[Exploratory thoracotomy: causes of inoperability of non-small-cell lung cancer]. / Eksplorativnye torakotomii: prichiny neoperabel'nosti nemelkokletochnogo raka lëgkogo.

The investigation is concerned with evaluation of different procedures of preoperative examination as well as reasons for carrying out explorative thoracotomy for lung cancer. The data on examination and surgical treatment of 81 patients who underwent explorative thoracotomy for primary non-small cell cancer of the lung were analyzed. The procedure was performed in 9.3% of surgical patients. Assessment of preoperative clinical and macro- and microscopic findings as well as resected material was carried out for each patient. The X-ray, bronchological, functional, angiographic and computed tomography evidence identified involvement of the mediastinal systems (pulmonary artery, vena cava superior, myocardium, aorta and trachea) and dissemination of tumor to the pleura as the most common cause of inoperability. Radical surgery was contraindicated in 65% because of the involvement of several organs and tissues. In certain situations, explorative thoracotomy should be resorted to as the last method of diagnosis of primary lung cancer.

[Treatment of metastatic pleural effusion with intrapleural administration of bleomycetin]. / Lechenie metastaticheskikh opukholevykh éksudativnykh plevritov vnutripolostnym vvedeniem bleomitsetina.

The report presents data on conservative treatment of pleuritis induced by metastases from tumors of different localization by bleomycetin. After the pleural cavity was drained dry in 24 patients, bleomycetin 45 mg was introduced into it. The latter procedure was repeated in 6 cases because profuse exudation continued. The results were evaluated by clinical and roentgenological means. Bleomycetin treatment was painless. Mean drainage duration was 3.8 days, admission time--6.2 days. Stable remission was recorded in 16 patients, partial--7. Pneumonia (2) and chronic empyema (1) were observed as complications. Bleomycetin-induced pleurodesis correlated with exudate pH: a pH value in excess of 7.3 made a patient good candidate for carrying out the procedure. According to Karnofsky index for long-term results, life quality of the patients improved. Eleven patients survived for 1 year after pleurodesis, and 2--more than two years.