Minimally Invasive Interventional Procedures for Pulmonary-Pleural Forms of Bacterial Lung Destruction in Children

Abstract

Bacterial destruction of the lungs is a severe form of purulent-septic respiratory diseases in children.

The severity of this pathology is due to the presence of a combined manifestation of respiratory, cardiac and other organ failure against the background of a pronounced intoxication syndrome and progressive changes in the bronchopulmonary system, manifested by formidable pulmonary-pleural complications that pose a threat to the child's life. Many researchers note that despite the improvement in the quality of diagnostics and the development of new methods for treating bacterial destruction of the lungs, the complications encountered continue to represent a serious medical problem in the children's contingent of patients[1, 5, 6, 7, 9, 14, 18, 19].

Analysis of the literature data indicates that the proportion of pulmonary-pleural forms of bacterial destruction of the lungs is about 26.5-60.0% in the structure of purulent-inflammatory diseases of the lungs and pleura in children, and has no significant tendency to decrease. Complex etiopathogenetic aspects of bacterial destruction of the lungs, a variety of clinical symptoms manifested by varying degrees of differentiable pathological syndromes, the development of frequent pulmonary-pleural forms of the disease due to late diagnosis, leads to a high percentage of predictable complications and an increase in unsatisfactory treatment results[2, 3, 11, 12, 13, 16, 17, 22].

The reasons for the unsatisfactory results of treatment of pulmonary-pleural forms of bacterial destruction are the inadequacy of the chosen tactics, as well as the unreasonableness in the choice of the method and method of early endoscopic or minimally invasive intervention, which leads to the forced implementation of wide traditional thoracotomies. In this regard, controversial and sometimes contradictory questions remain in the sequence of performing one or another method of treatment based on the principles from simple to complex: conservative pathogenetic therapy, minimally invasive puncture-draining and endoscopic interventions, as well as video-thoracoscopic surgical operations. The widespread introduction of modern medical technologies into the clinical practice of pediatric thoracic surgery made it possible to choose effective methods of treating many inflammatory diseases of the bronchopulmonary system at the early stages of their development, which in turn made it possible to prevent the development of severe pulmonary-pleural complications.[4, 8, 10, 15, 19, 20, 21, 22].

The above data clearly indicate the high urgency of the problem of diagnosis and treatment of pulmonary-pleural forms of bacterial destruction of the lungs in children.