main stage of operation -resection of three and more segments in one lung. After transformation of process into fibrous-cavernous tuberculosis, operation - upper lobectomy - is performed, and blowing remaining part of lung from narcosis apparatus up to 30 mm of water column, it is determined that lung does not fully fill pleural cavity and take decision about reducing hemothorax volume. Extrapleural cavity is artificially created from intrapleural thoracotomy access by cutting parietal pleura on third rib exterior section with 4-5 cm diathermocoagulator. Pleura is detached bluntly with swab from back side to fourth rib support, from front part to lung root level. Then into artificially created extrapleural cavity grown outside organism skin cells - human allogenic fibroblasts on microcarriers, included into first time collagen gel, with dosing volume not more than 20 ml, are transplanted and placed, and cervical pleura is stopped from intrapleural thoracotomy access by filling artificial extrapleural cavity with interstitial liquid in observed patient during 5-7 days, taking place without complications. Later, filled extrapleural cavity fibrolyzes and pariental pleura is sewn hermetically with continuous suture from non-dissolving material.

EFFECT: method allows to increase efficiency of extensive lung resections in case of fibrous-cavernous tuberculosis.

1 ex, 2 dwg