[Use of hypotensive anesthesia in endotracheo-bronchial surgery for tumor-related lesion of the trachea and/or central bronchi].

The paper presents a review of the literature data and our own experience with 25 endotracheabronchial operations for tumor-related stenosis of the central bronchi and/or trachea using hypotensive anesthesia. The latter condition was induced by speeding up propofol injection and maintaining general anesthesia at 4.4-9 mg/kg x hr. Mean arterial pressure was lower than in control (60-65 vs. 70-80 mmHg, respectively). As a result, blood loss fell 138-100 +/- 11 ml whereas gas exchange indices improved (pO2 112-87 mmHg). At intubation stage, rise in mean arterial pressure and heart rate was avoided.

[Way for improving the quality of life of elderly oncology patients]. / Puti uluchsheniia kachestva zhizni onkologicheskikh bol'nykh v pozhilom vozraste.

The study was concerned with the possibility to increase QL of cancer patients at older age. At our work we used lazeroauriculo-, acupuncture therapy in combination with psychotherapy. Results of tis treatment--74% good effect, 15%--statisfectory effect, 11%--without effect. Patients with advanced stage of cancer had a satisfactory effect only in 40% of cases.

[The use of Oxadol in tablet form for the treatment of chronic pain syndrome in late-stage cancer patients]. / Primenenie tabletirovannogo oksadola dlia lecheniia khronicheskogo bolevogo sindroma u onkologicheskikh bol'nykh pozdnikh stadii zabolevaniia.

Chronic pain management with tablets of oxadol, a non-narcotic central-action analgetic, was studied in 30 patients, focusing on combinations with "basic" drugs of the opiate and opioid group. Combined administration of tramal and oxadol for moderate pain relief raised the analgesic effect and improved certain parameters of quality of life. Possible side-effects and indications in cases of well-advanced tumor were established.

[Current principles and methods of radical therapy for locally extensive esophageal and gastroesophageal cancer]. / Sovremennye printsipy i metody radikal'nogo lecheniia mectorasprostranennogo raka pishchevoda i kardioèzofageal'noi zony.

The results of radical surgical and combined treatment of 124 cases of esophageal and cardioesphageal tumors are presented. Extensive local disease (stage III, T2-4N0-2M0) was diagnosed in 113 patients (91.1%). Esophagoectomy with transmediastinal esophagogastroplasty and cervical esophagostomy proved most useful for esophageal tumor, while extensive surgery after Lewis in combination with extirpation or proximal resection of the stomach--for proximal gastric disease involving the esophagus. Combined surgery with resection of adjacent organs was carried out in 50%. Post-operative mortality rates were reduced to 7.1% due to application of effective surgical, anesthetic and intensive care procedures. The 3-year survival rate was 26.5%. Prognosis improved significantly when radiation was used prior to dissection of lymph nodes.

[The use of transcranial electrostimulation for pain relief in cancer patients]. / Primenenie transkranial'noi èlektrostimuliatsii v analgeticheskom rezhime u onkologicheskikh bol'nykh.

The report discusses whether transcranial electrostimulation in cancer patients can be accepted. A number of tumors were inhibited in an experiment using 120 rats. The procedure used in 80 cancer patients was followed by favorable changes in the concentration of several hormones. The antinociceptive action of electrostimulation is similar to that of narcotic analgetics.

[Comprehensive palliative therapy--ways of improving the quality of life for cancer patients]. / Kompleksnoe palliativnoe lecheniie--put' k uluchsheniiu kachestva zhizni onkologicheskikh bol'nykh.

The results of evaluation of different kinds of palliative treatment (the complex one included) of 430 cancer patients are presented. The practices of the health service as well as the tentative conclusions of our investigations have shown that better palliation is both necessary and promising following radical surgery or in cases of extensive tumor process. If taken in combination, such procedures as transcranial electroanesthesia, electroacupuncture, palliative chemo- and hormone therapy, laser and analgetics of a new generation may be instrumental in considerably improving the quality of life in cancer patients, psychotherapy being an indispensable component.

