| 摘要 |
FIELD: medicine. ^ SUBSTANCE: method involves cranially moving a lung after a resection and realization of diaphragmolysis, exposing diaphragm surface to provide complete field of vision. Then, two conditional lines are drawn. The first conditional line is drawn in sagittal plane arranged tangentially to diaphragm vault in its tendinous center zone and in parallel to pericardium, 3-5 cm far from it. The second conditional line is drawn in perpendicular to the first one, being also tangent to the tendinous to diaphragm center through a point on a chest wall on median auxiliary line. Single suture is placed at point these lines are crossing near the tendinous diaphragm center used as label from which 3-4 separate sutures are additionally placed on diaphragm, without its piercing-through, in ventral direction along a line parallel to pericardium using biodegradable thread resorbable within 30 days, for example Vicryl No 5 or No 6. The sutures are placed equidistantly 1-2 cm far from each other. Their free ends, introduced through intercostal space of V and VI ribs in pericostal way between the middle and anterior axial lines, are arranged at an angle of 40-45°. Diaphragm is pulled cranially as far as possible without sharp tension being applied, to displace its tendinous center together with mediastinal organs towards ventralateral side for at least 7-10 cm. The threads are tied next to it outside of pleura between rib surface and chest wall muscles. ^ EFFECT: enhanced effectiveness of treatment; created optimum conditions for spreading the operated lung in pleural cavity without overstrain and pathological dislocation of the remained segments. ^ 2 cl, 2 dwg, 1 tbl |
