DOI: 10.25881/20728255_2021_16_3_106

Authors

Tarasov R.V., Nikitina N.M., Asoyan G.A., Sadovnikova S.S., Bagirov M.A.

Central Tuberculosis Research Institute, Moscow

Abstract

Аn observation from practice is given — surgical treatment of a patient with widespread pulmonary tuberculosis with an extensive mediastinal hernia of the right lung, due to progressive wrinkling of the left lung.

Patient B, 29 years old, suffered from pulmonary TB for 5 years. The course of treatment was repeatedly interrupted independently. He was admitted with complaints of hemoptysis, increased shortness of breath. The patient underwent transsternal occlusion of the left main bronchus and transpericardial occlusion of the left pulmonary artery with simultaneous plastic surgery of the anterior mediastinum with a mesh implant at stage 1. In order to reduce the left hemithorax and enhance the corrective effect on the mediastinal hernia, extrapleural thoracoplasty was performed with resection of the I-V ribs from the side of the previously performed occlusion at stage 2.

Keywords: transsternal occlusion of the main bronchus, polymer mesh implant, fibro-cavernous tuberculosis, mediastinal hernia, clinical case.

References

1. Nechaeva OB. Tuberculosis epidemic in Russia. Tuberculosis and lung disease. 2018; 96(8): 15 (In Russ).

2. Giller DB, Giller GV, Glotov AA, et al. Resection of the only lung in the treatment of bilateral destructive tuberculosis. Tuberculosis and lung disease. 2014; 7:31-39 (In Russ).

3. Bagirov MA, Krasnikova EV, Ergeshova AE, et al. Anterior mediastinal plastics during pneumonectomy as prevention and treatment of mediastinal hernias in patients with fibrous-cavernous pulmonary tuberculosis. Tuberculosis and lung disease. 2017; 95(11): 36-40 (In Russ.)

4. Matveev VYu, Khasanov RM, Bondarev AV, et al. Method of temporal bronchial occlusion and its effectiveness in empirical pleura patients with bronchopleural fistula. Practical medicine. 2015; 1:124 (In Russ).

5. Abruzzini P. Trattamento chirurgico delle fistole broncho principale consecutive a pneumonectomia Per tuberculosi. Сhir Thorac. 1961; 14: 165-71.

6. Bogush LK, Didenko VF. Treatment of tuberculosis patients with post-sectional bronchial fistula. Alma-Ata; 1975. (In Russ).

For citation

Tarasov R.V., Nikitina N.M., Asoyan G.A., Sadovnikova S.S., Bagirov M.A. Successful treatment of advanced pulmonary tuberculosis with simultaneous correction of mediastinal pulmonary hernia. Bulletin of Pirogov National Medical & Surgical Center. 2021;3(16):106-109. (In Russ.) https://doi.org/10.25881/20728255_2021_16_3_106