Vascular-atrial resections.

Extended combined resections of the lung vascular-atrial type include surgical interventions performed: with resection of the pericardium, pulmonary veins with the wall of the left atrium, superior vena cava, extrapulmonary departments of the pulmonary arteries and the walls of their common trunk, aorta.

Resection of this type is most often performed in combined operations undertaken for lung cancer. So, out of 605 patients operated in the clinic, they were performed in 424, which was 70.1%. Only in 168 (42%) were they single, and in the majority of patients, they were multiple in nature. At the same time, only in 82 observations they included performing other resections of the same type, and more often they were combined with resections of other types (mediastinal-esophageal, tracheobronchial, parietal-diaphragmatic). Of 424 patients, 401 (94.6%) had pneumonectomy and 23 (5.4%) had partial pneumonectomy.

resection of the lungs. 
 In all patients who underwent vascular-atrial resection

determined multiple metastases to the lymph nodes of the root of the lung and mediastinum. Only in 31 patients they were limited to damage to the lymph nodes of the root of the lung, in all other patients they affected the lymph nodes of the mediastinum.

Pericardial resection is the most frequent type of resection of extrapulmonary formations and organs of the thoracic cavity in patients with advanced stages of lung cancer. Pericardial resection was performed in 362 patients, which accounted for 85.4% among all patients who underwent resection of the vascular-atrial type and 59.8% among those undergoing combined operations. The need for its implementation arises in various tumor sites, equally often both on the right and on the left. In our observations, it was less often performed in isolation, more often it was combined with other resections of various extrapulmonary structures and organs of the chest cavity. Performing pericardial resection is, as a rule, a mandatory element in the resection of the heart wall and its vessels, often combined with resections of the mediastinal-esophageal and tracheobronchial type.

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