Abstract

Aim. This study was done to determine the feasibility and effectiveness of the proposed method of thoracoscopic hemostasis and aerostasis. Methods. The study included 85 patients operated for bullous lung disease, closed chest injury and penetrating chest wounds in the Lung and Mediastinum surgery department of the Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov for the period from 2015 to 2019. Total of 33 patients made up the main group: thoracoscopy using the proposed technique and 52 patients for the comparison group: thoracoscopic aerostasis was performed using known methods. In 21 (40.4%) cases of comparison group, we performed video-assisted thoracoscopic (VATS) excision and suturing with pleurodesis; in 14 (26.9%) cases – VATS with stitching of a lung wound. VATS excision and flashing of bullae of the lung using a stapler was performed in 19.2% (10 of 52) cases of the comparison group and 24.2% in the main group, where all VATS were supplemented with Geprotsel gel application. Results. Using the Geprotsel in VATS interventions allowed to reduce the necessity of lung tissue stitching from 67.7% to 27.3%, respectively, to limit excision in 36.4% of patients, to achieve complete tightness after hardware stitching (χ2 - 17.304; Df=3; p<0.001), which generally leveled the risk of postoperative pneumonia and impaired hemostasis. Recommendation. We suggest that applying Geprotsel gel during VATS for lung tissue damages allows to reduce the application of additional sutures, improve the efficiency of minimally invasive operations with a decrease in the frequency of postoperative disorders of aero- and hemostasis.