The choice between lymphatic dissection in phthisio-surgical interventions, basing on densitometric characteristics

Abstract

Objective. To determine the application possibilities of objective criteria for volume and spectrum of lymphatic dissection in phthisiatric interventions. Materials and methods. The work was based on results of the treatment analysis of 275 patients, suffering phthisio-surgical pathology, in whom densitonetric indices of pulmonary parenchyma and mediastinal lymphatic nodes were investigated. Results. There was established, that the changed densitometric indices of mediastinal lymph nodes may characterize the prevalence of specific pulmonary process objectively and to present the criteria of choice for the necessary lymphatic dissection borders in phthisio-surgical interventions. If in the affected parts of pulmonary parenchyma the minimal densitometric meanings of 15 U of Hounsfield (HU) are determined, the ipsilateral lymphatic nodes ablation is indicated, while in 15 HU and higher – the ablation of partial and segmentary lymphatic nodes during the operative intervention. Lymphatic dissection was not performed if the pulmonary parenchyma densitometric indices in specific pulmonary process have exceeded 55 HU. Conclusion. Lymphatic dissection in phthisio-surgical interventions («sampling») may be performed in accordance to objective criteria for lowering of the occurrence risk for pleuro-pulmonary complications and prevention of nonsubstantiated extension of operative intervention.