CONDITIONS FOR INCREASING THE EFFECTIVENESS OF TREATMENT IN PATIENTS WITH FIBROCAVERNOUS PULMONARY TUBERCULOSIS USING THORACOPLASTY
One of the existing methods of creating conditions for stabilizing and stopping the progression of widespread fibrocavernous pulmonary tuberculosis remains thoracoplasty. Refusal of the surgical stage leads to a deterioration in treatment results and increases the frequency of relapses and deaths. The research purpose was to study the reasons influencing the results of treatment in patients with fibrocavernous pulmonary tuberculosis using various thoracoplasty. Materials and methods. The analysis of 233 thoracoplasty performed from 2012 - 2018 was carried out with fibrous - cavernous pulmonary tuberculosis. The 1st group (n=70) with selective extrapleural upper - posterior thoracoplasty with polypropylene mesh; the group 2nd - (n=60) with selective osteoplastic thoracoplasty according to Bjork; the 3rd group (n=103) with selective extrapleural upper - posterior thoracoplasty according to Bogush. In the analysis, attention was paid to the elimination of the decay cavity, the cessation of the isolation of Mycobacterium tuberculosis within a year. The factors influencing the outcome of treatment were assessed. Results and its discussion. The use of the mesh as a compression device made it possible to increase the effectiveness of the pressure of the affected lung section by 20% in comparison with the upper - posterior thoracoplasty according to Bogush and osteoplasty according to Bjork (p<0.05). A significant inverse dependence of the treatment outcome on the duration of the disease and the volume of the destruction cavity was established. Conclusions. Timely performance of thoracoplasty with the selection of a compression method depending on the volume of the destruction cavity increases the effectiveness of treatment. The choice of a hybrid method of thoracoplasty allows more effective compression of the affected part of the lung, which significantly affects the effectiveness of treatment of patients with fibrous - cavernous pulmonary tuberculosis.