[Indocyanine green fluorescence in thoracoscopic segmentectomy: indications and benefits]. / Flyuorestsentnaya torakoskopiya s indotsianinom zelenym pri vypolnenii segmentektomii: pokazaniya i preimushchestva.

OBJECTIVE: To determine the role of ICG fluorescence in segmentectomies. MATERIAL AND METHODS: One surgical team performed 178 thoracoscopic anatomical segmentectomies in two hospitals between 2017 and 2023. Of these, 93 (52.2%) patients underwent ICG fluorescence perfusion tests. This study was retrospective and consecutive. Intraoperative and early postoperative results were analyzed. Patients were divided into 3 equal periods. Ventilation and perfusion methods were used to navigate the intersegmental planes in the first period. In the second one, only ventilation methods were used due to the absence of ICG. In the third period, the choice of navigation method was determined by «surgical complexity of segment¼. RESULTS: In 74% of patients, surgeries were performed for primary or metastatic lung tumors. The scheduled procedure was performed in all patients. However, 2 ones required lobectomy for total resection. Uneventful postoperative period was observed in 69.7% of patients. Other ones had complications grade I-IIIA. No reoperations or mortality were recorded. CONCLUSION: ICG perfusion is not inferior to ventilation methods in identification of intersegmental planes. This method is also more convenient for thoracoscopy. ICG fluorescence thoracoscopy is the only method in patients with COPD scheduled for thoracoscopic segmentectomy with two or more intersegmental planes.

[Video-assisted thoracoscopic anatomic lung resection: experience of 246 operations]. / Videotorakoskopicheskie anatomicheskie rezektsii legkikh: opyt 246 operatsii.

AIM: To present one of the largest materials of video-assisted thoracoscopic (VATS) anatomic lung resections in Russia. MATERIAL AND METHODS: It is a retrospective analysis of treatment of 246 patients who underwent VATS anatomic lung resection for the period from 2010 to 2014 at the Center for Thoracic Surgery of St. Petersburg Clinical Hospital №122. One surgical team has operated 125 men and 121 women aged from 20 to 85 years (58.8±13.4 years). There were 216 (87.8%) lobectomies, 4 (1.6%) bilobectomies, 9 (3.7%) pneumonectomies, 10 (4.1%) segmentectomies and 7 (2.8%) trisegmentectomies. Upper right-side lobectomy was the most frequent in this group (87 (40.3%)). Most of operations was performed via 2 approaches (119 patients). Average length of the longest incision was 4.3±0.93 cm (range 2-6 cm). All patients were examined according to a single plan. FEV1 less than 70% was observed in 26% of patients; comorbidity index was 5 scores or more in 24% of cases; 23.2% of patients were older than 70 years. RESULTS: Non-small cell lung cancer (NSCLC) was diagnosed in 168 patients (68.3%), pulmonary tuberculosis - in 27 (11%), chronic suppurative lung disease - in 27 (11%) cases. Furthermore there were 9 cases of pulmonary metastases, 11 cases of carcinoid, 1 - MALT-lymphoma, 1 - leiomyoma, 2 - small cell lung cancer, as well as one case of IgG-associated pseudotumor. Among 168 cases of NSCLC operations were performed in 87 (51.8%) cases for cancer stage I, in 46 (27.3%) patients for stage II, in 27 patients for stage III (including 16 cases of stage IIIA and 11 cases of stage IIIB). 8 patients (4.7%) with lung cancer stage IV have been operated in radical surgery for solitary metastasis. Mean duration of surgery was 202.1±58.2 minutes (range 100-380). On the average 12.8±5.6 (range 9-32) mediastinal lymph nodes were excised during lymph node dissection in cancer patients. Mean number of nodes groups was 4.1±1.1. In 11 (4.5%) patients conversion to open surgery was made due to intraoperative bleeding (3 cases) and technical difficulties (8 cases). Mean duration of postoperative pleural drainage and hospital-stay were 5.1±4.3 (median - 3 days) and 7.9±4.7 days (median - 6 days) respectively. Complications which were not associated with perioperative deaths were observed in 66 patients (26.8%). Prolonged air vent was the most common complication. CONCLUSION: VATS anatomical lung resections are safe and effective in most of pulmonary surgical diseases. Such interventions may be recommended for wider introduction at the Thoracic Departments of Russia because of small number of complications and rapid rehabilitation. Bleeding or its risk associated with fibrotic changes in pulmonary root are the most frequent causes of conversion to open access.

