Bacherikova Y. Miniinvasive thoracoscopical methods at spontaneous pneumothorax on base of nonspecific diseases of lungs.

Object of the study: spontaneous pneumothorax of nonspecific etiology. Purpose of the study: the improvement of results of surgical treatment of patients with spontaneous pneumothorax of nonspecific etiology by working out of medical-diagnostic algoritm, using and improvement of methods of miniinvasive surgery. Methods of the investigation: general clinical examination of the patients; laboratory (a general clinical blood analysis, a biochemical blood analysis, definition of indexes of coagulating system of blood); instrumental (a electrocardiography, research of function of external respiration, roentgenologic research of thorax, computer tomography of thorax); the pathomorphologic; the statistical. Theoretical and practical results: wide using miniinvasive thoracoscopic methods in diagnostic and treatment of spontaneous pheumothorax of nonspecific etiology was proved. The expediency of providing of the diagnostically-medical help patients with spontaneous pheumothorax of nonspecific etiology in the conditions of specialised hospital. There were developed and implanted in practical activities method of treatment of spontaneous pheumothorax which includes (video)thoracoscopy of pleural cavity research in the fourth intercostals space by forward-axillary line – in Bogush-Lukomsky’s point with the subsequent drainage of pleural cavity (the patent of Ukraine № 17823 from 16.10.2006), the method local diathermocoagulated pleurodesis (the patent of Ukraine № 28557 from 10.12.2007) and consolidation of subpleural buls by layers «Takhokomb» (the patent of Ukraine № 27561 from 12.11.2007), that contributes to improvement of the results of treatment, acceleration spreading of lung, reduction of terms of postoperative treatment, decrease number of relapses. Indications to traditional and miniinvasive methods of surgical treatment, performance pleurodes at spontaneous pheumothorax of nonspecific etiology were defined what has helped to develop diagnostically-medical algorithm of surgical tactics. Novelty: there weredefined fundamental principls of diagnostics and surgical treatment with use of miniinvasive technologies at patients with spontaneous pheumothorax of nonspecific etiology. There were carry out comparative research of use of traditional methods of surgical correction of spontaneous pheumothorax and miniinvasive methods with studying of clinical efficacy at the specified pathology. Advantage and efficacy resection methods of treatment of spontaneous pheumothorax of nonspecific etiology were proved. There were proved priority videothoracoscopic re-search, the method of treatment of spontaneous pheumothorax of nonspecific etiology were developed. There were developed and positioned the positive results of use the new method of local pleurodesis and consolidation by collagenic layers of visceral pleura of the buls which located in anatomically remote regions (preradical), at impossibility to execute resection of the specified region. The algorithm of diagnostics and treatment of spontaneous pheumothorax of nonspecific etiology with use of videothoraco-scopic technologies, taking into account the changes of pulmonary parenchyma taped during a diagnostic video thoracoscopy were offered. Sphere of application: medicine, surgery.