[Diagnostics and surgery of combined lung echinococcosis].

An analysis of surgical treatment of 162 patients with lung echinococcosis was made. The main group consisted of 74 patients with combined forms of echinococcosis of the lung and other organs. They were treated in clinic in the period of time since 1982 till 2011 years. The control group included of 88 patients with echinococcosis of lung and the patients were followed-up in the period of time since 1991 till 2000. Plasma technology was applied in all patients of control group. The patients from main group (25) were operated by using the conventional methods and 49 patients - with the application of plasma technology. An analysis shows a reliable reduction of the rate of postoperative complications after application of plasma technology in 4 times. The lethality significantly decreased in this group of patients.

[Long-term results of treatment of patients with liver echinococcosis operated by a traditional method and by using high temperature (plasma) technologies].

A comparative analysis of surgical treatment of 160 patients with liver echinococcosis treated by traditional surgical methods and with using plasma technologies followed by a complex assessment of the long-term results has reliably confirmed advantages of operations using the plasma flow. They were followed by less incidence of postoperative complications and recurrences of the disease. It was also confirmed by high quality of life of the contingent observed that was estimated by a specially developed questionnaire.

[Plasma technologies in treatment of purulent wounds].

The article is devoted to using plasma flow for treatment of purulent wounds. The authors have shown an anti-inflammatory, antibacterial, stimulating effect of plasma radiation on the basis of clinical methods of control of the wound process in 143 patients (hypothermia, pain syndrome in rest, the presence of purulent discharge, edema, granulation tissue).

[Surgical treatment of patients with acute pancreatitis].

Results of treatment of patients with acute pancreatitis are analyzed. Efficacy of staged treatment of patients with acute destructive pancreatitis is demonstrated. The ineffective conservative therapy during 1-3 days is regarded as indication for half-open surgical method (median laparotomy, necrsecvestrectomy, omentopancreatobursostoma and lumbostoma formation). General purulent peritonitis is indication for open method (laparostoma formation). Unitized surgical tactics permitted to reduce lethality from 4.2 to 2.5%.

[Plasma technologies in surgery of pulmonary echinococcosis]. / Primenenie plazmennykh tekhnologii v khirurgii ékhinokokkoza legkikh.

178 patients were operated over 18 years for pulmonary echinococcosis, 100 of them with standard methods, 78--with plasma technologies (surgical device SUPR-2M). Close echinococcectomy was performed in 22.5% patients, open--in 69.1%, combination of these operations--in 8.4% patients. Plasma technologies were used at pneumolysis, cysts section, antiparasitic treatment of residual cavities, fibrous capsule resection (pericystectomy) or cystpericystectomy, marginal resection of the lung with cyst, bronchotomy, sanation of pleural cavity, zone of operation and margins of operative wound. It is demonstrated that postoperative complications were seen in 34% patients operated by standard methods and in 8.9% patients operated with plasma technologies, lethal outcomes were in 2 (2%) and 1 (1.3%) patients, respectively. Plasma technologies permitted to reduce postoperative complications rate 3.8 times and postoperative treatment by 9.8 bed days or by 45.8%. Long-term results were studied in 61 (78.2%) operated patients followed from 1 month to 7 years, there were no recurrence of echinococcosis.

[Use of plasma technologies in surgery of hepatic echinococcosis]. / Primenenie plazmennykh tekhnologii v khirurgii ékhinokokkoza pecheni.

During 15 years 271 patient have been operated upon in the clinic for hepatic hydatidosis. Traditional methods of operations were used in 100 of them, in 171 patients plasma technologies were applied. Plasma technologies allowed to make the number of complications 2.5-3 times rarer and the duration of postoperative treatment 18.2 bed-days shorter (51.7%). No recurrences were detected within the period from 1 month till 10 years.

[Factors influencing the remote patency of distal shunts in patients with atherosclerosis of lower extremity arteries]. / Faktory, vliiaiushchie na otdalënnuiu prokhodimost' distal'nykh shuntov u bol'nykh aterosklerozom arterii nizhnikh konechnostei.

