Clinical assessment of the risk of failure of a sutured bronchial stump in the postoperative period

Bronchial drainage function disorder is a predictor of complications in patients with purulent destructive lung diseases in the early postoperative period. Acute lung abscesses are characterized by a mortality rate of 7 to 28 %. Acute pulmonary gangrene is associated with a mortality rate of 30 to 90 %. Performing a pneumonectomy in patients with pulmonary gangrene at the height of bleeding is accompanied by a high mortality rate of up to 90 %. The failure of bronchial stump sutures or tracheobronchial anastomosis does not depend on plastic methods, but rather on risk factors that determine the failure development. Purpose of the study. To develop a score assessment of the risk of failure of the sutured bronchial stump in the postoperative period for the prevention of purulent complications in the pleural cavity. Research objectives. To study the volume of surgical interventions and various surgical techniques, features and methods of performing combined anesthesia, blood and plasma transfusion, duration of surgery, histological data of the removed bronchus tissue, nosocomial infection in the thoracic department, and the erythrocyte sedimentation rate in patients with purulent destructive lung diseases for a score assessment of bronchial stump failure in the postoperative period. Material and methods. In total, clinical, laboratory, and instrumental data of 2,246 patients, residents of the Penza Region, with lung abscesses and pulmonary gangrene for the period from 1999 to 2019 were studied to develop score scales. The control group consisted of 150 healthy blood donors. Statistical processing of medical data was carried out using SPSS, the Statistical Package for Social Sciences, in order to further develop original software tools for diagnosing and predicting complications of purulent destructive lung diseases. Conclusion. This level of the score scale for assessing the severity of the condition of patients with purulent destructive lung diseases, based on the presented groups of parameters, allows determining the risk of failure of a sutured bronchial stump in the pleural cavity in the postoperative period to improve patient treatment.