[Algorithm of preoperative preparation in surgical treatment of lung echinococcus complicated by a rupture into the bronchus].

The clinical material includes 10 years of observations of 289 patients with lung echinococcosis complicated by a rupture into the bronchus. Different operative interventions were performed in 278 cases. The indications for operation, their volume and preoperative preparation were based on clinico-rentgenological signs and divided into 4 groups: 1 - patients with a rentgenological sign of the folded chitin membrane, or a ring-shaped shadow; 2 - patients with non-homogeneous complicated cysts; 3 - patients with "floating chitin membrane"; 4 patients with a rupture of the cyst into the bronchus and pleural cavity simultaneously. The third group patients needed more intensive preoperative preparation while the fourth group patients had an indication to urgent drainage of the pleural cavity or urgent operations in the absence of the purulent discharge from the drains. So, the proposed algorithm of the preoperative preparation of lung echinococcosis patients complicated by a rupture into the bronchus facilitates the improvement of the management of this category of patients.

[Rationale for the tactics and a scale of surgical intervention for bilateral pulmonary hydatid disease]. / Obosnovanie taktiki i ob"ema khirurgicheskogo vmeshatel'stva pri dvukhstoronnem ékhinokokkoze legkikh.

The authors of this study have examined some experience gained in surgically treating 151 patients with bilateral pulmonary hydatid disease in 1991 to 2001, i.e. over 11 years. The examinees were divided into 7 groups. A hundred and forty patients underwent 205 surgical interventions. With this, organ-preserving operations and resections were made in 198 and 7 cases, respectively. Postoperative complications were observed in 12 cases. There were 3 fatal cases in the postoperative period.

[Treatment of middle-lobe syndrome]. / Lechenie srednedolevogo sindroma.

Results of treatment of 242 patients with middle-lobe syndrome are analyzed. Indications for surgical treatment of middle-lobe syndrome must be determined very individually. Organo-saving surgeries are the methods of choice for benign processes in the middle lobe. In malignant tumors, destructive and cirrhotic processes of the middle lobe the resections are indicated.

[Diagnosis and surgical treatment of bilateral pulmonary echinococcosis]. / Diagnostika i khirurgicheskoe lechenie dvustoronnego ékhinokokkoza legkikh.

Results of diagnosis and treatment of 205 patients with bilateral pulmonary echinococcosis were analyzed. 141 patients underwent two-sided surgeries: 77--staged operations with interval from 2 weeks to 3 months, 64--one-stage operations on both lungs. One-stage operations through thoracotomies were performed in 49 patients, through medial sternotomy--in 15. Mean hospital stay was 20 bed-days. Long-term results from 6 weeks to 15 years were studied in 60 patients. Stable curative effect was achieved in all the patients.

[Surgical treatment of pulmonary echinococcosis drained into the bronchus]. / Khirurgicheskoe lechenie drenirovavshegosia v bronkh ékhinokokka legkogo.

526 patients with lung echinococcus complicated by a break to bronchus were studied. 462 operations were performed which in 430 cases were organo-saving and in 61--resectional. It is demonstrated that operations performed in early period after this complication were organo-saving with good postoperative results.

[The morphological changes in the lung after its dissection with a CO2 laser and a plasma scalpel in an experiment]. / Morfologicheskie izmeneniia legkogo posle rassecheniia ego s pomoshch'iu CO2-lazera i plazmennogo skal'pelia v éksperimente.

An advantage of the laser scalpel over the plasma scalpel was shown in experiments in animals (60 observation). On the 3rd-5th days after cutting with a laser the inflammation symptoms subside and on the 7th day there appear fine fibrous connective tissue since the operation with the plasma scalpel is followed by the formation of the fine fibrous connective tissue as late as on the 10th-14th days, the inflammatory reaction being observed up to the 30th day.

[Diagnosis and surgical treatment of benign tumors of the lungs]. / Diagnostika i khirurgicheskoe lechenie dobrokachestvennykh opukholei lëgkikh.

Benign tumors of the lungs may be treated only by operation. Operative treatment may be rejected in patients with tumors measuring less than 2 cm in diameter and absence of clinical signs of their growth. In central benign lung tumors, preference must be given to organ-preserving operations: bronchotomy with adenomectomy, resection of the bronchus together with the involved part and subsequent plastics. In peripheral tumors their enucleation of economical resection is advisable. The most promising method is precision laser removal of benign lung tumors providing reliable aero- and hemostasis.

[The use of low-frequency ultrasound in the surgical treatment of pulmonary echinococcosis]. / Primenenie ul'trazvuka nizkoi chastoty pri khirurgicheskom lechenii ékhinokokkoza legkikh.

A convincing evidence is given that the low-frequency ultrasound (26.4-26.6 kHz) has pronounced parasiticidal and bactericidal effects and can completely replace the drugs commonly used for disinfection. The low-frequency ultrasound used for treatment of the parasitic cyst bed allows the indication for organ preserving operations to be wider, the complicated forms of the disease included.

[Combined use of various laser radiations in thoracic surgery in experimental studies]. / Sochetannoe primenenie pazlichnykh vidov lazernogo izlucheniia v torakalnoi khirurgii v éksperimente.

