ANALYSIS OF DATA OF IMPLEMENTATION OF THE "CONTROLLED FISTULA" METHOD AND VAC-THERAPY IN A COMPLEX TREATMENT OF PERFORATION OF THE MIDDLE AND LOWER THIRD OF THORATHIC ESOPHAGUS COMPLICATED BY MEDIASTINITIS AND PLEURAL EMPYEMA
A retrospective analysis of the results of a comprehensive examination and treatment of 34 patients with perforation of the middle and lower third of the thoracic esophagus complicated by mediastinitis and pleural empyema for the period from 2010 to 2020 was performed. The most common causes of perforation of the middle and lower third of the thoracic esophagus were foreign bodies of the esophagus - 52,9 %, spontaneous rupture of the esophagus - 35,4 % and penetrating stab wounds - 8,8 %. It was revealed that the improvement of the results of the complex treatment of this category of patients was achieved due to the implementation of the «off» operation technique in surgical practice by creating the so-called «controlled fistula». The introduction of this method of treatment into the structure of surgical interventions, supplemented by subsequent VAC-therapy of the mediastinal space and pleural cavity, significantly reduced mortality from 56,3 % to 11,1 %.