Thoracoscopy and Video-Assisted Thoracoscopy in Diagnostics of Pneumothoraxes, Traumatic Defeats of Thorax with Pneumothoraxes

Abstract

In modern conditions, it is necessary to carry out interdisciplinary clinical and pharmacological, organizational and pharmaceutical researches on the correctness of diagnosis, treatment, pharmacotherapy and the appointment of life-necessary, effective, safe and high-quality medicines. This is due to the fact that the system of legal relations "doctor-patient-pharmacist" during the pandemic of COVID-19 and associated diseases (cardiovascular, oncological, tuberculosis, type I and II diabetes, asthma, HIV/AIDS, drug addiction, alcoholism, psychoneurological, injuries resulting from traffic accidents and combat operations, pain of various genesis and others) showed the need to improve the health care sector in each country, in general, and the work of a separate health care institution, doctor, nurse and pharmacist , in particular, that is, access to medical services and provision of medicines to patients. The analysis of the anonymous results of diagnostics among 1368 patients and in 160 victims with closed chest trauma was carried out. There were 425 patients with spontaneous pneumothorax. Thoracoscopy or video thoracoscopy was used to verify nosologies. During the thoracoscopic examination, bullous emphysema of the lungs was found among 336 patients (79%) with pneumothorax, tuberculosis was diagnosed among 47 people (11%), lung cancer in 6.8% – 29 people; silicosis – 2.4% (10 people); sarcoid – 0.7% (3 people). According to the results of histopathological examination of biopsies obtained during thoracoscopy, tuberculous exudative pleurisy was found in 563 patients, lung cancer was the cause of the exudate in 133 cases, pleural mesothelioma was diagnosed in 98 cases, exudative pleurisy was caused by a nonspecific inflammatory process of the lungs in 149 patients. Video-Assisted Thoracoscopy is recommended to be used in patients with closed chest trauma with multiple rib fractures, complicated by small hemothorax, pneumothorax, to diagnose possible damage to the diaphragm, lungs, and pericardium.