From Big Medical Encyclopedia

DECORTICATION OF THE LUNG (Latin the de-prefix extraction, destruction + cortex bark) — operation of release of a lung from the pleural imposings formed by fibrin and fibrous connecting fabric. It is offered in 1894 by the fr. surgeon Delorm (E. Delorme). Its technique at various diseases, including at tuberculosis, was improved by Yu. Yu. Dzhanelidze, P. A. Kupriyanov, L. K. Bogush, N. I. Gerasimenko, H. M. Amosov, Fowler (G. And. Fowler), etc. The purpose of operation — creation of conditions for a raspravleniye of the squeezed lung, recovery of its function and elimination of a residual cavity. Distinguish D. of l. partial and full. It can be made as independent intervention or to be combined with thoracoplasty (see), pleurectomy (see), a pneumonectomy and even with operations on other bodies of a chest cavity. Operation found a wide spread occurance in thoracic surgery.

Indications: rigid pleurisy, it is long the current pneumopleuritis, a residual cavity with bronchial fistula or without it, hron, an empyema of a pleura, an effect of a hemothorax.

Contraindication: active tubercular process in the same lung.

Operation is made under an intubation anesthesia with relaxants. Access — side or posterolateral thoracotomy (see) in the V—VI mezhreberye. In the beginning under the fibrous shvarta covering a lung enter solution of novocaine, and then cut it along a backbone, allocate the site of pulmonary fabric. Using hydraulic preparation, by means of a tupfer and the cutting surgical instruments otslaivat fibrous fabric from a visceral pleura on all surface of an affected area of a lung, and then excise a shvarta the uniform block or in parts. Operation is finished with a raspravleniye of a lung and drainage of a pleural cavity for the subsequent active aspiration.

The most typical complications — damage of pulmonary fabric, pheumothorax, bleeding. Good results after D. of l. are observed at most of patients.

See also Lungs, operations .

V. I. Petrov.