Dmitry Giller
I.M.Sechenov First Moscow State Medical University, Russia
Title: Completion pneumonectomy and re-resection of previously operated lung for drug-resistant pulmonary tuberculosis
Biography
Biography: Dmitry Giller
Abstract
We summarized the experience of performing repeated surgery for destructive drug-resistant pulmonary tuberculosis and other pathologies from 1984 to 2014. In total 276 (60,8%) pneumonectomies and pleuropneumonectomies and 178 (39,2%) lung re-resections were performed for recurrence of various diseases in the previously operated lung. 402 patients had a recurrence of pulmonary tuberculosis, 29 - nonspecific pathology and 25 – lung cancer. 454 patients underwent 765 operations including 44 preliminary transsternal occlusions of the main bronchus, 276 pneumonectomies and pleuropneumonectomies, 178 re-resections, 23 resections of the only one lung, 14 thoracoplasties on the only one lung side, 32 operations for early postoperative complications. Extrapleural VATS thoracoplasty on the side of the first operation (by using our original method) were carried-out on 75 patients with pneumonectomies and at 123 patients with re-resections for the purpose of the prevention of postoperative recurrence in the only one lung in the presence of considerable focal changes or cavities .
We explored frequency and character of the complications for re-operation and the risk factors of occurrence. Recommendations about the technique of performing of re-operations were developed that allowed to reduce the frequency of complications significantly. The postoperative mortality was 1% after pneumonectomies and pleuropneumonectomies. There was no mortality after re-resections. Full clinical effect reached in 94, 9% cases as a result of the carried-out surgical treatment. Long-term results and long-term survival after surgery were studied
