Efficacy of Extrapleural Plombage With Silicone Plug in Destructive Pulmonary Tuberculosis Patients and Its Impact on Pulmonary Functions and Blood Gases

Krasnikova, Elena; Багиров, М. А.; Lovacheva, Olga; Попова, Л. А.; Sadovnikova, S. S.; Karpina, Natalya

doi:10.21292/2075-1230-2019-97-3-16-25

Cited by 5 publications

(1 citation statement)

References 3 publications

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“…Из материалов синтетического происхождения использовали пенополиуретан, стеклопластик, полиметилметакрилат, полистирол, силикон и др. В последние годы лучше всего зарекомендовали себя силиконовые протезы и экспандеры, предназначенные для реконструктивной и пластической хирургии молочной железы [11][12][13][14].…”

Section: Introductionunclassified

<i>In vivo</i> assessment of the biocompatible properties of resorbable porous materials for pleural implantation

Васильева¹,

Sevastianov

Токаев³

et al. 2021

RJTAO

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Correcting the pleural cavity space or filling large residual cavities (up to 500-700 cm3), arising as a result of extensive combined resections of the lung or extrapleural pneumolysis in tuberculosis and other lung diseases, still remains a challenging issue. The surgical methods used to correct the pleural cavity space are traumatic in nature. Moreover, various biological and synthetic materials used are not effective enough. Objective: to conduct an in vivo study of the biocompatible properties of laboratory samples of porous materials based on polylactide (PLA) and polycaprolactone (PCL) as potential materials for pleural implants development, as part of the general problem of developing a resorbable porous implant for intra- and extrapleural implantation and in situ formation of a «biological filling» to correct the volume of the pleural cavity. Materials and methods. In vivo subcutaneous implantation was performed in Wistar rats. The experiment involved the following samples: No. 1 - 3.0%; No. 2 - 4.0%; No. 3 - 1.7%. The ratio of the polymers in the solution was, respectively: 3/1, 1/3 and 1/1 PLA/PCL. Highly porous implants were obtained by lyophilization. The porosity of the samples ranged from 96.0% to 98.3%. The Young's modulus was from 100 to 1800 kPa. In the control group, a Mentor silicone implant shell was used. The explantation time was 1, 2, 3, 4, 5, 8, 12, 14 weeks. Histological, histochemical and immunohistochemical studies of explants and surrounding local tissues were conducted. Results. Reaction of local tissues to the implantation of three types of samples of different composition from PLA/PCL, accompanied by material resorption processes, replacement by fibrous tissue, vascularization and encapsulation, without perifocal inflammation and reactive changes, indicates the biocompatibility of the materials studied. In control samples with silicone implant, a long-lasting perifocal reaction from eosinophilic leukocytes was revealed, which prevents us from excluding the possibility of an allergic reaction to the implant material in the surrounding tissues. Conclusion. In vivo experiments on the small animals show the biosafety and high biocompatibility of laboratory samples of bioresorbable highly porous matrices based on polylactide and polycaprolatcon as potential materials for development of pleural implants. Further studies with scaling of laboratory samples and a detailed study of the dynamics of biodegradation of porous matrices in vivo in large animals are required. The need for further improvement in laboratory samples of bioresorbable pleural implants is associated with giving the porous matrices antibacterial, bioactive and X-ray contrast properties.

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Section: Introductionunclassified

<i>In vivo</i> assessment of the biocompatible properties of resorbable porous materials for pleural implantation

Васильева¹,

Sevastianov

Токаев³

et al. 2021

RJTAO

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The efficacy of different extrapleural fixations in upper-posterior thoracoplasty in fibrous cavernous pulmonary tuberculosis patients

Белов¹,

Григорюк

2021

Tuberk. bolezni lëgk.

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The objective of the study: to compare the efficacy of different modifications of thoracoplasty in patients with apical fibrous cavernous pulmonary tuberculosis.Subjects and methods. The article describes the analysis of the results of thoracoplasty in 65 fibrous cavernous pulmonary tuberculosis patients performed from 2016 to 2019. Three types of thoracoplasty were used: thoracoplasty with polypropylene mesh, osteoplastic thoracoplasty, and traditional thoracoplasty. The results were assessed by the severity of intraoperative trauma, development of bronchopulmonary complications, lack of compression, and healing of cavities.Results. No significant difference in the degree of intraoperative injury was found when comparing three types of thoracoplasty (p > 0.05). Clinical and X-ray examinations of patients in 3 weeks after surgery revealed that in thoracoplasty with a polypropylene mesh, the frequency of bronchopulmonary complications and lack of compression was lower than in other types of thoracoplasty (p < 0.05). Using the patient's own tissues for extrapleural fixation, especially with large cavities, results in a significant decrease in the thoracoplasty efficacy.

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The basics and prospects of surgical collapse treatment for advanced pulmonary tuberculosis

Donchenko,

Krasnikova,

Salikhov

et al. 2023

Vrach

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The paper presents the evolution of a surgical collapse approach to treating advanced pulmonary tuberculosis in circumstances where the causative agent shows a higher drug resistance and where the possibility of performing resection operations and pneumonectomies is limited. The authors show the historical aspects of development from thoracoplastic surgery to extrapleural pneumolysis, by filling the extrapleural space. They also depict stages in searchiing for effective biocompatible filling materials that provide a stable collapse of the lung tissue containing cavities and bullous deformity. The paper shows the experience with extrapleural pneumolysis via silicone implant filling, which demonstrates reliability, high efficiency and cosmetic advantage over thoracoplasty. The beneficial effect of extrapleural pneumolysis with silicone filling with silicone on respiratory function and pulmonary microcirculation was studied. Today, experience continues to accumulate in the use of extrapleural pneumolysis with silicone filling in the staged surgical treatment of advanced tuberculosis in combination with lung resections of various sizes and pneumonectomy, which considerably expands the boundaries of operability in patients with a decrease in functional indicators that have been previously considered hopeless. The prospects of the described method to treat this complex patient category necessitates further development of a wide range of issues, including the clarification of indications depending on the localization of the process and the degree of a respiratory function decrease, the improvement of equipment, the features of hospital management of the patients who have undergone surgery and their postoperative rehabilitation.

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Efficacy of Extrapleural Plombage With Silicone Plug in Destructive Pulmonary Tuberculosis Patients and Its Impact on Pulmonary Functions and Blood Gases

Cited by 5 publications

References 3 publications

<i>In vivo</i> assessment of the biocompatible properties of resorbable porous materials for pleural implantation

<i>In vivo</i> assessment of the biocompatible properties of resorbable porous materials for pleural implantation

The efficacy of different extrapleural fixations in upper-posterior thoracoplasty in fibrous cavernous pulmonary tuberculosis patients

The basics and prospects of surgical collapse treatment for advanced pulmonary tuberculosis

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