Solodovnyk O. Extrapleural thoracoplasty of widespread tuberculosis of lungs in the conditions of epidemic tuberculosis.

Thesis is dedicated to studying the potential for optimization of the treatment of contemporary lung tuberculosis, which is in most cases characterized by the prevalence of the process, primary resistance of mycobacterium tuberculosis to antibacterial preparations with 28-33 % firstly uncovered patients, development of secondary resistance with 65-77% patients in 5-6 months of the treatment, including at the level of multidrug-resistant that in the majority of cases is a contra-indication to resective methods of surgical treatment. Besides that, in a considerable percentage of cases the contra-indication to such methods of treatment can be functional insufficiency of the patient's pulmonary and cardiovascular systems. In the process of investigation the possibility of application with such patients of extrapleural thoracoplasty in its standard (classical) variant is proved. With the aim of individualization of an operative intervention that optimizes the results of the treatment a candidate for a degree suggested and embodied two modifications of extrapleural thoracoplasty. For intensification of the effectiveness of the intervention and avoidance of some complications a surgical collapse was amplified with an additional collapse by means of pneumoperitonim. The results of the treatment by most indexes for certain turned out to be better during the application of collapse-surgical intervention compared to resective one. Distant results in medical indexes, efficiency and social rehabilitation are studied.