grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2019-178-5-121-126grekov-1146Research ArticleОБЗОРЫREVIEWSОТБОР ПАЦИЕНТОВ С СОПУТСТВУЮЩЕЙ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ДЛЯ ПРОВЕДЕНИЯ АНАТОМИЧЕСКИХ РЕЗЕКЦИЙ ПРИ РАКЕ ЛЕГКОГО (обзор литературы)SELECTION OF PATIENTS WITH CONCOMITANT CHRONIC OBSTRUCTIVE DISEASE FOR ANATOMICAL RESECTIONS IN LUNG CANCER (review of literature)АкоповА. Л.AkopovA. L.

Акопов Андрей Леонидович - профессор, зав. отделом торакальной хирургии НИИ хирургии и неотложной медицины

Andrey L. Akopov

akopovand@mail.ruГорбунковС. Д.GorbunkovS. D.

Горбунков Станислав Дмитриевич - канд. мед. наук, старший научный сотрудник отдела торакальной хирургии НИИ хирургии и неотложной медицины

Stanislav D. Gorbunkov

sdgorbunkov@mail.ruРоманихинА. И.RomanikhinA. I.

Романихин Аркадий Игоревич - аспирант кафедры госпитальной хирургии № 1

Arkadyi I. Romanikhin

romanihin.arkadiy@mail.ruКовалевМ. Г.KovalevM. G.

Ковалев Михаил Генрихович - канд. мед. наук, доцент кафедры анестезиологии и реаниматологии

Mikhail G. Kovalev

kov_mg@mail.ruПервый Санкт-Петербургский государственный медицинский университет имени академика И.П.ПавловаРоссияPavlov UniversityRussian Federation2019081020191785121126Copyright © Акопов А.Л., Горбунков С.Д., Романихин А.И., Ковалев М.Г., 20192019Акопов А.Л., Горбунков С.Д., Романихин А.И., Ковалев М.Г.Akopov A.L., Gorbunkov S.D., Romanikhin A.I., Kovalev M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/1146

Проведен анализ отечественной и зарубежной литературы относительно возможности выполнения анатомических резекций легких у пациентов с сопутствующей хронической обструктивной болезнью легких (ХОБЛ). По мнению большинства исследователей, ОФВ1 и ДСЛ(co) более 80 % указывают на высокую вероятность неосложненного послеоперационного периода, после любой анатомической резекции легкого. При значении указанных параметров менее 80 % необходимо выполнение дополнительных исследований – функциональных тестов (6-минутный тест с ходьбой, лестничная проба), КРНТ, расчет послеоперационных значений функции внешнего дыхания, также при необходимости, с целью исследования региональной функции дыхания, возможно выполнение сцинтиграфии легких. При пороговых значениях указанных параметров решение о возможности и необходимости проведения оперативного лечения должно приниматься в индивидуальном порядке. В то же время на настоящий момент нет системы оценки риска послеоперационных осложнений для конкретного пациента на основе всех известных о нем сведений, что представляет собой потенциал для дальнейших исследований.

Авторы заявили об отсутствии конфликта интересов.

Авторы подтверждают, что соблюдены права людей, принимавших участие в исследовании, включая получение информированного согласия в тех случаях, когда оно необходимо, и правила обращения с животными в случаях их использования в работе. Подробная информация содержится в Правилах для авторов.

The analysis of literature on the possibility of performing anatomical pulmonary resections in patients with concomitant COPD was performed. According to most researchers, FEV1 and DL (CO) more than 80 % indicated a high probability of an uncomplicated postoperative period after any anatomical resection of the lung. If the specified parameters were less than 80 %, additional studies were required: functional tests (6-minute walk test, staircase test), stress testing, calculation of predicted postoperative values of respiratory function, and, if necessary, lung scintigraphy could be performed to study regional respiratory function. The decision about the possibility and need for surgical treatment should have been made individually at the threshold values of these parameters. At the same time, there is currently no system for assessing the risk of postoperative complications for a particular patient, based on all the information about it, which represents the potential for further research.

The authors declare no conflict of interest.

The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

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The authors declare that there are no conflicts of interest present.