[Postoperative complications in proximal stomach resection]. / Posleoperatsionnye oslozhneniia pri proksimal'noi rezektsii zheludka.

During 20 years (1972-1994) the authors carried out proximal resections of the stomach in 106 patients for cancer of proximal part of the stomach extended to the esophagus. Morphological verification data are presented. Total lethality rate made up 20.8%. It decreased with gaining of experience and improvement in selection of patients (1972-1982--29.6%, 1983-1994--17.7%). The most common complication in postoperative period was exudative pleuritis: in 16% of operated patients insufficiency of sutures of the esophagogastric anastomosis was observed. For prophylaxis of suture insufficiency pyloroplasty by Heineke-Mikulich and continuous (to 4-5 days) naso-gastral drainage were of principal significance. Great importance was attached to establishment of the anastomosis by the method developed by the authors. The results of the operations depend also on the operative approach: two-stage combined approach (laparotomy, thoracotomy) brings the least lethality.

[The humeral immunity indices of pleural exudate in the diagnosis and prognosis of the pleural complications after lung operations and chest trauma]. / Issledovanie pokazatelei gumoral'nogo immuniteta plevral'nogo ékssudata v diagnostike i prognozirovanii plevral'nykh oslozhnenii posle operatsii na legkikh i travm grudi.

Examination of humoral immunity factors in the pleural exudate was carried out in 49 patients: 15 patients had clotted postoperative hemothorax, 10 patients had bronchial fistulas after pulmonectomy, 24 patients were included in a control group. In patients with clotted postoperative hemothorax a decreased circulating immune complex (CIC) level in the pleural exudate was observed on the 10th-14th days followed by the elevation of the CIC level with a simultaneous increase in the IgA concentration and a decrease in the IgC and IgM concentration. Characteristic of the patients with bronchial fistulas and pleural empyemas was the two-fold increase of the IgA, IgM and IgG level in the pleural exudate as compared with the normal postoperative course.

[Difficulties and errors in diagnosis of intrathoracic adipose tumors]. / Trudnosti i oshibki diagnostiki vnutrigrudnykh zhirovykh opukholei.

The authors treated 9 patients with intrathoracic adipose tumors of rare localization. In 4 cases the lipoma arose from the thoracic wall, in 2 directly from the mediastinum, and in another 2 from the pericardium. Lipoma of the lung and, 6 years later, liposarcoma of the diaphragm were removed in one patient. Tomography (3), bronchoscopy (2), diagnostic pneumothorax (5), thoracoscopy (3), and scanning of the thyroid gland (1) were performed to make a precise diagnosis. The nosological diagnosis was established in none of the patients, the topic diagnosis was most difficult in lipomas of organs. The diagnostic errors are analysed and the clinical pictures are described.

[Diagnostic difficulties and errors in neoplasms of the diaphragm]. / Trudnosti i oshibki diagnostiki novoobrazovanii diafragmy.

During 1972-1990 twelve patients with tumors of the diaphragm were operated upon. Age of the patients was from 39 to 60 years. Nine patients had benign tumors and cysts, 3 patients had malignant tumors. Exact nosological diagnosis before operation was not made. Topical diagnostic errors were either due to incomplete volume of examinations or to a refusal of using special roentgen contrast methods.

[Rethoracotomies and repeat operations on the lungs]. / Retorakotomii i povtornye operatsii na legkikh.

The article generalizes materials of 148 rethoracotomies. Main complications are described. Grounds are given for the use of perfusion through the xenospleen at the early postoperative period in order to liquidate the coagulated haemothorax mainly after pulmonectomy. An original method of determination of the coefficient of relative viscosity of the exudate on the absorbing base is described. The method allows the objective control of infectivity of the pleural exudate to be performed. The clinical use of different methods of detoxication in the preoperative period is substantiated: UVI of blood, hemocarbosorption and xenohemosorption, which allowed to reduce lethality after rethoracotomies and reoperations on the lungs.

[Blood reinfusion in stab-incision heart injuries]. / Reinfuziia krovi pri koloto-rezanykh raneniiakh serdtsa.

The authors had 110 patients with heart injuries (HI) under observation. The blood loss was, 1,092 +/- 120 ml in isolated HI and 2,410 +/- 246 ml in combined HI. Blood reinfusion (BR) was performed during 91 operations, the average volume was 1,233 +/- 215 ml. The peculiarities of reinfusion techniques are analysed and its advantages and shortcomings are critically appraised. The causes of fatal outcomes are shown according to the character of the heart damage and the volumes of blood loss and reinfusion. Mortality in HI with the use of BR was 16.5%.

[Heart injuries in isolated and multiple trauma]. / Povrezhdeniia serdtsa pri izolirovannykh i sochetannykh raneniiakh.

Under investigation were specific features of the clinical picture in 34 patients with associated wounds of the heart and pericardium. Four dissimilar clinical groups were established. A comparative analysis of associated and isolated injuries (38 patients) has been made from the viewpoint of frequency of diagnostic errors, volume of the intraoperative blood loss and character of postoperative complications.

[Multiple thoracic trauma]. / Mnozhestvennaia travma grudi.

The authors observed and helped 157 patients with multiple trauma of the chest. Trauma shock was observed in 97 of them. A clinical classification of such injuries is proposed. Main combinations of injuries of internal organs have been found. Surgical tactics is considered.

[Surgical treatment of complicated esophageal diverticula]. / Khirurgicheskoe lechenie oslozhnennykh divertikulov pishchevoda.

In 1973-86 the authors encountered esophageal diverticula (ED) in 44 patients. The disease was clinically manifested in all cases. Concomitant diseases of the abdominal and thoracic organs were found in 27 patients; ED followed a complicated course in 23 patients. Progressive clinical signs due to increase in the size of the diverticulum and the presence of complications are considered to be indications for operation. The surgery was performed on 18 patients. Complications developed in 4 cases after diverticulectomy. There were no fatal outcomes.