Results of parenchymal-sparing pulmonary resections with bronchial reconstruction for diseases and injuries of bronchi

Abstract

The results of diagnosis and surgical treatment of bronchial diseases and injuries in 829 patients, including 92 (11 per cent) children aged from 8 months to 18 years and 737 (89 per cent) adults under the age of 76 years, are shown in the article. Among adult patients, women accounted for 271 (37 per cent) persons and men – 466 (63 per cent). The examination plan, in addition to general clinical methods, included thoracic multispiral computed tomography and endoscopy, histological and immunohistochemical assays to verify malignant tumours. In the case of malignant tumours, a positron emission tomography – computed tomography (PET-CT) was employed at the final stage of diagnostic assessment. Among the operated patients, the main group consisted of patients with tumours – 636 (77 per cent), of these 193 (23 per cent) patients underwent interventions for six diseases. Isolated bronchial resections were performed in 37 per cent of cases, and parenchymal-sparing bronchopulmonary resection with bronchial reconstruction – in 63 per cent. The main types of surgical interventions on the tracheobronchial tree were circular (62 per cent) and fenestrate (30 per cent) bronchial resection, the rest 8 per cent were other types of interventions. Out of 523 bronchopulmonary resections, a lobectomy was performed in 354 (68 per cent) cases, and other variants of parenchymal-sparing resection were made in 169 (32 per cent) patients. The surgeries were ended up with the standard restoration of bronchial tree integrity in 550 (66 per cent) patients, in 279 (34 per cent) patients – non-typical clinic-designed corrective multiaxial or polybronchial reconstruction was used. Postoperative mortality rate was 1.9%.