rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2025-106-1-3-27-44rentrad-947Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHКТ-диагностика ранних послеоперационных осложнений при лечении рака легкогоCT Diagnostics of Early Postoperative Complications After Lung Cancer Treatmenthttps://orcid.org/0000-0002-3136-5825ДворецкаяМ. А.DvoretskayaМ. А.

Дворецкая Мария Алексеевна, к. м. н., врач отделения рентгеновской компьютерной томографии № 1

ул. Льва Толстого, 6-8, Санкт-Петербург, 197022

Мaria А. Dvoretskaya, Cand. Med. Sc., Physician, X-ray Computed Tomography Department No. 1

ul. L’va Tolstogo, 6-8, Saint Petersburg, 197022

mariavasilek.87@mail.ruhttps://orcid.org/0000-0001-8746-9343ДворецкийС. Ю.DvoretskiyS. Yu.

Дворецкий Сергей Юрьевич, д. м. н., доцент, профессор кафедры онкологии факультета послевузовского образования

ул. Льва Толстого, 6-8, Санкт-Петербург, 197022

Sergey Yu. Dvoretskiy, Dr. Med. Sc., Associate Professor, Professor of Chair of Oncology, Faculty of Postgraduate Education

ul. L’va Tolstogo, 6-8, Saint Petersburg, 197022

https://orcid.org/0000-0001-8322-4509СперанскаяА. А.SperanskayaА. А.

Сперанская Александра Анатольевна, д. м. н., профессор, профессор кафедры рентгенологии и радиационной медицины

ул. Льва Толстого, 6-8, Санкт-Петербург, 197022

Аleksandra А. Speranskaya, Dr. Med. Sc., Professor, Professor of Chair of Roentgenology and Radiation Medicine

ul. L’va Tolstogo, 6-8, Saint Petersburg, 197022

ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииРоссияPavlov First Saint Petersburg State Medical UniversityRussian FederationФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава РоссииРоссияPavlov First Saint Petersburg State Medical UniversityRussian Federation2025230920251061-32744Copyright © Дворецкая М.А., Дворецкий С.Ю., Сперанская А.А., 20252025Дворецкая М.А., Дворецкий С.Ю., Сперанская А.А.Dvoretskaya М.А., Dvoretskiy S.Y., Speranskaya А.А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/947

Цель: оценить возможности компьютерной томографии (КТ) в диагностике и дифференциальной диагностике ранних послеоперационных осложнений при лечении рака легкого. Материал и методы. В отделении торакальной онкологии ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Минздрава России за период с 2014 по 2025 гг. по поводу рака легкого были прооперированы 564 пациента. Средний возраст больных составил 64±0,7 года (от 29 до 90 лет). Выполнено 426 (75,6%) анатомических резекций легких (лобэктомия, билобэктомия) и 138 (24,4%) пневмонэктомий. Всем пациентам в раннем послеоперационном периоде (до 30 сут) назначалась обзорная рентгенография органов грудной полости. Для диагностики возникших послеоперационных осложнений КТ проведена в 77 случаях (13,6%). Результаты. Серьезные послеоперационные осложнения (IIIB и выше по классификации Clavien–Dindo–Strasberg) после анатомических резекций легких возникли у 27 (6,3%) пациентов, после пневмонэктомии – у 50 (36,2%). На основании данных КТ осуществлена диагностика и дифференциальная диагностика послеоперационных осложнений при хирургическом лечении рака легкого. Рассмотрены варианты осложнений у пациентов, перенесших открытую или видеоторакоскопическую операцию по поводу рака легкого в раннем послеоперационном периоде. Заключение. КТ позволяет выявить патогномоничные признаки разных вариантов ранних послеоперационных осложнений при лечении рака легкого, что имеет существенное значение для тактики ведения пациентов, их выживаемости и прогноза течения заболевания.

Objective: to evaluate the capabilities of computed tomography (CT) in the diagnosis and differential diagnosis of early postoperative complications in the treatment of lung cancer. Material and methods. In the Department of Thoracic Oncology, Pavlov First Saint Petersburg State Medical University, 564 patients were operated for lung cancer from 2014 to 2025. The mean age of patients was 64±0.7 (from 29 to 90) years. Surgeries performed included 426 (75.6%) anatomical lung resections (lobectomy, bilobectomy), and 138 (24.4%) pneumonectomies. All patients in the early postoperative period (up to 30 days) were prescribed a chest survey radiography. To diagnose postoperative complications, CT was performed in 77 cases (13.6%). Results. Serious postoperative complications (IIIB and higher according to the Clavien–Dindo–Strasberg classification) after anatomical lung resections occurred in 27 (6.3%) patients, after pneumonectomy – in 50 (36.2%). Based on CT data, diagnostics and differential diagnostics of postoperative complications in surgical treatment of lung cancer were carried out. The variants of complications in patients who underwent open or video-assisted thoracoscopic surgery for lung cancer in the early postoperative period were considered. Conclusion. CT allows identifying pathognomonic signs of different variants of early postoperative complications in the treatment of lung cancer, which is of significant importance for the tactics of patient management, their survival and prognosis of the disease course.

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The authors declare that there are no conflicts of interest present.