[Palliative resection in esophageal cancer].

A 20-year experience of treatment of 633 patients with cancer of the thoracic esophagus has been evaluated. Far advanced disease was diagnosed in 384 (60.7%). Radical, palliative and symptomatic surgery was performed in 421 (66.5%), 44. (6.9%) and 168 (26.6%), respectively. No significant differences were reported between the immediate results of radical and palliative treatment. Since survival and quality of life after palliative resection appeared to be better than after symptomatic surgery, the former should be recommended for use in clinic.

[Prophylaxis and treatment of primary insufficiency of bronchial stump after pneumonectomy].

Efficacy of gel DAM+ in bronchial surgery was evaluated in experimental and clinical studies. In clinical practice DAM+ was used for treatment of 22 patients with insufficiency of bronchial stump, and in 12 patients with high risk of stump insufficiency this gel was administered into submucosal layer before stump closure. It is demonstrated that administration of DAM+ gel into submucosal layer is simple and effective method of treatment and prophylaxis of bronchial stump insufficiency.

[Diagnosis and treatment of lung cancer associated with paracancerous changes in the thoracic cavity].

Incidence of lung cancer associated with secondary paracancerous changes is known to range 13.7-30%. Since they reveal such clinical symptoms as pneumonia or empyema, most out-patients with complicated cancers are referred to general wards. Inflammatory parenchymal pathology may be conducive to false-positive or -negative diagnosis even when highly-sophisticated radiation procedures are used.

[Surgical treatment of lung cancer complicated by intrathoracic inflammatory paracancrous alterations].

An experience with diagnostics and surgical treatment of 291 patients with complicated course of lung cancer is described with special reference to specificities of the clinical course, preoperative management and operation technique. It was shown that the purposeful preoperative management allowed the assessment of the patients, previously thought to be inoperable, to be revised in 25% of cases, and the frequency of postoperative complications and lethality to be reduced to 14 and 3.5% respectively. The 5 year survival of lung cancer patients with paracancrous alterations was 20.7%.

[Single-stage operations for synchronous multiple primary and metastatic cancer of the lung and other organs].

The work presents an experience with the diagnosing of synchronous tumors of double localization in 256 patients. Operations were performed on 146 of them. Single-stage operations were made in 55 cases. When performing single-stage operations, 20 patients were found to have cancer of the lung with distant metastases or cancer of other localization with a metastasis in the lung. In the other 35 patients the diagnosis of true polyneoplasia was made followed by radical operations. Advantages of single-stage operations are shown, performing the first stage of the operation on the lung being substantiated. The five year survival after surgical treatment of multiple primary cancer was 15%.

[The endoscopic treatment of bronchial fistulas by submucosal injections].

A total of 21 patients (aged 30-72) with bronchial stump fistulas (307 mm) were treated by a newly developed method of treatment of purulent-destructive pulmonary diseases. This technique represents a gradual narrowing of the bronchial fistula lumen due to infiltrate formation in the submucosal bronchial layer. The volume formation substance biopolymer "DAM+", hydrogenous biopolymer with ions of silver "Argiform" for endoprosthesis of the soft tissues, is injected into the submucosal bronchial layer. It is necessary to make 5-20 fibrobronchoscopies for bronchial fistula healing. No complications occurred as a result of this treatment. The healing of bronchial fistula and bronchial stump epithelization were found in 18 patients.

[Surgical treatment of lung cancer patients with brain metastases].

The authors present an experience with diagnosing and treatment of 16 patients suffering from lung cancer with solitary metastasis into the brain. The examination performed has shown that in 7 out of 16 patients the surgical treatment was found to be not expedient. This solution was based on the detection of an extensive spread of lung cancer: multiple metastasis outside the thoracic cavity and the brain or inside the brain, and in one case--due to a considerable reduction of indices of the functional and reserve capacities of respiration and blood circulation. Single-step operations were carried out in 9 patients with lung cancer with a solitary metastasis into the brain (resection of the lung with an ablation of the brain metastasis). Out of the 9 patients operated on 6 patients survived for as long as 1.5 to 2 years, one patient lived longer than 4 years. Two other patients operated upon in June 2003 and March 2004 are still alive and feel much better. Satisfactory results of treatment of these patients show such methods to be expedient.

[One-stage operations on the lungs and other organs in multifocal and metastatic cancer].

Surgical treatment of 135 patients with multifocal and metastatic cancer of the lungs and other organs is analyzed. The absence of absolute differential diagnostic differences between true poly-neoplasia and synchronous or metachronous solitary metastases leads to extension of indications to surgical treatment of these patients. Surgical procedures were performed in 109 patients, 37 (33.9%) of them were one-stage. One-stage procedures meet the requirements of radical surgery and are most preferable biologically and clinically. These surgeries decrease treatment duration, prolong survival to 3-5 and more years in many patients. As cytoreductive operations, one-stage resections improve the condition of the patients, enable effective polychemotherapy.

[Surgical treatment of patients with primary-multiple cancer and involvement of the lungs and other organs]. / Khirurgicheskoe lechenie bol'nykh s pervichno-mnozhestvennym rakom s porazheniem legkikh i drugikh organov.

The article presents experiences with diagnosis and treatment of 43 patients with synchronous primary-multiple cancer of the lung with localization of one and more tumors in the lung which makes 4.8% of the number of the examined and treated patients with lung cancer in the clinic of thoracic surgery of the Military Medical Academy during 1995-2003. In 10 patients with primary-multiple cancer the injury of the lungs was combined with a tumor of the gastro-intestinal tract, in 13 with cancer of the urinary system, in 19 patients the synchronously developing tumor was localized in the lungs with a bilateral affection and in 1 case in different lobes of one lung. Surgical operations on 24 patients with primary-multiple cancer with the involvement of lungs were performed at one stage on each of the organs involved. Satisfactory results of treatment of these patients confirm the expedience of such strategy.

