[Treatment of peritonitis using ozone and hydropressive technology]. / Lechenie peritonita s primeneniem ozona i gidropressivnykh tekhnologii.

In the experiment on 144 mongrel dogs and 546 white rats the methods of ozone therapy and hydropressive treatment of the abdominal cavity have been worked out. These methods were used in the treatment of 94 patients aged from 13 to 89 years with severe forms of acute peritonitis. The control group consisted of 174 patients with peritonitis. A high antimicrobial effect was detected in the treatment of the abdominal cavity with microdisperse stream of the ozonated solution under pressure. After 1-2 procedures of the intestinal ozone dialysis the number of microbial bodies in the lumen of the small bowel in 65% of patients has decreased 2-3 times, the terms of elimination of the paresis has decreased 3-4 times, and more rapid dynamics of elimination of the endogenous intoxication syndrome was detected. The application of the developed programme of curative measures promote lowering of the lethality from 62.07% in the control group to 37.23%--in the test one.

[Surgical treatment of multiple thromboembolism of pulmonary artery segmental branches ]. / Khirurgicheskoe lechenie mnozhestvennoi tromoémbolii segmentarnykh vetvei legochnoi arterii.

The experience in the treatment of 32 patients with thromboembolism of the pulmonary artery is presented. Thrombolytic therapy has been carried out in 10 patients, implantation of antiembolism cava-filter REPTELA has been carried out in 15 patients. Original method for extraction of multiple emboli from segmental branches of pulmonary artery under the conditions of the artificial circulation is described.

[Thoracoscopic interventions in spontaneous pneumothorax]. / Torakoskopicheskie vmeshatel'stva pri spontannom pnevmotorakse.

The results of 188 thoracoscopic operations for spontaneous pneumothorax (SP) were studied, in 47 from them videothoracoscopic technique was used. It was established that radical videothoracoscopic procedures, such as subsegmental resection of the lung combined with coagulation pleurodesis in primary pneumothorax, are almost untraumatic and highly effective both just after the procedure and in far off period. Palliative operations could be recommended in secondary spontaneous pneumothorax and at definite stages of surgical aid in primary SP.

[Wound treatment using the flow of an ozonized solution under high pressure]. / Lechenie ran s ispol'zovaniem potoka ozonirovannogo rastvora pod vysokim davleniem.

New method for treatment of infected and festered, among them wounds with lingering healing was developed. The method was based on local application of fine-dispersion ozonized solution stream high pressure. This stream of ozonized fluid is generated under pressure of 350 ATM with the help of "Device for hydro-pressive treatment of wounds", ozonization of the solution is performed by the "OZh-2" apparatus developed by the authors. Application of the method of hydropressive ozonization provides fast cleansing of wound surface from pyonecrotic masses, promotes elimination of infection and thus substantially reduces the period of treatment of the patients.

[Choice of revascularization procedure in obliterative disease of leg's distal arteries]. / Vybor varianta revaskuliarizatsii pri obliteriruiushchikh zabolevaniiakh distal'nogo sosudistogo rusla nizhnikh konechnosteí.

The results of surgery of the lower extremities' distal arterial occlusive lesions in 182 patients are analysed. The total number of surgical operations was 211. The doppler ultrasound examination and angiography were used to evaluate hemodynamic significance of the lesions. Various types of grafting operations were performed in case of adequate of the lower and middle parts of crural arteries. The indirect methods of revascularization were used in the distal arterial lesions. Transplantation of the free tissue flaps with the use of microvascular anastomoses has provided the best results. The rate of postoperative lethality was 1.6%. Good and satisfactory results were achieved in 153 (84.1%) patients. The preventive operations were performed in 10 patients with stenoses of anastomoses and grafts in long-term period after the surgery. Satisfactory results occurred in 51% of the patients by the end of the 5th year.

[Prehospital diagnostic errors and therapeutic policy in spontaneous pneumothorax]. / Diagnosticheskie i takticheskie oshibki pri spontannom pnevmotorakse do gospitalizatsii v spetsializirovannyí statsionar.

The authors analyze diagnostic and tactical errors in rendering prehospital emergency and outpatient care for spontaneous pneumothorax (SP). Delay in hospitalization to thoracal department threatens intrapleural complications, makes treatment more difficult and durable. SP was diagnosed as primary in 510 of 615 SP cases (576 patients). 105 SP episodes occurred in patients with bronchopulmonary diseases (secondary SP). Accurate diagnosis was made immediately or after a short examination in 431 patients, misdiagnosis took place in 194 patients (31.04%). Secondary and primary SP was missed in 39.4 and 29.4% of patients, respectively. Primary SP was mistaken for extrapulmonary affection (intercostal neuralgia, ischemic heart disease, osteochondrosis, etc), while secondary SP was misdiagnosed as progression or onset of bronchopulmonary diseases.

[Non-reflux esophago-gastric anastomosis]. / Arefliuksny i pishchevodno-zheludochny i anastomoz.

