[Extended and combined operations for lung cancer]. / Rasshirennye i kombinirovannye operatsii pri rake lëgkogo.

On the basis of classificating components of the TNM system 1720 patients with "later" stages of the development of lung cancer were selected from 3000 patients with this disease operated upon in the clinic for many years. Specific features of performing extended and extended combined operative interventions, treatment at the postoperative period are described and substantiated. After their discharge from the hospital correspondingly 26% and 21.5% of the patients who had the IIIA stage of the disease are alive for more than 5 years, that convinces in expediency of their surgical treatment.

[Classification of surgical procedures in lung cancer]. / Klassifikatsiia operativnykh vmeshatel'stv pri rake legkogo.

Various aspects of classification of surgical operations in cancer of the lung are presented. The authors suggest their supplement and changes in systematization of surgical interventions in malignant tumors of the lungs published by V.I. Chissov et al. (1995). Basing on the study and analysis of many years experience in surgical treatment of patients with advanced stages of lung cancer in the clinic of thoracic surgery of the Military Medical Academy, the authors suggest classification of combined operations which takes into account both a character and an extent of an extrapulmonary spread of the tumors and thus reflects peculiarities and a high degree of traumatism of surgical intervention and allows to approach more differentially to the assessment of initial and long-term results of surgical treatment of patients.

[Extensive combined resections in lung cancer]. / Rasshirennye kombinirovannye rezektsii pri rake legkogo.

Extensive combined resections were made on 190 of 705 patients operated upon for lung cancer. The results have shown a prognostic value of the factor of variability of resections for immediate results. Long-term results were better in patients with highly differentiated cancers and without a metastatic involvement of the regional lymphatic system. Favourable results with 5-year survival (20.2%) point to the expedience of the extensive combined resections in patients with the long-neglected stages of lung cancer.

[The effect of temporary endobronchial occlusion on pulmonary gas exchange in the treatment of pyopneumothorax]. / Vliianie vremennoi éndobronkhial'noi okkliuzii na legochnyi obmen pri lechenii piopnevmotoraksa.

An estimation of changes of main hemodynamic, biochemical and laboratory indicators and the function of external ventilation was fulfilled when performing temporary endobronchial occlusion at the level of lobular and main bronchi in 37 patients with pneumothorax. Favorable changes were established in the systems of blood circulation and external ventilation in occlusion of lobular bronchi. Grounds are given for the necessity of intensive anti-inflammatory treatment, oxygenation and maintenance of cardiodynamics in occlusion of the main bronchus.

[The functional assessment of the late results of surgical treatment in lung cancer]. / Funktsional'naia otsenka otdalennykh rezul'tatov khirurgicheskogo lecheniia raka legkogo.

Results of a complex clinico-functional examination of 48 patients after resection for lung cancer 8-10 years ago are presented. The satisfactory pumping function of the heart was revealed with practically normal volumes of the cardiac output. Among patients subjected to resection of a lobe of the lung two groups were determined: with relatively satisfactory parameters of the function of external respiration and blood circulation and with a pronounced degree of strain of the functioning of these systems.

[Extensive and combined resections in poorly differentiated lung cancer]. / Rasshirennye i kombinirovannye rezektsii pri nizkodifferentsirovannom rake legkogo.

The article generalizes an experience with surgical treatment of lung cancer of low-differentiated structures in 108 patients. Extended and combined resections of the lung in such patients were shown to be expedient. From 83 patients who had had bronchial biopsy in the process of preoperative examination 35 patients (42.2%) had results of histological examinations of the biopsy and operative materials which did not coincide. Extended and combined resections for lung cancer of low-differentiated structure gave 5-year survival in 15.6% of the patients.

[The invasion of a tumor into the bronchial wall in central cancer of the lung]. / Rasprostranennost' opukholi v stenke bronkha pri tsentral'nom rake legkogo.

The paper analyzes histological findings of a number of bronchial sections made proximal the visible margins of a tumor in 54 patients operated on for central cancer of the lung. In coincidence of micro- and macroscopic limits of the extension of tumor cells was revealed in 29 (53.7%) patients. Statistical analysis revealed that the extension of tumor invasion obeys the exponential law of distribution. Probability of detecting tumor cells at various distances from the visible margin of the tumor was found. The findings suggest that one may predict that tumor cells can remain in the bronchial stump depending on the level of its elimination.

[Radionuclide diagnosis of disorders of the central lymph dynamics in thoracic duct pathology]. / Radionuklidnaia diagnostika narushenii tsentral'noi limfodinamiki pri patologii grudnogo protoka.

The experience in using radiolymphography in the diagnosis of central lymph dynamics disorders in thoracic duct pathology has been analysed. For the first time in Soviet literature we encounter two observations over the state of lymph dynamics along the thoracic duct by means of lymphoscintigraphy with colloid 113mIn in patients with lymphangiectasia of the thoracic duct and chylothorax. In importance of lymphoscintigraphy in determining the compensatory mechanisms of the lymph flow in primary pathology of the main lymph collector is emphasized.

[Formation of the bronchial stump in pulmonectomy]. / Formirovanie kul'ti bronkha pri pul'monéktomii.

An analysis of different incidence of the development of the bronchus stump incompetence after right and left pulmonectomies (228 observations) has shown that the width of the membranous part and the form of the transverse cross-section of the main bronchus might influence the reliability of the stump created in suturing by approximating stitches. A method of strengthening the posterior wall of the bronchus stump has been developed by means of suturing the bronchus wall in the lateral direction so that the longitudinal axis of the stump be oriented in the sagittal plane. The method was used in 39 pulmonectomies. The punctate incompetence of the bronchus stump made its appearance in 3 patients.

[Clinical importance of changes in thrombocytic hemostasis in lung cancer]. / Klinicheskoe znachenie izmenenii trombotsitarnogo gemostaza pri rake legkogo.

Clinico-laboratory examinations of 86 patients have shown that lung cancer develops against the background of activation of the thrombocytic link of hemostasis which manifested itself in thrombocytosis, greater degree of destruction of the lysosomal membranes, lower energy resources of the cells, their tendency to slow and little reversible aggregation. The authors consider that the indicators of the ADP-induced aggregation of thrombocytes may be used for prognosis of postoperative pyo-inflammatory and thromboembolic complications. HBO is good for correction of alterations in the thrombocytic link of hemostasis in lung cancer and its suppurative complications.

[Expansion of the lung after partial resection for gangrene]. / Raspravlenie legkogo posle chastichnykh rezektsii po povodu gangreny.

On the basis of the experience with the treatment of 69 patients with lung gangrene the authors recommend to use a combination of active aspiration from the pleural cavity, occlusion of the segment bronchus and pneumoperitoneum for the efficient expansion of the lung after its resection in the early postoperative period.