[The new method "cascade" thoracoplasty in surgery of destructive pulmonary tuberculosis]

A new method has been developed for two-stage thoracoplasty with pneumopexy for destructive pulmonary tuberculosis, which is called "cascade" thoracoplasty. The essence of the developed operation is thoracoplasty made in two steps; the objective of Stage 1 is to form limited pleurodesis below the level of lung destruction. At Stage 2, traditional upper posterior thoracoplasty is performed by the method developed by L. K. Bogush. The subjects of the study were 36 patients with destructive forms of pulmonary tuberculosis, including 11 (30.6%), 12 (33.3%), and 13 (36.1%) patients with fibrocavernous, cavernous, and disseminated tuberculosis, respectively. The efficiency of the new developed surgical technique was 83.3% whereas that of traditional thoracoplasty was 78.1% (p < 0.05). According to the clinical forms of pulmonary tuberculosis, the new developed thoracoplastic procedure was effective in 9 (81.8%), 11 (84.6%), and 10 (83.3%) patients with fibrocavernous, disseminated, and cavernous tuberculosis, respectively (p > 0.05). Collapse surgical intervention into the adhesion-free pleural cavity is a basically new technique.