[Saving the musculus pectoralis minor in radical mastectomy]. / K voprosu ostavleniia maloi grudnoi myshtsy pri radikal'noi mastéktomii.

Eighty-five patients were surgically treated for postmastectomy edema of the upper extremity. In 20 of them, phlebolysis of the subclavian vein was performed. It was established that the vein was most often compressed by a long stump of the small pectoral muscle. Surgery and subsequent radiation treatment create unfavorable conditions for the muscle leading to its morphologic restructuring. Classic mastectomy after Halsted-Meier is recommended.

[Surgical tactics in post-mastectomy edema of the arm]. / Khirurgicheskaia taktika pri postmastéktomicheskom oteke konechnosti.

Based on examinations and treatment of 210 patients with postmastectomy edema of the extremity (with operations made on 75 of them) the authors have developed a clinico-surgical classification of the postmastectomy edema with special reference to the character of morphologic alterations of soft tissues which determinates tactics of treatment and choice of surgical methods (LVA, phlebolysis of the subclavian vein, RRO or their combination in different succession). Phlebographic and tonometric examinations are shown to be necessary, their findings being compared for the establishment of indications for phlebolysis for stenosis of the vein resulting from X-ray therapy and long stump of the musculus pectoralis minor in radical mastectomy after Holsted.

[Immediate results of the use of microsurgical technics in the treatment of cancer of the large intestine (clinical and experimental study)]. / Neposredstvennye resul'taty ispol'zovaniia mikrokhirurgicheskoi tekhniki v lechenii raka tolstoi kishki (kliniko-éksperimental'noe issledovanie).

The analysis of the results of 74 experiments involving large bowel resection for intestinal obstruction in rabbits demonstrated advantages offered by microsurgical procedures intended to form large bowel anastomosis. The results were used in clinical practice. The immediate results of surgery, postoperative complications and lethality were evaluated in 133 cases of large bowel cancer (anastomosis formed by microtechnique-67; by standard procedures-66). In group I, heart-lung complications resulted in one death (lethality-1.5%); group II--in 18, 13 of them being caused by anastomotic leakage and peritonitis development (lethality-27.3%). It was clinically confirmed that precision formation of large bowel anastomosis by microsurgery prevents suture failure--the main factor of postoperative lethality.

[Diagnostic value of determining endogenous proteinase inhibitors in cancer patients]. / Diagnosticheskaia tsennost' opredeleniia éndogennykh ingibitorov proteinaz u onkologicheskikh bol'nykh.

Patients with stage III and IV cancers of different sites revealed a 47-76% increase in serum total antitrypsinic activity. A mean 40% increase was observed in cases of inflammatory pathology. Both study groups demonstrated raised alpha 1-antitrypsin levels, while that of alpha 2-macroglobulin did not show any significant changes. The level of alpha 1-antitrypsin accounted for 89 and 83% of total antitrypsinic activity in cases of inflammation and controls, respectively, while in cancer patients this index was significantly lower (70%). The diagnostic value of total antitrypsinic activity appeared to be higher than that of alpha 1-antitrypsin level determination. It is inferred that, apart from alpha 1-antitrypsin, malignant growth is associated with raised levels of more specific endogenous proteinase inhibitors, except alpha 2-macroglobulin.

[Use of microsurgical technic in abdominal surgery]. / Primenenie mikrokhirurgicheskoi tekhniki v abdominal'noi khirurgii.

Results of the surgical treatment of 172 patients with tumors of the proximal part of the stomach and colon are analyzed. The patients were divided into 2 groups according to the method of forming the esophago-intestinal and colono-intestinal anastomoses. Suture incompetence and peritonitis were shown to appear much more rarely after using a microsurgical technique than after using surgical methods.

[Regional oxygenation in the treatment of severe destructive forms of occlusive arterial diseases of the limbs]. / Regionarnaia oksigenatsiia pri lechenii tiazhelykh destruktivnykh form obliteriruiuschikh zabolevanii arterii konechnostei.

