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.