[Surgical tactics in spontaneous pneumothorax]. / Khirurgicheskaia taktika pri spontannom pnevmotorakse.

219 cases of nonspecific spontaneous pneumothorax have been analysed. The bullous lung disease was the reason of pneumothorax in 55% of cases. Diagnostic and curative thoracoscopy is an important element of diagnosis. It was performed in 45 patients. Surgical operations were done in 56 patients. An active surgical policy in the treatment of spontaneous pneumothorax is advocated. Partial and subtotal pleurectomy plays an important role in surgery, especially in diffuse bullous lung disease.

Some problems of tracheobronchoplasty for lung cancer in a Regional Hospital in Russia.

Tracheobronchoplastic procedures formed part of the operation for lung cancer in 41 patients of a Regional Hospital in Russia over the past 2 and a half years. Twenty-nine patients underwent sleeve lobectomy; in a further 12 patients, right pneumonectomy was combined with resection of other mediastinal structures. In 16 patients, sleeve lobectomy was indicated by the high risk of pneumonectomy. Involvement of the carina in the tumour indicated its resection. High frequency jet ventilation was a particular feature of anaesthesia for carinal resection. Omentopexy was used in 10 patients to prevent dehiscence of the bronchial anastomosis. Postoperative complications were encountered in 10 patients. The most frequent, in patients, was dehiscence of the tracheobronchial anastomosis after resection of the carina. Five patients died after operation, the causes of death being dehiscence of anastomosis, pneumonia, empyema, and acute heart failure. Despite the frequency of complications, tracheobronchoplastic operations are often the only possible option in the surgery of extensive lung cancer.

[The use of a pedicled greater omentum in pneumonectomies for the prevention of bronchial fistulas]. / Ispol'zovanie bol'shogo sal'nika na nozhke pri pnevmonéktomiiakh dlia profilaktiki bronkhial'nykh svishchei.

Expanded (13) and combined (9) pneumonectomy with laparotomy and plastics of the bronchial stump with the greater omentum on a vascular pedicle were conducted on 22 patients in the period from 1988 (June) to 1990 (April). The omentum was used for the prevention of bronchial fistulas and correction of defects in the pericardium. Laparotomy and omentopexy did not aggravate the patients' condition essentially and did not affect the terms of treatment. A defect in the bronchial stump occurred only in 2 patients in the post-operative period and closed spontaneously in one of them.