[The diagnostic and curative strategy for spontaneous pneumothorax]. / Diagnosticheskaia i lechebnaia taktika pri spontannom pnevmotorakse.

The article presents the authors' experiences with treatment of 292 patients with spontaneous pneumothorax. Results of the suction drainage (188 patients), thoracoscopy and talc pleurodesis (43 patients), videothoracoscopic surgical treatment and pleurodesis (61 patients) are compared. The proposed algorithm allowed to make recurrences 2.8% rarer, the indications for tracheotomy appeared in 1.7% of the patients.

[Lung cancer complicated by paraneoplastic state]. / Rak legkogo, oslozhnennyi parakankrozom.

A 10 year experience with dealing with the problem of surgical treatment of patients with lung cancer complicated by paracancrosis is described. Paracancrosis is characterized by the appearance and manifestation of different inflammatory and pyodestructive alterations in the thoracic cavity resulting from the tumor. The paracancrosis pathogenesis, its clinical symptoms, methods of diagnosis are described. The specific features of surgical treatment of patients with lung cancer complicated by paracancrosis are shown as well as the results of 5-year follow-up.

[Surgery in the treatment of metastatic lesions of the lung and pleura]. / Khirurgiia v lechenii metastaticheskikh porazhenii legkikh i plevry.

An experience with treatment of 53 patients with intrapulmonary metastases of malignant tumors of different nature included 65 surgical interventions, among them there were bilateral operations and reoperations. During the postoperative period complications took place in 5 cases (9.1%). After the operations there were no lethal outcomes. Long-term results of the surgical treatment of intrapulmonary metastases insignificantly differed from those of surgical treatment of primary lung cancer. The surgical treatment is thought to be an expedient method of treatment of intrapulmonary metastases in patients without recurrent tumors, late metastasis of another localization, satisfactory condition of the patient. High effectiveness of thoracoscopic methods for treatment of metastatic lesions of pleura is also noted.

[Local use of recombinant interleukin-1 beta in the complex treatment of patients with acute lung abscess]. / Mestnoe primenenie rekombinantnogo interleikina-1beta v kompleksnom lechenii bol'nykh s ostrymi abstsessami legkikh.

An analysis of results of examination and treatment of 59 patients with a prolonged duration of acute abscesses of the lungs has shown the influence of immune disorders on the dynamics of the development and outcome of pyo-destructive disease in the lung. The indications to local immunosubstituting therapy were determined. A new original method of administration and a scheme of prescription of the medicine Betaleukin are proposed. Clinical efficiency of the method proposed is shown. The local immunocorrection used in the complex treatment of patients with acute abscesses of the lungs allows to get recovery of 89% of the patients.

[Extended and combined operations for lung cancer]. / Rasshirennye i kombinirovannye operatsii pri rake lëgkogo.

On the basis of classificating components of the TNM system 1720 patients with "later" stages of the development of lung cancer were selected from 3000 patients with this disease operated upon in the clinic for many years. Specific features of performing extended and extended combined operative interventions, treatment at the postoperative period are described and substantiated. After their discharge from the hospital correspondingly 26% and 21.5% of the patients who had the IIIA stage of the disease are alive for more than 5 years, that convinces in expediency of their surgical treatment.

[Diagnostic and surgical approach in the combined thoracic trauma complicated by pulmonary and heart contusion]. / Diagnostika i khirurgicheskaia taktika pri sochetannoi travme grudi, oslozhnennoi ushibom legkikh i serdtsa.

Experience of treatment of 782 injured persons with combined thoracic trauma was summarized. Of the total number of injured persons with pulmonary contusion 177 (control group) were treated using conventional methods and 165 (basic group)--an early active operative tactics. Of the total number of injured persons in 150 with heart contusion (basic group) the cardiotropic therapy conduction was started from the hospitalization moment and in 134 (control group)--from the second day and later. Mortality while pulmonary contusion in control group was 43% and in the basic one--31%; in the heart contusion--46 and 12% accordingly.

[Diagnosis and correction of pathological changes of the tracheobronchial tree during lung surgery]. / Diagnostika i korrektsiia patologicheskikh izmenenii trakheobronkhial'nogo dereva vo vremia operatsii na legkom.

In 32% of patients operated on the lungs various changes in the tracheobronchial tree develop as early as during the surgical intervention. They are of determining significance in pathogenesis of postoperative disorders in the external breathing function. Bronchoscopy is the most effective method of diagnosis and of timely correction of these disorders during operation on the lungs.

[Classification of surgical procedures in lung cancer]. / Klassifikatsiia operativnykh vmeshatel'stv pri rake legkogo.

Various aspects of classification of surgical operations in cancer of the lung are presented. The authors suggest their supplement and changes in systematization of surgical interventions in malignant tumors of the lungs published by V.I. Chissov et al. (1995). Basing on the study and analysis of many years experience in surgical treatment of patients with advanced stages of lung cancer in the clinic of thoracic surgery of the Military Medical Academy, the authors suggest classification of combined operations which takes into account both a character and an extent of an extrapulmonary spread of the tumors and thus reflects peculiarities and a high degree of traumatism of surgical intervention and allows to approach more differentially to the assessment of initial and long-term results of surgical treatment of patients.