Ivashchenko V. Optimization of technology of videothoracoscopic diagnosis in patients with pleural effusion syndrome

Differentiated tactic for deciding the method of performing videothoracoscopy based on creating of artificial pneumothorax and x-ray estimating of the pleural cavity was developed. Patients with free pleural cavity carried the videothoracoscopy by simplified method. We analised 124 cases of patients with the pleural effusion syndrome who underwent VTS for etiologic diagnosis. To 62 patients of the basic group we applied our differentiated tactic. 62 patients of the control group were diagnosis diagnosed by the conventional method. Each group was divided to two subgroups with 31 patients in each. Subgroups I had free pleural cavity, and subgroups II had many adhesions, encapsulations and sacculations. Therefore they had a different extent of operation. As a result of implantation of our differentiated tactic into clinical practice, the number of post-anesthetic side effects was decreased by 65.9%, frequency of use of narcotic analgesia was reduced from 2.8 to 1.4 per day, recovery of physical activity shortened from 23.8 to 10.3 hours, recovery of digestive system decreased from 72.0 to 43.3 hours, period of stay in the intensive care unit dropped from 24.8 to 9.6 hours, and length of post-operative treatment was reduced from 16.0 to 10.1 days. It was proved that worked out methodology of simplified method of diagnostic videothoracoscopy was not inferior in efficiency compared to standard method and has significant advantages.