The use of endobronchial valve occlusion in the comprehensive treatment of severe purulent destructive pulmonary processes complicated by bronchopleural fistula

Authors

  • I. Ya. Kelemen SHEI «Uzhgorod National University», Uzhgorod, Ukraine Andrii Novak Zakarpattia Oblast Clinical Hospital, Uzhgorod, Ukraine, Ukraine
  • M. M. Savula Andrii Novak Zakarpattia Oblast Clinical Hospital, Uzhgorod, Ukraine, Ukraine
  • V. S. Didyk Andrii Novak Zakarpattia Oblast Clinical Hospital, Uzhgorod, Ukraine, Ukraine

DOI:

https://doi.org/10.15574/PS.2018.61.42

Keywords:

pulmonary gangrene, bronchopleural fistula, video-assisted thoracoscopy, valve bronchial occlusion

Abstract

Objective: to implement endobronchial occlusion in the comprehensive treatment of patients with purulent-destructive pulmonary diseases, to evaluate and improve the management of a such group of patients.

Materials and methods. In total 130 patients with purulent-destructive pulmonary and mediastinal diseases of different severity and complications were treated. The patients with destructive pneumonia and pleuritis complicated with pleural empyema prevailed and made up 94 (72.3%) cases; solitary and multiple lung abscesses accounted for 26–20%, pulmonary gangrenous lesions – 10–7.7%. Bronchial occlusion (provided to 10 patients) was preceded by multiple therapeutic bronchoscopies of the affected bronchopulmonary areas and intrapleural hydrolavages with variable vacuum pressure. Temporary bronchial occlusion was performed using a bronchoobturator, the endobronchial valve «MEDLANG».

Results and conclusions. All patients were discharged recovered. There were no fetal outcomes. The proposed method is the most efficient comprehensive treatment of patients with severe forms of purulent-destructive lung lesiones, significantly improves recovery indices, reduces the length of hospital stay and contributes to the rapid recovery of performance capability.

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Issue

Section

Original articles. Thoracic surgery