Central Asian Journal of Medicine


Aim: Intrapleural bleeding is a serious complication of the first hours and days after surgery. Judging by the literature, it occurs in 2-20% of cases. A timely retoracotomy removes the cause of bleeding and often saves the life of the patient. The goal is to form and improve the tactics of treatment of postoperative intrapleural bleeding. Material and methods: The main group - 109 patients, these are patients operated on after 2006, the control group until 2006 - 225 patients. The tactics of managing patients with intrapleural complications differed in the set of new technologies introduced in parallel in the two centers under consideration after 2006, respectively, patients treated after 2006 were included in the main group, until 2006 in the control group. The development of postoperative bleeding was observed in 123 patients. In the main group, this complication developed in 48 cases (44% of all intrapleural complications — 109), in the control group in 75 patients (33.3% of all complications — 225). The diagnosis of intrapleural bleeding after surgery should be quick, because sometimes the patient's life depends on the minutes of delay. Result: The study is based on the results of the examination and treatment of 334 patients with postoperative intrapleural complications, operated on at the Central State Clinical Hospital at the Regional Clinical Hospital No. 1 named after prof. S.V. Ochapovsky (Krasnodar) from 2003 to 2008. and in the Department of Surgery of the Lung and Mediastinum of the RSCH named after Acad. V.Vakhidova from 1999 to 2018. The development of postoperative bleeding was observed in 123 patients. Of them, 72 (58.53%) had intrapleural bleeding, 39 (31.7%) had coagulated hemothorax and 12 (9.7%) patients had parietal hematoma. Of the 123 patients, 67 were operated on during the first day after the development of the complication, while the proportion of satisfactory results was 98.5% (in 66 out of 67 patients), an attempt at conservative hemostasis and repeated intervention on the second day increased the number of unsatisfactory results by almost 4 times from 1.5% to 5.6%. Conclusions: Minimally invasive interventions have several advantages in eliminating postoperative intrapleural hemorrhages: low invasiveness, reduce the length of stay of patients in the hospital and thereby reduce the material costs. The use of PTS in coagulated hemothoraxes is the method of choice.

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