The impact of various types of low-intensive lasers (He-Ne, copper vapour, ultraviolet, infrared, infrared gallium arsenide) on healing of a wound made by CO2 laser at an output power of 25 W was studied in an experiment on 120 albino Wistar rats. It was found that a concurrent application of high- and low-intensive lasers resulted in acceleration of reparative processes in the lung, stimulating the healing of laser-induced wounds. The infrared gallium arsenide laser was demonstrated to be the best tool in stimulating the healing process.

[Diagnosis and treatment of mediastinal neoplasms and cysts]. / Diagnostika i lechenie opukholei i kist sredosteniia.

Possessing experience in the treatment of 314 patients with tumors and cysts of the mediastinum, the authors discuss problems of their diagnosis and surgical treatment. The patients' ages ranged from 7 to 64 years. Tumors were recognized in 216 (68.8%) and cysts in 98 (31.3%) patients. The radiological method, including computed tomography, is the main method for the diagnosis of mediastinal tumors and cysts. The presence of a pathological structure in the mediastinum is an indication for surgery independent of the development of complications. Operations for tumors and cysts of the mediastinum must be carried out in specialized medical institutions because they are complicated surgical interventions.

[Radiodiagnosis of echinococcosis of the lungs]. / Luchevaia diagnostika ékhinokokkoza legkikh.

The paper is devoted to analysis of radio-diagnostic findings of 79 patients with parietal round pulmonary formations. All the patients were investigated by x-ray and ultrasound, perfusion scintigraphy of the lungs with a postural test was performed in 43 of them. Diagnostic x-ray and echographic methods were compared and evaluated in terms of defining the origin of pulmonary formations. The origin of pulmonary formations was established by x-ray in 50 of 79 patients (63.3 per cent) whereas ultrasound findings proved correct in 74 of 79 patients (93.6 per cent). Perfusion scintigraphy can be recommended to patients with pulmonary echinococcosis only for limited indications when a necessity arises to assess the lesser circulatory state in terms of patients' functional operability.

[Use of a precision technique in surgical treatment of pulmonary echinococcosis]. / Primenenie pretsizionnoi tekhniki pri khirurgicheskom lechenii ékhinokokkoza legkikh.

More that 15 variants of operative interventions in hydatid disease of the lungs have been suggested to date, but all have shortcomings and, in addition, do not exclude the possibility of a recurrence. The recent method of precision operation, when conducted, excludes completely a recurrence of the disease. In precision removal of hydatid cysts, the pulmonary tissue remains undamaged to maximum. The use of medical glue and carbon dioxide laser in the stages of the surgical intervention improves the operative techniques, reduces the number of operative and postoperative complications, and improves the results of treatment. The authors used the method in 24 patients and produced good results.

[Reserves of pulmonary ventilation and gas exchange in patients with pulmonary echinococcosis]. / Rezervy legochnoi ventiliatsii i gazoobmena u bol'nykh ékhinokokkozom legkikh.

An examination of 33 patients has shown that complicated course of Echinococcosis of the lungs and their multiple lesions results in certain exhaustion of reserves of the external ventilation system. A conclusion is made on preference of performing organ-preserving and organ-sparing operations, on necessity of dispensary observations and physical rehabilitation of patients operated upon for complicated forms and multiple lesions of the lungs.

[Treatment of rupture of pulmonary echinococcosis to the pleural cavity]. / Lechenie proryva ékhinokokkoza legkogo v plevral'nuiu polost'.

The authors describe 19 cases of rarely encountered complications of hydatid cyst of the lung: rupture into the pleural cavity in 13 patients and simultaneous rupture into the bronchus and pleural cavity in another 6 patients, which accounted for 2.4% of the total number of patients (840). These complications are serious and their diagnosis is made with certain difficulties. Complex roentgeno-bronchological and laboratory methods of examination must be used. Patients with the above-mentioned complications must be subjected to strictly individual surgical treatment in specialized clinics in the early periods of the development of the complication. Organ-preserving operations, supplemented by decortication and pleurectomy whenever necessary, is the method of choice. Temporizing tactics and prolonged nonoperative therapy lead to irreparable changes in the pleura and pulmonary tissue, and later--to extended operations.

[Therapeutic procedures in the middle lobe syndrome]. / Lechebnaia taktika pri srednedolevom sindrome.

From study of the case records of 113 patients with isolated affection of the middle lobe or lingular segments of the left lung the authors believe that nonspecific inflammatory diseases of the lungs are the most frequent cause of the development of the syndrome. Tomography and bronchography of the involved lung play the principal role in the diagnosis of the middle-lung syndrome. The etiological factor is verified by the findings of tracheobronchoscopy. The authors consider surgery to be the main method of treatment of the middle-lobe syndrome or syndrome of the lingular segments.

[Modeling of pulmonary cysts and a method of their treatment]. / Modelirovanie kist legkogo i sposob ikh lecheniia.

A cyst of the lung was modelled by implanting a celloidin ball into its tissue. Experiments were conducted on 43 male and female mongrel dogs whose weight ranged from 8 to 22 kg. Implantation of a foreign body into the lung leads to the development of an inflammatory reaction in its tissue with the formation of a connective-tissue capsule which can be compared with acquired cysts of the lung. Liquidation of an experimental cyst by means of MK-7 glue causes aseptic inflammation terminating in the formation of a connective-tissue scar.