Journal of Life Science and Biomedicine
J Life Sci Biomed, 10 (2): 10-16, 2020
Comparative analysis of the videothoracoscopic
Otabek Djurayevich ESHONKHODJAEV1, Ravshan Aliyevich IBADOV1, Ulugbek Nasirovich BOBAYEV2
and Bakhodir Abdimusayevich ISMAILOV1
1Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov, Tashkent, Uzbekistan
2Andijan State Medical Institute, Andijan, Uzbekistan
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
Rec. 05 January 2020
Rev. 15 March 2020
Pub. 25 March 2020
the lung using a stapler was performed in 19.2% (10 of 52) cases of the comparison group and Keywords
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.
The number of complications in thoracoscopic lung surgery associated with the development of postoperative
intrapleural bleeding and leakage of the pulmonary parenchyma, as well as with a violation of the tightness of
the sutured bronchus stump, remains significant and does not have a noticeable downward trend . Under
conditions of persistent pneumothorax, prerequisites are created for the development of infectious
complications, the formation of a persistent residual cavity, which, in turn, may require repeated interventions
or prolonged drainage .
Some studies showed that air leakage occurs immediately after surgery in 28-60% of patients who
undergo conventional lung resections, including lobectomy and smaller resections . On the 1st day after
surgery, air leakage is observed in 26-48% of patients; on the 2nd day, air leakage is present in 22-24% of cases;
on the 4th day - in 8% of cases . The National Emphysema Treatment Trial assumes that air leakage occurs at
some point in the postoperative period in 90% of patients undergoing bilateral procedures with both
thoracotomy and thoracoscopy, with average air leak duration of 7 days, and 12% of patients had a constant air
leak even 30 days after surgery [5, 6].
To achieve adequate hemoaerostasis - reliable sealing of the resection line - various methods of
strengthening the wound surfaces of the lung are used in clinical practice: laser exposure, plasma factors,
ultrasound, electrical coagulation, applying synthetic and biological adhesives to the surgical wound,
application of adhesive collagen plates and synthetic materials [7, 8].
This study aimed to determine the feasibility and effectiveness of the proposed method of thoracoscopic
hemostasis and aerostasis.
Citation: Eshonkhodjaev OD, Ibadov RA, Bobayev UN and Ismailov BA. Comparative analysis of the videothoracoscopic interventions results. J Life Sci Biomed,