ANATOMOMETRIC CHANGES OF THORAX AND SPINE AFTER PNEUMONECTOMY

Аннотация

Полный текст

Aim. Identification of topographic-anatomical changes of thorax and spine after pneumonectomy Material and Methods. An analysis of computed tomograms of 32 patients (29 men and 3 women aged 39 to 68 years) to pneumonectomy for lung cancer and 12 months after the operation was carried out. From 32 pneumonectomies 15 were performed on the right, 17 - on the left. The postoperative period passed without complications, leading of the post-pneumonectomy cavity was passive. The investigations were performed on a multispiral tomograph. On axial scans the retraction of the thoracic wall, anteroposterior and transverse dimensions of the thorax of the operated side were evaluated. In the mode of multiplanar reconstruction, the angle of inclination of lateral segments of the III and VII ribs was studied. The kyphotic and scoliotic deformation in the spinal were assessed by the Chaklin method. For statistical evaluation, Statistica 10.0 were used. Results and Discussion. The obtained data showed that over one year after pneumonectomy in the chest on the side of the operation, the anteroposterior size decreased by 19.8±2.6 mm and transverse by 10.8±2.6 mm. The degree of decrease in anteroposterior direction is more pronounced, that leads retraction of the thoracic wall by 19.8±3.7 mm. The deformation of the chest occurs due to a decrease in the angles of the inclination of the ribs: the III rib by 5.6±1.7, the VII rib by 3.9±1.1. Deformity of the spine consists in significant scoliotic changes, after pneumonectomy on the right on 3.1±2.5, after pneumonectomy on the left on 5.8±4.2. Kifotic changes of the spine are minimal (1.7±1.8). Conclusions. Performing of pneumonectomy leads to significant changes in the thorax: deformity of the chest on the operated side and scoliosis of the spine.