[Extensive selective thoracostomy in the treatment of pleural empyema]. / Rasshirennaia selektivnaia torakostomiia v lechenii émpiemy plevry.

Fifty-seven patients with disseminated bilateral destructive pulmonary tuberculosis complicated by empyema were followed up. Treatment included laser radiation at wavelengths of 0.69 and 0.43 micron, which can enhance therapeutical efficiency on an average of 37.5% and reduce preoperative preparation by 1.7 times. The procedure of selective extended thoracostomy expanded indications for surgery in critically ill patients with destructive pulmonary tuberculosis by reducing the surgical risk by several times.

[The immediate and late results of the surgical treatment of patients with complicated forms of pulmonary tuberculosis]. / Blizhaishie i otdalennye rezul'taty khirurgicheskogo lecheniia bol'nykh oslozhnennymi formami tuberkuleza legkikh.

Immediate and long-term outcomes of repeated and multistage operations were analyzed in 190 patients with pulmonary tuberculosis. The aspects of work rehabilitation were studied in these patients. The efficiency of repeated and stage surgical interventions in patients both with disseminated and complicated types of tuberculosis and with pleural empyemas and in those with uncomplicated postoperative disease is 87.5 and 92.2%, respectively. The long-term results indicated that the complete clinical effect preserved in 79.2% of patients. Work rehabilitation was achieved in 64.8% of the examinees in the long-term postoperative period. The use of repeated and stage surgical interventions in patients with pulmonary tuberculosis may rehabilitate a rather large proportion of those operated on, assuming a great socioeconomic significance.

[Temporary occlusion of the bronchi in patients with bronchial fistula]. / Vremennaia okkliuziia bronkhov u bol'nykh s bronkhial'nym swishchom.

Temporary bronchial occlusion to reestablish air tightness of the resected lung has been performed in 42 patients. Persistent expanding of the lung occurred within 2-3 days in a single early bronchial occlusion (on day 1-2). In late occlusion (on day 10-15) the residual pleural cavity disappears on day 30-35. Steady expanding of the lung in spontaneous pneumothorax of tuberculous or nontuberculous origin and in empyema (89 patients) was observed within 30 days in 76.5, 87.5 and 36.3% of cases, respectively, unless fistula size is more than 1 cm. In the rest cases (31.5%) temporary bronchial occlusion allows cutting air passage, partial expanding of the lung, cleansing of empyema cavity, alleviation of purulent intoxication, this creating conditions for radical surgery.

[Use of laser therapy in combined treatment of pulmonary tuberculosis in children and adolescents]. / Primenenie lazerterapii v kompleksnom lechenii tuberkuleza legkikh u detei i podrostkov.

The effect of 0.89 micron wave gallium arsenide laser radiation was studied on 19 patients with various forms of pulmonary tuberculosis. Laser therapy was conducted in combination with antibacterial drugs. Laser skin radiation was projected into the pathologic process. The regimen included 15 sessions at 7-day intervals. The use of laser energy in the complex management of pulmonary tuberculosis patients makes it possible to reduce lung destruction healing and to accelerate normalization of biochemical indices and their hemogram.

[Endobronchial use of hemostatic drugs feracryl and amifer]. / Endobronkhial'noe primenenie gemostaticheskikh preparatov ferakrila i amifera.

The results of endoscopic administration of hemostatic agents feracryl and Amifer in 147 cases are analysed. In 123 patients 5-10 ml of 1% feracryl were administered after endobronchial bioptic manipulations. Bleeding after collection of bioptic material from the bronchial mucosa was arrested by this method in 69 cases. Moderate bleeding in 42 cases was arrested by pressing to the wound surface a tampon saturated with a feracryl solution. Endoscopic occlusion of a bleeding bronchus by means of feracryl and Amifer was conducted in 16 patients with various forms of lung tuberculosis complicated by hemoptysis and pulmonary hemorrhage. In 9 cases with massive pulmonary hemorrhage 3-4 ml of 20% Amifer solution was administered by endobronchial route into the bleeding area. In 7 cases up to 10 ml of feracryl was introducedby ++endobronchial route. Temporary endoscopic hemostasis in patients with various forms of pulmonary tuberculosis made it possible to postpone an emergency operation for a period of up to 2 weeks in all cases. For the prevention of aspiration pneumonia the bronchi were repeatedly cleansed in 8 patients and therapeutic lavage of the bronchi was carried out in 7 patients.