[Ways to expand indications for surgical treatment of patients with fibro-cavernous pulmonary tuberculosis]. / Puti rasshireniia pokazanii k khirurgicheskomu lecheniiu bol'nykh fibrozno-kavernoznym tuberkulezom legkikh.

The authors present original operative techniques developed in the Novosibirsk Tuberculosis Research Institute for management of fibro-cavernous pulmonary tuberculosis. These include: a 4-5-rib variant of osteoplastic thoracoplasty as an independent intervention and as a stage followed by pulmonary resection, atypical extrapleural pneumolysis with open tamponade followed by local thoracoplasty. A complex of combined surgical adjuvant procedures comprises extrapleural pneumolysis with open tamponade, dissection of cavernous part of the lung prior to selective thoracoplasty. Indications to the use of the above techniques are provided. Their use in addition to conventional interventions gives one more chance of cure in fibro-cavernous tuberculosis of the lungs.

[Possibilities of the use of immobilized proteolytic enzyme immozymase in tuberculosis]. / Vozmozhnosti primeneniia immobilizovannogo proteoliticheskogo fermenta immozimazy vo ftiziatrii.

The paper summarises the experience gained in the use of immozymase in tuberculous patients to advance the disease diagnosis and treatment. Immozymase proved valuable in obtaining sputum enriched with M. tuberculosis in patients who were previously considered noncarriers. M. tuberculosis became detectable in 28.3% of them. Immozymase instillations of the urethra before its massage for stimulation of prostatic secretion led to getting secretion in all the patients (0.35 ml, on the average). Immuzymase inhalations were used in the treatment of purulent bronchitis in patients with destructive pulmonary tuberculosis in conservative and preoperative regimens. Postoperative immozymase inhalations promoted prevention of pleuropulmonary complications. Open treatment of the caverns with immozymase after cavernotomy shortens the treatment duration. Positive results were also reached in the treatment of pleural empyema.

[Artificial pneumothorax in the surgical treatment of progressing bilateral destructive lung tuberculosis]. / Vozmozhnosti iskusstvennogo pnevmotoraksa v khirurgii progressiruiushchego dvustoronnego destruktivnogo tuberkulëza lgkikh.

23 patients with fibrous-cavernous pulmonary tuberculosis received surgical treatment at the Novosibirsk Research Tuberculosis Treatment Institute. In the contralateral lung all the patients had recent infiltrative lesions with destruction. M. tuberculosis were determined in all the cases. The patients underwent resection of the lung, osteoplastic thoracoplasty, osteoplastic thoracoplasty followed by pulmonary resection, open treatment of the caverns (10, 5, 2, 6 cases, respectively). Therapeutic pneumothorax eliminated destruction in the contralater lung in 18 patients. The other 5 patients achieved stabilization of the specific process in remaining destruction for which they subsequently underwent segmental resection. The cure was documented in all the patients treated.

[Surgical tactics in bilateral destructive pulmonary tuberculosis]. / Khirurgicheskaia taktika pri dvustoronnem destruktivnom tuberkuleze legkikh.

43 patients with pulmonary tuberculosis (mean age 36.8 years) were treated surgically. All the patients had disseminated bilateral disease with destruction. Preoperative bacteriological examination identified M.tuberculosis in 67.5% of the examinees. In two-thirds of them x-ray evidenced total pulmonary lesion. 40 subjects of all surgical patients underwent operation for bilateral fibrous-cavernous tuberculosis with caverns location in the upper lobe or upper lobe and 6 segment. The disease was diagnosed to be 1-3 years in duration. The interventions developed in the Novosibirsk Research Institute of Tuberculosis included: osteoplastic thoracoplasty, resection following osteoplastic thoracoplasty, atypical extrapleural resection with limited thoracoplasty, open treatment of the caverns. The surgery resulted in marked improvement (abacillation, cavernous healing) in 42 patients. Long-term follow-up recorded cure in 41 patients (95.3%).

[Local enzyme therapy of an open cavern]. / Lokal'naia enzymoterapiia vskrytoi kaverny.

The results of local application of the immobilized proteolytic enzyme immunozymase (USSR) for the open treatment of a cavern in 30 cases are presented. Prolonged continuous proteolysis (for about 100 hours) of the caseous-necrotic content in an open cavern with the help of the enzyme reduces the term of full cleansing of an open cavern to 7-12 days. This provides for earlier plastic intervention, in most of the cases under discussion, aimed at removing the remaining cleansed cavity, thus reducing hospital stay of patients from 6-8 to 2-4 months.