Korpusenko I. Surgical tactics with mini invasive approach in the treatment of bilateral destructive pulmonary tuberculosis

The dissertation covers the issue of increasing the effectiveness of therapy in patients suffering from bilateral destructive pulmonary tuberculosis by developing and introducing mini-invasive surgical technology, which use is based on improvement of pre-operative testing and treatment strategies, according to the algorithm. The analysis of surgical treatment of 259 patients with bilateral pulmonary tuberculosis has been performed with break into two groups: with use of mini-invasive technique (129) and with traditional surgical approach (130). Criteria for optimal type, volume and timing of bilateral surgery were justified in the dissertation as well as expediency of intralymphatic injections of antituberculosis medications as part of preoperative management. Effectiveness of one-step video-assisted bilateral lung resection with use of argonoplasmic coagulation and hemithorax correction by autopleurocollagenoplasty, one-sided mini-invasive therapeutic thoracoplasty in case of bilateral pulmonary tuberculosis was established. Indications, contraindications and timing of bilateral mini-invasive collapso-surgical procedures was justified. Effectiveness of mini-invasive surgical tactics in treatment of bilateral pulmonary tuberculosis, complicated by pleural empyema was proven. Complex approach to use of one- and two-step mini-invasive surgeries in patients with destructive bilateral pulmonary tuberculosis was developed.