RESULTS OF PALLIATIVE SURGICAL CORRECTION FOR PATIENTS WITH RESPIRATORY FAILURE DEPENDING ON THE VARIANT OF EMPHYSEMATOUS LESION

Abstract

The OBJECTIVE is to estimate the immediate and long-term results of palliative surgical correction of the respiratory failure (RF) depending on the variants of emphysematous lesion of the lungs. MATERIAL AND METHODS. 175 patients with the severe pulmonary emphysema (PE) were operated, 111 resections of large and giant bullas (RB) (55.5 %), 85 lung volume reduction surgery (LVRS) (42.5 %) were performed, the proportion of repeated interventions on the contralateral lung were 12 %. RESULTS. Complications in the early postoperative period were in 107 patients (53.5 %), postoperative lethality was 12.0 % (n=24). Complications in the group of patients with the absence of practically preserved lobe were in 84 patients (69.4 %) while the complications in the group with practically preserved lobe were revealed only in 23 patients (29.1 %) (p=0.001). After RB in the groups where bullas adjoined to almost unchanged pulmonary tissue, the lethality during the five-year observation period was much less, than in the groups with clinically significant pulmonary emphysema in the remaining after operation part of a lung, 4.1 % and 40.0 % respectively (p=0.001). CONCLUSION. After the palliative surgical correction of RF through RB or LVRS, the most favorable survival criterion is the presence of parenchyma in the operated lung, which is practically not affected with emphysema.

Keywords

• pulmonary emphysema
• lung volume reduction surgery
• resections of large and giant bullas