[Advanced techniques in surgical treatment of penetrating gunshot wounds of the chest]. / Novye tekhnologii pri khirurgicheskom lechenii ognestrel'nykh pronikaiushchikh ranenii grudi.

The results of treatment of 322 wounded with penetrating gun-shot wounds of the chest during local hostility from 1994 till 1996 are analyzed. Aggravation in the condition of the hospitalized wounded was observed due to reduction of time of evacuation in hospitals. The indications for surgery were in 96.3% wounded. The main surgical methods were thoracocentesis and drainage of pleural cavity performed in 80.1% wounded. Thoracotomy was performed in 9.6% wounded. High efficiency of operative videothoracoscopy performed in 4.4% wounded in hospital of the first aid is demonstrated, it allowed to reduce frequency of thoracotomy to 2.4%.

[Rendering emergency surgical aid in gunshot penetrating thoracic wounds]. / Okazanie neotlozhnoi khirurgicheskoi pomoshchi pri ognestrel'nykh pronikaiushchikh raneniiakh grudi.

In modern limited military conflicts the gunshot penetrating wounds of breast (GPWB) are the most severe type of fighting trauma with high lethality on field and development of complications. Today the main method of treatment in GPWB is low-invasive intervention--thoracocentesis and drainage of pleural cavity. In stationary conditions it is reasonable to conduct the active drainage of pleural cavity with the help of vacuum-aspirators and during evacuation of casualties to use the devices for drainage of pleural cavity with petalled valve. In GPWB to provide rendering of surgical service in time it is necessary to equip hospitals with home-produced equipment and apparatus according to achievements thoracic surgery as well as training of military field surgeons.

[The operative videothoracosopy in rendering emergency surgical care in penetrating gunshot chest wounds]. / Operativnaia videotorakoskopiia v okazanii neotlozhnoi khirurgicheskoi pomoshchi pri ognestrel'nykh pronikaiushchikh raneniiakh grudi.

The modern doctrine of military surgery is based on the concept of maximal and, if possible, simultaneous surgical aid to the wounded in the shortest period of time after the injury. It could be achieved by approximation of specialized surgical section to the zone of fighting and improvement of medical evaluation. These are conditions for applicability of modern methods of treatment and for perfecting of surgical strategies to the wounded, such as videothoracoscopy. To report the experience of the usage of videothoracoscopy in the treatment of the wounded with penetrating gunshot wounds of chest (PFAWT) in military hospital. 23 patients with PFWAT was administer surgical therapy: 19 patients had pleural draining at previous stages of medical evacuation, 4 patients were delivered directly from the battle Geld 1.5 hours after the injury. 11 patients with pleural drains and 4 patients, delivered from battle Geld, had indications for videothoracoscopy. These indications included ongoing intrapleural bleeding, clotted hemothorax and prolonged leakage of the air through the drain. Suturing of the lung wounds was performed by Endo-GIA-30 stapler. If it was impossible, manual suture EndoStitch USSC was used. In 2 cases was performed wedge-like resection by EndoGIA-30. The bleeding from the thoracic wall wounds was controlled by electrocautery. The clotted hemothorax was removed by fragmentation with EndoBabcock, washing out and aspiration through large diameter tubes. The duration of the procedure ranged from 40 to 90 minutes. None had suppurative complications. All patients was survived. The mean duration of inpatient period was 20 days, rehabilitation period-14 days.