Methods of prevention and elimination of the most frequent intraoperative and postoperative complications in the surgical treatment of pulmonary and pleural tuberculosis using video-assisted surgical interventions

Abstract

Objective — to identify and analyze methods of prevention and elimination of the most common intraoperative and postoperative complications in the surgical treatment of pulmonary tuberculosis and pleura using VATS.
 Materials and methods. In the Department of Thoracic Surgery and Invasive Diagnostic Methods of the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine for the period from 2008 to 2019 performed 169 VATS operations on patients with tuberculosis surgery, of which: 130 (79.3 ± 3.2) % VATS lung resections; 35 (20.7 ± 3.1) % VATS pleurectomy with decortication (PE with DC) of the lung; 4 (2.4 ± 1.2) % of patients underwent other VATS interventions.
 Results and discussions. The level of intraoperative complications among all 169 operated patients was recorded in 9 (5.3 %) cases. Postoperative complications were detected in 29 (17.1 %) patients.Methods of prevention of complications in VATS are the selection of patients at the preoperative stage, correction of hemostasis, safe areas of thoracoport and minitracotomy, lymph dissection, separate treatment of lung root elements, conversion to thoracotomy.
 Conclusions. VATS interventions are minimally invasive, effective and convenient methods of surgical treatment of patients with pulmonary and pleural tuberculosis. Adequate assessment of the possibility of performing VATS, methods of prevention of complications and their timely application provides a predictable course of the postoperative period and reduces the number of complications. Diagnosis of complications and timely use of various methods of their elimination allows you to effectively and reliably apply medical manipulations to resolve both intra­ and postoperative complications in this type of surgery. Understanding and using methods of prevention and elimination of complications, allows to determine the correct tactics of operation and management of the postoperative period.