Under study was the prognostic value of local risk factors of the development of late reocclusion of distal shunts in 149 patients with critical ischemia of lower extremities. It was found that the greatest influence on the remote patency of transplants is exerted by the state of the arterial wall in the area of the distal and in less degree of the proximal anastomoses. In a less degree the duration of functioning of the shunt depended on its length, position in soft tissues, transplant material and the level of the proximal anastomosis. The distal anastomosis level, the history of the simultaneous or previously made aorto-femoral shunt, geometry of the proximal and distal anastomoses did not have any reliable influence on the distal shunt patency.

[Intra-arterial regional perfusion in destructive forms of acute pancreatitis]. / Vnutriarterial'naia regionarnaia perfuziia pri destruktivnykh formakh ostrogo pankreatita.

The results of using regional infusion therapy in 17 patients with destructive pancreatitis are analyzed which appeared to be more effective, than the systemic infusion of drugs in stopping the symptoms of endotoxicosis leveling the functional insufficiency of the liver and kidneys, disturbances in hemodynamics and hemostasis. The best results have been obtained when using a modified method of regional therapy (celiac-aortal dislocational regional infusion) in the complex treatment of destructive pancreatitis. This method has a number of advantages as compared with intra-aortic variant of regional therapy. Hospital lethality in the process of using the methods of regional therapy in the complex treatment of destructive pancreatitis was 17.5%. In the control group of patients treated without regional infusion lethality was within the limits of 28%. A modified classification of endotoxicosis according to the degree of the disease is proposed. In order to estimate the severity of the syndrome of intoxication and effectiveness of the given therapy principally new integrative parameters of clinical and laboratory research are used.

[Prevention of recurrent parasitic infections after surgical treatment of echinococcosis]. / Aparazitarnost i antiparazitarnost khirurgicheskikh vmeshatelstv priékhinokokkoze.

The results of surgical treatment of 741 patients with hydatid disease of the lungs, liver, and other abdominal organs were studied. Recurrences were found in different periods after the operation in 147 (19.8%) patients: solitary cysts in 34, multiple cysts in 90, and a combined affection in 23 patients. The recurrent cysts were revealed in a previously operated on hepatic lobe in 69, in the other lobe in 42, and in the other abdominal organs in 37 patients in 29 of which the cysts were located on the serosa of the abdominal organs. The recurrences were caused by a nonradical character of the first operation and dissemination of the embryonic elements with their subsequent implantation growth. On the basis of this, the author draws a parallel between the recurrence of malignant new growths and echinococcosis (alveococcosis) and formulates the general principles of aparasitism and antiparasitism of surgical interventions and similar principles of ablastemics and antiblastemics in oncology.

[Relapses in echinococcal disease]. / Retsidivy ékhinokokkovoi bolezni.

The incidence of echinococcus disease recurrences after the surgical treatment equals 16,1% including 2,2% of true recurrences and 13,9% of pseudorecurrences. The cause of pseudorecurrences is an associated and primary-multiple injuries of organs of the thoracic and abdominal cavities, dissemination due to spontaneous rupture of cysts or an improper technique of the operation. Since pseudorecurrences are more frequent, prophylaxis of recurrences of echinococcus is completely dependent on the quality of preoperative examinations, wide revision of organs of the thoracic and abdominal cavities and observation of the operation technique undertaken to prevent dissemination of the operation zone.

[Complications of catheterization of the subclavian vein and their prevention]. / Oslozhneniia kateterizatsii podkliuchichnoi veny i ikh profilaktika

The frequency of complications related with catheterization of the subclavian vein was 16.2%. The most hazardous complications were as follows: the pulmonary artery embolism, migration of a catheter in the venous bed and thrombosis of the catheterized vein. The proper selection of indications, careful observation of the rules of puncturing and catheterization may reduce the incidence of complications to a minimum.