[The surgical correction of pressure in the lesser circulation after extensive lung resections for cancer]. / Khirurgicheskaia korrektsiia davleniia v malom kruge krovoobrashcheniia posle obshirnykh rezektsii legkogo po povodu raka.

The surgical bypass of v. azygos and v. pulmonalis sup. dext. to decompress the lesser circulation after extensive resections of the lung is elaborated. The operation was performed on 21 patients for cancer of the right lung, and in one patient with bilateral disease. The shunting followed pneumonectomy in 11 cases, the lower bilobectomy in 7, the upper lobectomy in 2. In 1 patient the operation was performed after successive left-sided lower lobectomy and right-sided upper lobectomy. The shunting reduced the middle pressure in the lung artery by 13,9-21,0% of the postresection level. The bypass did not cause statistically significant decrease of the oxygenation in the arterialized capillary blood.

[Hyperbaric oxygenation--a method that improves the quality of life for cancer patients in the process of surgical and combined therapy]. / Giperbaricheskaia oksigenatsiia--metod, uluchshaiushchii kachestvo zhizni onkologicheskikh bol'nykh v protsesse khirurgicheskogo i kombinirovannogo lecheniia.

The feasibility and advantages of application of hyperbaric oxygenation (HBO)-assisted polychemotherapy have been demonstrated. A procedure for treatment of lymphorrhea following breast surgery has been developed. The therapeutic effect of HBO procedures in postoperative cases of enteroparesis, wound infection and posthemorrhagic anemia has been demonstrated.

[Use of lithium oxybutyrate for improving results in the early post-operative period in lung cancer patients]. / Primenenie litiia oksibutirata dlia optimizatsii rannego posleoperatsionnogo perioda u bol'nykh rakom legkogo.

Application of antihypoxant drugs in postoperative period has been investigated. Lithium oxybutyrate was administered to 30 lung cancer patients before and shortly after operation. The results were compared with the data on 26 patients in control. Major characteristics, and, primarily, its antihypoxic protective effect have been evaluated. Lithium oxybutyrate administration is recommended in lung cancer patients during and shortly after surgery.

[Age-related changes in the reaction of the adrenal cortex to surgical stress in cancer patients]. / Vozrastnye izmeneniia reaktsii kory nadpochechnikov na operatsionnyi stress u onkologicheskikh bol'nykh.

11-Oxycorticosteroids levels were determined in 371 patients with breast, stomach and rectal cancer in the process of surgical treatment. More pronounced reaction of the adrenal cortex to surgical stress and/or time-delayed restoration of the hormone level within the next few days were found in older patients. Resistance to inhibition by dexamethasone in stomach cancer patients was accompanied by elevated cortisol levels during operation. It is concluded that age-related decrease in hypothalamo-pituitary complex sensitivity to inhibition by corticosteroids may be a cause of hypercortisolemia in the course of surgery.

[Analysis of the work of an analgesia service in an outpatient clinic]. / Analiz raboty poliklinicheskogo protivobolevogo kabineta.

The management of patients with chronic pain syndrome in out-patient clinics is a new form of specialized therapy. 347 cancer patients were treated using a modified "analgetic staircase" technique (14% of them at home), with an analgetic effect achieved in 60-70% of cases. The patients with pain syndrome were managed using sacral, epidural and subarachnoidal neurolysis blockades.

[Effect of analgesics on the growth and metastasis of sarcoma 37]. / Vliianie nekotorykh anal'getikov na rost i metastazirovanie sarkomy 37.

Treatment with such analgetics as analginum, promedol and pantopon was shown experimentally either to inhibit or to stimulate the growth of sarcoma-37 and its dissemination. It was also found to reduce the tumor growth--stimulating effect of operative trauma.

[Effect of anesthesia on a neoplastic process in an experiment]. / Vliianie narkoza na opukholevyi protsess v éksperimente.

The modifying influence of anaestesia on tumourigenic process (its stimulative or inhibitory effect upon tumour and metastasis growth) was established. It may occur indirectly, i.e. through endocrine link of the host-tumour system, and due to cytostatic effect of the anaesthetic drug (fluothane in particular).