Background: The aim of the study was to determinate the optimal surgical treatment and evaluate the different methods of surgical treatment of descending purulent mediastinitis in our clinic and evaluate their effectiveness.
Patients and methods: The results and treatment protocols of 73 patients with with neck phlegmon (NF) and descending purulent mediastinitis (DPM) from 2004 to 2020 year. The study was performed as a analysis of various types of surgical treatment of purulent mediastinitis. All patients were fully comparable in age, sex, duration and course of the pathological process.


Results: The use of pre-emptive surgery such as video-assisted thoracoscopy (VATS) in the surgical treatment of DPN allows a complete review of the mediastinum, allowing the effective surgery and sanation of all affected mediastinal areas and their adequate drainage. With the use of surgical interventions to prevent the spread of purulent process in the mediastinum, we managed to reduce the number of repeated surgical interventions from 48.3 % to 12.5 % and mortality from 24.1 % to 8.3 %.
Conclusions: The basis for surgical treatment of descending purulent mediastinitis is surgery to prevent the spread of purulent-necrotic process with the priority use of video-assisted thoracoscopy. The use of pre-emptive surgery can reduce the number of common forms of total mediastinitis and reduce mortality.
Key words: mediastinitis, descending purulent mediastinitis, video-assisted thoracoscopy.
Lek Obz, 2021, 70 (1): 16-20

Článok vyšiel iba v anglickom jazyku


Sergiy SNIZHKO, Igor SHEVCHUK

Department of Surgery 2 and Cardio-surgery, Ivano-Frankivsk National Medical University, Ukraine
Department of Surgery 2 and Cardio-surgery, Ivano-Frankivsk National Medical University, Ukraine


Cite:

SNIZHKO S., SHEVCHUK I.:  Evaluation of the effectiveness of various types of surgical treatment of upper descending purulent mediastinitis.  Lek Obz, 2021, 70 (1): 16-20