[The experience with thoracoscopic sympathectomy for the treatment of distal lesions of limb arteries].

The study included 107 patients with distal lesions of limb arteries treated with the use of thoracoscopic sympathectomy. The best results in the early postoperative period were obtained in patients with Raynaud's disease. Modifications introduced into the methods of its treatment permitted to retain effectiveness of sympathectomy till the late postoperative period in 90% of the patients. Surgery for obliterative endarteritis and atherosclerosis was viewed as a possibility to preserve the supporting function of the limb. This purpose was attained in 73.2 and 62.5% of the patients respectively in the early and in 62 and 25% in the late postoperative periods.

[Experience with thoracoscopic sympathectomy in distal lesions of lower-limb arteries].

We studied the results outcomes of thoracoscopic sympathectomy in 107patients with distal lesions of lower-limb arteries. The best results in the early postoperative period were observed in patients with Raynaud's disease and syndrome, reaching 100% efficacy. Due to implementation of novelties, we managed to preserve the efficiency of sympathectomy in 90% of patients with this pathology in the remote period. In patients with obliterating endarteritis and atherosclerosis, the efficacy of the operation was regarded as a possibility to preserve the supporting function of the extremity. In the postoperative period this goal was achieved in 73.2% and 62.5% of patients, respectively, while in the remote period in 62% and 25%, respectively.

[Cytology of peritoneal exudate as the criterion for phases of inflammation in diffuse purulent peritonitis]. / Tsitologicheskaia kartina ékssudata briushnoi polosti kak kriterii faz vospaleniia briushiny pri rasprostranennom gnoinom peritonite.

A cytological study was made of the exudation from the abdominal cavity in 131 patient with diffuse peritonitis to determine the time-related course of the inflammatory process in the peritoneum against the background of the therapy conducted. The exudation from the abdominal cavity was assayed at hospital admission, at surgery, and in the postoperative period, the planned ointment assanations having been performed. Used in the cytological study was the M. P. Pokrovsky and M. S. Makarov method in modification of D. M. Steinberg (1948) who suggested ways for the amounts of the microflora and those cell types occurring in the exudate to be determined in smears-impressions with the relevant cytogrammes made up. The most significant characteristics of the maiden, second, and third phases of inflammation of the peritoneum were revealed. On the basis of the above characteristics (cytologic signs) we have developed criteria for phases of inflammation of the peritoneum that permit the assessment of efficiency of the therapy treatments administered to be carried out.

[Minimally invasive surgery in cholelithiasis]. / Maloinvazivnye vmeshatel'stva pri zhelchekamennoi bolezni.

The results of minimally invasive surgical interventions (percutaneous transhepatic cholecystostomy, retrograde cholangiopancreatography with endoscopic papillosphincterotomy, percutaneous transhepatic cholangiostomy with endobiliary intervention, extracorporeal shock wave lithotripsy, laparoscopic cholecystectomy) in 1590 patients were analyzed, 2 methods and more were used in 74 of them. In 155 patients minimally invasive interventions were combined with open surgery. Rational combination of minimally invasive methods in cholelithiasis permits to cure majority of the patients, to avoid open operation and associated complications.

[Changes in the microflora of the suppurative cavities resulting from the treatment of acute bacterial destruction of the lungs]. / Izmeneniia mikroflory gnoinykh polostei v rezul'tate lecheniia ostroi bakterial'noi destruktsii legkikh.

The results of complex bacteriologic examination of 62 patients with acute bacterial destruction of the lungs during the process of treatment were analysed. The complex of investigations included the express methods (bacterioscopy, studies in the ultraviolet light, chromatography-mass spectrometry), inoculation under aerobic and anaerobic conditions. A role of anaerobic non-clostridial infection in the development of acute pulmonary destruction, polymicrobial character of microflora are shown. It was established that complex conservative therapy with inclusion of the methods for drainage of the cavities of destruction, prolonged intraarterial infusion, aimed antibacterial therapy permitted to achieve rapid suppression of microflora, its anaerobic component in particular. In chronization of the disease, the gram-negative aerobic flora is playing the leading part in its pathogenesis.

[Intraoperative dilatation of the ilio-femoral segment combined with reconstructive operations on the femoral arteries in "multi-level" lesions in patients from the risk group]. / Intraoperatsionnaia dilatatsiia podvzdoshno-bedrennogo segmenta v sochetanii s rekonstruktivnymi vmeshatel'stvami na bedrennykh arteriiakh pri "mnogoétazhnykh" porazheniiakh gruppy riska.

The authors analyse experience in the treatment of 96 patients at an increased risk of intervention. Ischemia of the lower extremities with relatively maintained peripheral vascular bed was the main criterion of an indicated operation. The malleolar systolic pressure index of at least 0.35 +/- 0.15 was considered essential in this case. With consideration for the risk, the interventions were carried out mainly under peridural anesthesia. Intraoperative dilatation of the iliac arteries was conducted under radiotelecontrol in combination with profundoplasty, thrombendarterectomy from the femoral arteries, and femoropopliteal autovenoplasty. The efficacy of the operations was appraised by intraoperative angiography, electromanometry, and blood flow measurement. The results were studied in follow-up periods of up to 3 years. In the group of 96 patients 8 had poor results. Amputation of the extremity was performed in different periods.

[Diagnostic and therapeutic choices in lung diseases complicated by hemorrhage]. / Diagnosticheskaia i lechebnaia taktika pri zabolevaniiakh legkikh, oslozhnivshikhsia krovotecheniem.

The results of treatment of 76 patients with various diseases of the lungs complicated by hemorrhage are analysed. A complex of diagnostic and therapeutic measures were applied in a certain order, including bronchoscopy with temporary occlusion of the bronchi, bronchial arteriography with acute embolization of the bronchial artery. Hemorrhage was arrested in 73 patients with the use of such tactics, in 48 of them an economical operative intervention was carried out.

[Changes in the structure of the gastric mucosa in chronic disorders of visceral blood circulation]. / Izmenenie struktury slizistoi obolochki zheludka pri khronicheskom narushenii vistseral'nogo krovoobrashcheniia.

Experiments were conducted on 63 healthy mongrel dogs to study the character of structural changes in the mucous membrane of the stomach in 50% obstruction of the celiac trunk (21), protracted gradual obstruction of the celiac trunk (22), and protracted gradual occlusion of the celiac trunk and cranial mesenteric artery (20). The authors revealed a direct dependence of the structural shifts in the gastric mucosa on the duration and degree of disorders of visceral circulation, which confirms the need for surgical correction; the indications and terms for performing restorative operations are directly dependent on the degree of disorders of the main blood flow.