The use of methods of collapse therapy and valvular bronchoblocation as preoperative preparation in a patient with drug-resistant pathogen: a clinical observation

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Abstract

The main indications for the use of surgical treatment methods are destructive forms of the tuberculosis process with drug resistance of the pathogen, including bilateral ones. However, the use of resection methods of treatment may be accompanied by a large amount of loss of lung tissue and a violation of the functional parameters of the lungs in the future. A possible solution to this problem can be the use of methods of collapse therapy (artificial pneumoperitoneum) and valvular bronchoblocation as preoperative preparation in patients with pulmonary tuberculosis, including those with drug resistance of the pathogen.

A clinical case is given, which demonstrates the high effectiveness of using these methods in the framework of preoperative preparation in a patient with a widespread tuberculosis process and drug resistance of the pathogen. The proposed integrated approach contributed to reducing the volume of surgical intervention and preventing the development of functional disorders in the postoperative period.

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About the authors

N. V. Chumovatov

Central Tuberculosis Research Institute

Author for correspondence.
Email: Necro5412@mail.ru
ORCID iD: 0000-0001-8745-7940
SPIN-code: 7088-5717

Candidate of Medical Sciences

Russian Federation, Moscow

N. A. Chernykh

Central Tuberculosis Research Institute

Email: Necro5412@mail.ru
ORCID iD: 0000-0001-6787-2362
SPIN-code: 9144-7729

Candidate of Medical Sciences

Russian Federation, Moscow

O. G. Komissarova

Central Tuberculosis Research Institute; N.I. Pirogov Russian National Research Medical University

Email: Necro5412@mail.ru
ORCID iD: 0000-0003-4427-3804
SPIN-code: 6006-6732

MD

Russian Federation, Moscow; Moscow

V. V. Romanov

Central Tuberculosis Research Institute

Email: Necro5412@mail.ru
SPIN-code: 1695-1280

Professor, MD

Russian Federation, Moscow

References

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2. Fig. 1. Axial computed tomography slices of the chest, lung window: focal infiltrative changes in the left lung and decay cavities in the lung tissue

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3. Fig. 2. Axial computed tomography slices of the chest, lung window, after 2 months of treatment: partial resorption and consolidation of focal infiltrative changes in the left lung, reduction in the size of decay cavities

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4. Fig. 3. Axial computed tomography slices of the chest, lung window, after 4 months of treatment: closure of decay cavities in the left lung, formation of cirrhotic changes in the lung tissue

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5. Fig. 4. Axial computed tomography slices of the chest, lung window, after 5 months of treatment: chain of metal brackets, their integrity is preserved, no new focal and infiltrative changes are determined

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