Extrapleural pneumolysis for cavitary pulmonary tuberculosis treatment

Objective. To increase efficiency of cavitary pulmonary tuberculosis treatment by developing modern indications and technology of extrapleural pneumolysis with filling material.Material and Methods. We reviewed 25 patients with cavitary pulmonary tuberculosis and bacterial excretion who had undergone extrapleural pneumolysis with different types of filling material in 2004–2015. In 16 cases, we performed surgery in patients with one lung.Results. 56% of operated patients demonstrated extensively drug-resistant TB, 40% had multidrug-resistant TB. Cavities were closed and bacterial excretion ceased in 92% of patients at discharge. Long-term results with observation period from 1 to 12 years were analyzed in 24 patients, 17 (71%) of them had complete clinical efficacy.Conclusion. Extrapleural pneumolysis is a mini-invasive surgical treatment that can prove positive effect in patients with non-fibrotic changes in a cavity wall and pathological process in upper parts of the lungs

The surgical treatment of destructive pulmonary tuberculosis in patients with diabetes

The purpose of the study was to improve quality of surgical treatable of destructive pulmonary tuberculosis in patients with diabetes.Materials and Methods. D.B. Giller and employees of the Department of Phthisiopulmonology and Thoracic Surgery of the First Moscow State Medical University M.I. Sechenov performed operations on 200 patients with diabetes due to tuberculosis. Group 1 was mustered from 78 patients from 2004 to 2009. Group 2 was mustered from 122 patients from 2011 to 2017.Results. An analysis of the results showed that after 31 operations, 27 (13.5%) patients from both groups developed 33 complications. The second group (6.6%) had fewer complications after surgery than the first group (24.4%) 3.7 times. The first group had more vulnerary and bronchopleural complications than the second group. 12 patients (15.4%) of the first group and 6 patients (4.9%) of the second group had bronchopleural complications (empyema, residual cavity, delayed expansion of the lung and intrapleural bleeding). 2 patients died in the hospital (30-day mortality was 0.66%) after 303 surgical intervention in both groups. 1 patient (0.9%) died after 106 surgical interventions in the first group. 1 patient (0.5%) died after 197 surgical interventions in the second group. The full effect was achieved in 75 (96.2%) patients in the first group and 114 (93.4%) in the second group. The survival value of patients of the second group was 100% after 1 year, 98% after 2 years, 98.8% after 3 years, 96.9% after 4 years, 95.2% after 5 years. The surgical treatable affected the occupational rehabilitation of patients from group 2. 61.5% of patients from group 2 became able to work after 1 year. 64.5% of patients from group 2 became able to work after 5 years.Conclusion. If doctors use our tactics in patients with destructive pulmonary tuberculosis and diabetes, the risk of complications after surgery will drop and reactivation of tuberculosis will not occur

ПРЕДПОСЫЛКИ СОЗДАНИЯ ПЕРСПЕКТИВНОГО АППАРАТА НЕИНВАЗИВНОЙ ЛУЧЕВОЙ МЕДИЦИНСКОЙ ДИАГНОСТИКИ НА ОСНОВЕ МИКРОВОЛНОВОГО ИЗЛУЧЕНИЯ

Background for development of perspective apparatus for non-invasive medkal radiation diagnostics of functional state of inner organs and tissues on the base of application of microwave sensing and visualization techniques in non-ionizing range of electromagnetic spectrum safe for human organism, practically implemented using smart antenna array, is given. Perspective medical apparatus will have previously unachievable functional technological characteristics, particularly - principal possibility of high-resolution visualization of organs and tissues without using any contrast agents and costing less in comparison with existing systems of computer, magnetic resonance and positron emission tomography on the market.Обоснована возможность создания перспективного аппаратного комплекса неинвазивной медицинской лучевой диагностики функционального состояния внутренних органов и тканей на основе применения методов микроволнового зондирования и визуализации в неионизирующей области электромагнитного спектра с безопасной дозой излучения для организма человека, реализуемых на практике с помощью использования адаптивной цифровой антенной решетки. Перспективный диагностический комплекс будет иметь ранее недостижимые функциональные технологические свойства, в частности, возможность высокоразрешающей визуализации органов и тканей без использования контрастных веществ, обладая при этом более низкой стоимостью по сравнению с существующими системами компьютерной, магнитно-резонансной, позитронно-эмиссионной томографии на рынке