OBJECTIVE. Despite the increasingly use of video-assisted approaches in thoracic surgery, intraoperative conversion from minimally invasive to «open» takes place quite often, especially during anatomical lung resection. METHODS AND MATERIALS. A retrospective analysis of 106 consecutive anatomical lung resections (lobectomies) initiated by thoracoscopic access was performed. The patients were divided into two groups: a group of 90 patients

The OBJECTIVE was to identify prognostic factors of long-term air leak after lobectomies based on the analysis of the main preoperative and surgical clinical and functional indicators.METHODS AND MATERIALS. A retrospective study included 71 patients who underwent lung resection in the volume of lobectomy for lung cancer. The patients were divided into three groups - group 1 (n=42, 59 %) - air leak through the drains stopped within a day after surgery; group 2 (n=10, 14 %) - the duration of air leak from the pleural cavity from 1 to 5 days; group 3 (n=19, 27 %) the duration of air leak more than 5 days after surgery.RESULTS. The average values of the main clinical, surgical and functional indicators, such as the frequency of concomitant COPD, the severity of its course, smoking status, access (thoracotomy / thoracoscopy) in the three groups were almost the same. The difference in the average value of DLCO was characterized by the greatest tendency to reliability: the longer the pulmonary air leak was, the lower the values of this indicator turned out to be. Correlation analysis revealed a noticeable feedback between the long-term pulmonary air leak and the preoperative level of FEV1 (r=-0.59), a direct relationship between the level of FEV1 and DLCO (r=0.51), as well as a noticeable feedback between the long-term pulmonary air leak and the level of DLCO (r=-0.61) and a direct moderate relationship between the pulmonary air leak and the time spent on the stair climbing test (r=0.38).CONCLUSIONS. The combination of a low level of FEV1, a low level of DLCO and a long duration of the stair climbing test makes it possible to assess the risk of prolonged pulmonary air leak as significant and take this into account during the surgical intervention.

Представлено описание клинического наблюдения развития рака пищевода у пациентки, перенесшей ранее двустороннюю трансплантацию легких. Онкологическое заболевание характеризовалось чрезвычайно быстрым ростом; несмотря на регулярное обследование в посттрансплантационном периоде, рак пищевода диагностирован уже в IV стадии (метастазы в печени). Опухоль осложнилась рецидивирующим массивным кровотечением, в связи с чем по жизненным показаниям выполнена субтотальная резекция пищевода с пластикой широким желудочным стеблем. Послеоперационный период протекал без осложнений. Проводится послеоперационная полихимиотерапия, достигнута стабилизация опухолевого процесса.