A new method of performing esophago-gastric anastomosis in proximal gastric resection is proposed. It is based on a circular enveloping of the anastomotic zone with the "spurs" of the greater curvature of the stomach. The method was designed and experimentally tested on nonfixed cadavers, as well as on the 60 dogs. Esophago-gastroscopy, histological examination of the anastomotic zone and mucosa of esophagus were used to evaluate long-term results. The method was used in 8 patients with proximal gastric resections. Good permeability of the esophagus and lack of signs of anastomotic insufficiency were found. The method is advocated for the use in clinical practice to provide safe peritonization of anastomotic zone and prevent gastroesophageal reflux.

[Surgical treatment of complicated forms of cancer of the right side of the colon]. / Khirurgicheskoe lechenie oslozhnennykh form opukholeí pravoí poloviny obodochnoí kishki.

The results of the treatment of 53 patients with complicated forms of the right side colon cancer are analysed. The radical surgical method with primary removal of the tumor is preferable in this situation. It was possible to perform radical surgery in 69.8 of the cases. In older patients with marked anemia and in patients with decompensated forms of ileus various modifications of hemicolectomy were used. 3 variants of U-shape ileotrasversoanastomosis are described.

[The organization of microsurgery at a provincial center]. / Organizatsiia mikrokhirurgii v usloviiakh oblastnogo tsentra.

The 5-year experience of microsurgery in regional medical centre is analysed. 1014 operations were performed. Certain managerial items and practical recommendations, necessary for development of microsurgery in regional medical centers are discussed. The importance of a close contract with other surgical services is advocated.

[The technic of liver resection]. / K tekhnike rezektsii pecheni.

The use of the method of jet dissection of tissue with the "jet scalpel" in resection of the liver for separation of the parenchyma allows to substantially decrease the intraoperative blood loss, to visualize the vessels and ducts and thus facilitates their ligation which prevents different complications. The device developed by the authors for reinfusion of blood is very helpful for preventing complications associated with the hemotransfusion therapy.

[Jet dissection of tissues in liver surgery]. / Struinaia dissektsiia tkanei v khirurgii pecheni.

The results of applying jet dissection in resections of the liver in experiments and in the clinic are discussed. The method is based on washing off the hepatic tissues with a high-pressure jet of liquid to expose the intact vessels and ducts. To realize the method, "A device for separating tissues of parenchymatous organs" was developed, which worked according to the principle of an injector without a needle. The efficacy and the degree of trauma inflicted by the method were tested in experiments, after which it was applied in the clinic in 14 patients. The method made it possible to reduce essentially the volume of intraoperative blood loss, prevent the escape of bile in the postoperative period, reduce to the minimum hemotransfusion therapy, and shorten the stay of patients in the clinic. The results of jet dissection show the expedience of its use in surgical hepatology.

["Jet scalpel" in the liver resection]. / Opyt primeneniia "struinogo skalpelia" pri rezektsiiakh pecheni.

The use of the "jet scalpel" in liver resection allows the vascular-ductal structures to be adequately separated. This, in turn, prevents the risk of leaving hepatic areas devoid of blood supply or bile drainage, contributes to essential decrease of intraoperative blood loss, and decrease of the number of postoperative complications: bile seeping, biliary peritonitis, hepatic insufficiency, etc. The obtained results provide evidence that the use of the "jet scalpel" in surgical hepatology is advisable.

[The restoration of esophageal patency in cicatricial strictures by using magnetic elements]. / Vosstanovlenie prokhodimosti pishchevoda pri ego rubtsovykh strikturakh s pomoshch'iu magnitnykh élementov.

The authors present their clinical experience (4 observations) with magnetic devices for application of the esophageal anastomosis and removal of its scarring strictures in an area of anastomosis application. They also describe the procedures for introducing the magnetic elements to the site of anastomosis with fiberscopes. The procedure allowed traumatic surgery to be avoided and a stable positive result to be achieved.

[Blood serum cardiotoxicity in patients operated on under cardiopulmonary bypass]. / Issledovanie kardiotoksichnosti syvorotki krovi bol'nykh, operirovannykh v usloviiakh iskusstvennogo krovoobrashcheniia.

Experiments using the isolated hearts of laboratory animals have established that in 56% of patients blood serum became cardiotoxic after cardiopulmonary bypass surgery. The postoperative period in this group of patients was characterized by marked heart failure. Cardiodepressive blood serum effect is determined by medium- and low-molecular fractions.

[Doppler ultrasonics in the solution of tactical problems of the surgical treatment of patients with obliterating diseases of the arteries of the lower limbs]. / Ul'trazvukovaia doplerografiia v reshenii takticheskikh voprosov khirurgicheskogo lecheniia bol'nykh s obliteriruiushchimi zabolevaniiami arterii nizhnykh konechnostei.

The work deals with the analysis of the results of ultrasonic dopplergraphic examination (USDG) of the blood flow in the lower limbs of 251 patients with various stages of obliterating diseases of the lower limb arteries. The authors developed the tactics of treatment in different anatomical variants of affections of the vascular bed with consideration for the results of USDG, in "story" occlusions among others. The role of USDG in prognosticating the results of reconstructions and in the regular medical examination of the patients in the late-term postoperative period is shown. The importance of ultrasonic examination in the recognition of developing late reocclusions is emphasized. Preventive vascular reconstructions in the prethrombotic stage of the process makes it possible to improve the late-term results of surgical treatment of occluding diseases of the main arteries of the lower limbs.