[Initial experience of thoracoscopic lobectomy performance with bronchoplasty].

The article presents an initial Russian experience of video- thoracoscopic bronchoplastic lobectomies performed in 2 clinical cases of centric lung tumors. The upper bronchoplastic lobec- tomies with right lymphodissection were carried out on two patients in 2012. Complications weren't observed in intraopera- tive and postoperative periods. There wasn't relapse during two years after operation. Thus, the authors came to conclusion that thoracoscopic bronchoplastic lobectomies turned out to be safe and effective interventions in individual patients with centric tumor location, which wasn't extended outside mouth of the lobar bronchus. The choice of candidates for thoracoscopic bron- choplasty was made using video-bronchoscopy, angio-computer tomography of the thorax and PET. This allowed avoiding an invasive staging and excluded patients with substantial extra- bronchial lesions.

[Reconstruction of production of souvenirs by cold polymerization of methylmethacrylate as an important means in providing healthier working conditions]. / Rekonstruktsiia proizvodstva suvenirov metodom kholodnoi polimerizatsii metilmetakrilata kak vazhnoe meropriiatie po ozdorovleniiu uslovii truda.

Cool polymerization production of souveniers was reconstructed according to recommendations of sanitary service. The reconstruction prevented occupational poisoning among the workers, led to considerably better work conditions, lower morbidity with transitory disablement.

[The role of social hygiene factors in the spread of virus diseases among miners]. / Rol' nekotorykh sotsial'no-gigienicheskikh faktorov v rasprostranenii virusnykh zabolevanii u shakhterov.

The article presents characteristic of isolated and complex influence of some socio-hygienic factors on singling out miners suffering from acute viral respiratory infections (AVRI). Estimates prognostication table suggested by the authors is intended to enable doctors treating miners to calculate the degree of individual risk of frequent AVRI and adjust preventive measures.

[A method for studying the effect of social hygiene factors on the health of workers in industrial enterprises]. / Metodika izucheniia vliianiia sotsial'no-gigienicheskikh faktorov na zdorov'e trudiashchikhsia promyshlennykh predpriiatii.

The method suggested allows to study complex and separate influence of different socio-hygienic factors on workers' health. Determining the most essential factors and creating estimate prognostic tables on their basis make it possible to form risk groups and elaborate preventive programs. The method may be used in analogous studies of different groups of population.

[Study of muscular work capacity in operators using manual mechanical instruments]. / Izuchenie myshechnoi rabotosposobnosti u operatorov, ispol'zuiushchikh ruchnoi mekhanizirovannyi instrument.

The article contains a hygienic assessment of the influence of vibration on the muscular and working capacity of the workers using manual mechanical devices. The neuro-muscular state evaluation was performed with a manual dynamograph. 161 workers from different professional groups and a sample group of 26 workers were examined. The indices of the maximum muscular force and resistance to fatiguability proved to be the most informative ones. The most apparent neuro-muscular changes were found in the professional groups of moulders and mould-cutters, which could be related to the greatest dosages of vibration and intensive physical overload.

[A method of determining the permissible time of working with vibration-generating hand-operated machines]. / Metodika opredeleniia dopustimogo za smenu vremeni raboty s s ruchnymi mashinami, generiruiushchimi vibratsiiu.

To limit the hazardous action of local vibration, a special nomogram was elaborated to determine, basing on newly established hygienic norms and regulations, the admissible duration of working with hand-operated vibrators. The normogram was based on the relation of vibrocontact duration to the vibration intensity, and was recommended to be applied to hand-operated vibrators with vibration intensity lower 10 cm/s (126dB).

[Improvement in the primary immunization scheme for children against whooping cough, diphtheria and tetanus]. / Sovershenstvovanie skhemy pervichnoi immunizatsii detei protiv kokliusha, difterii i stolbniaka.

The authors studied the reactigenic properties, immunological and epidemiological efficacy of vaccination of children aged under one year by the experimental schemes (AKDC-AKDC-K -- 1 ml, and AKDC-AKDC-K -- 0.5 ml) in comparison with the official pertussis, diphtheria, and tetanus immunization scheme. There proved to be a greater immunogenicity and a better protective effect against pertussis in vaccination according to the experimental schemes. The vaccine reactions were somewhat more incident in children vaccinated according to the AKDC-AKDC-K -- 1 ml scheme, but their essential reduction was reached with reduction of the pertussis antigen third vaccination dose to 0.5 ml.