Femoral regional perfusions and continuous intraarterial infusions were used for the treatment of 84 patients. The 0,15-0,25% solution of H2O2 was used as the oxygenator. The methods used when combined with sympathectomy allowed to restrict the operation by a parcimonious amputation of the extremity and to retain the knee joint in most of the patients.

[Treatment of postmastectomy edema of the upper extremity using microsurgical technics]. / Lechenie postmastéktomicheskogo oteka verkhnei konechnosti s ispol'zovaniem mikrokhirurgicheskoi tekhniki.

Reconstructive microsurgery carried out in 25 cases of postmastectomy edema of the upper extremity proved to be the most effective and safest in treatment of the said complication. The procedure should be supplemented with phlebolysis of the subclavicular vein (when occlusion of the latter exceeds 50%) or with resection of dermatofascial flap of the brachial area (fibrous stage of lymphostasis). Sequence of stages and the results of the surgical treatment are discussed.

[Mononuclear cell reactions in the combined treatment of patients with a cutaneous melanoblastoma of the lower extremities]. / Reaktsii mononuklearov pri kombinirovannum lechenii bol'nykh melanoblastomoi kozhi nizhnikh konechnostei.

Changes in lymphocyte and monocyte counts in peripheral blood of patients who had undergone combined treatment for malignant cutaneous melanoma of low extremities were evaluated. The posttreatment counts were compared with those for mononuclear cell infiltration of tumor stroma. Mononuclear cell levels in blood and in tumor stroma versus patients' survival time were analysed. A moderate correlation between lymphocyte and monocyte (macrophage) levels in tumor stroma, on the one hand, and survival time, on the other, was established.

[Comparative evaluation of treatment results of melanoblastoma of the limbs with or without perfusion chemotherapy]. / Sravnitel'naia otsenka rezul'tatov lecheniia melanoblastom konechnostei s ispol'zovaniem perfuzionnoi khimioterapii i bez nee.

The clinical picture and long-term results of the treatment of 123 patients with melanoblastoma of the limbs have been studied. 39 patients were subjected only to the surgical treatment, 84 patients with a developed tumor process were subjected to the combined treatment -- surgery with perfusional chemotherapy. 3 years survival has proved to be similar in both groups; (70.0% and 72.9%); 5 years survival has been 10% higher in the group subjected to the combined treatment (54.5% and 64.0%).

[Late results of ilio-inguinal lymphadenectomy in melanoblastoma of the skin of lower limbs]. / Otdalennye rezul'taty podvzdoshno-patkhovoi limfadenéktomii pri melanoblastome kozhi nizhnei konechnosti.

Under examination were 3--5--10 year results of ilioinguinal lymphadenectomy in 83 patients with skin melanoblastoma of the lower extremity. It is found that the status of inguinal and especially iliac lymphnodes is of primary importance for patients' survival. The latter were metastases involved in 24 cases (28.9%). Metastases may also develop in intact inguinal lymphnodes (in 4 cases). A 3-year survival, if one group of regional lymphnodes is involved (inguinal or iliac), is 20% lower than in the intact noes. With both groups of the nodes involved it is 4 times lower. A 5--10 year survival with involved inguinal nodes is 2 twice as low as with intact nodes. In iliac lymphnodes metastases there was no 5-year survival. Most poor results were noted in melanoblastoma located on the foot.

[Free dermatoplasty in melanoblastomas treated by perfusion chemotherapy]. / Svobodnaia kozhnaia plastika pri melanoblastomakh v usloviiakh perfuzionnoi khimioterapii

In the paper, the data on the immediate and late results of skin tranplantation in the complex treatment of limb melanoblastomas are reported. The latter consisted in a one-moment massive regional chemotherapy by perfusion of the extremity (iliac, femoral, brachial) with antitumor drugs, against which background melanoblastoma was excised electrosurgically, and lymphadenectomy was performed. The defect of the limb tissues, which was located on the foot or leg in 61 cases, was replaced by a free skin graft. The results of the plastic repair were followed up within the terms from 1 to 10 years.