| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, namely to thoracic surgery. Essence of method lies in carrying out operation 3-4 weeks after lung resection. Access is performed in the following way: 6-8 cm long cut is made from level of spinous process of III thoracic vertebra paravertebrally, parallel to medial edge of shoulder-blade, layer-by layer cut are skin, subcutaneous cellular tissue, part of trapezius muscle, latissimus dorsi and greater rhomboid muscle, partially cut muscles and shoulder-blade are separated from external surface of ribs in projection of future removal of bone frame and are taken apart and outwards by means of wide hooks, with formation of operation field cavity for surgical manipulations between greater skeletal muscles and rib frame, into said cavity through separate puncture installed is videothoracoscope and further manipulations, including thoracoplasty, are performed under videothoracoscopic control. Fibres of back-straightening muscle are separated in layers, opening access to posterior rib segments. Removal of bone frame is started with III rib, which is removed partially, after which II and I ribs are removed completely, rib is hermetically sutured. ^ EFFECT: application of claimed invention makes it possible to obtain expressed clinical effect, achieve more considerable reduction of hemithorax in comparison with standard method, reducing trauma of surgery, blood and plasma loss. ^ 1 ex, 8 dwg |
