METHOD OF TREATING OF COMMON COMPLICATED PULMONARY TUBERCULOSIS WITH MEDIASTINAL PULMONARY HERNIA Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine; thoracic surgery; phthisiosurgery.

SUBSTANCE: median sternotomy is performed. A layer-by-layer dissection of the skin and subcutaneous fat is performed. The sternum is cut. The main bronchus of the affected lung is isolated and transected at the level of the ostium. The tracheobronchial defect is sutured with polypropylene thread. The size and boundaries of the pulmonary hernia are assessed. The tissue of the only lung is returned to their hemithorax according to the type of hernia reduction. Mediastinoplasty is performed by suturing a polypropylene non-absorbable mesh implant over the area of the hernial orifice. A mesh implant measuring 15×15 cm is fixed along the periphery to the surrounding tissues in front to the parietal layers of the pleura, and behind to the pericardial layers with through U-shaped prolene sutures along the entire length of the mediastinal surface. Three drains are installed in the suturing area. The first drainage is installed in the retrosternal area. The second drainage is installed in the apical region of the hemithorax of the remaining lung with connection to the Bullau jar. The third drainage is installed plugged into the diastasis area of the stump. After this, the sternum is sutured with interrupted lavsan sutures with the mesh implant being picked up. The first drainage is removed on the third day after surgery, the second drainage is removed on the fifth day, and the third drainage is removed on the tenth day.

EFFECT: method makes it possible to increase the effectiveness of treatment of common complicated pulmonary tuberculosis with mediastinal pulmonary hernia and reduce the level of postoperative complications.

1 cl, 6 dwg, 1 ex