Esophagocoloplasty for cicatricial stenosis after chemical injury.

Our experience with esophageal replacement by transposition of the right colon with a segment of ileum in patients with cicatricial esophageal strictures caused by the ingestion of caustic agents has been discussed. We demonstrated, by means of the D-xylose test, that the length of ileal segment did not adversely affect the absorptive ability of the intestine, which returned to the preoperative level shortly after the operation and even exceeded that level 12 months thereafter.

Preoperative treatment of patients with thyrotoxicosis.

A combination of antithyroid drugs and thyreoidine appears to be the optimal preoperative treatment for patients with thyrotoxicosis. A combination of methimazole and thyroid in adequate dosages can eliminate thyrotoxicosis and prevent postoperative reactions and increased intraoperative bleeding.

Laparoscopic transparietal puncture of the gallbladder.

Transparietal laparoscopic puncture of the gallbladder with concomitant therapeutic treatment is shown to be an effective method for the prevention of acute cholecystitis as a stage in the preparation of the patient for surgery.

Complications of bronchoscopy: comparison of rigid bronchoscopy under general anesthesia and flexible fiberoptic bronchoscopy under topical anesthesia.

A prospective study of 4,595 bronchoscopic procedures performed over four years (1975 to 1978) on 2,143 patients with various bronchopulmonary diseases is described. Of the 4,595 procedures, 1,146 were performed with a flexible fiberoptic bronchoscope (Olympus BF-5B2 or BF-B2) under topical anesthesia with tetracaine and procaine, and 3,449 procedures were performed with a rigid bronchoscope under general intravenous anesthesia with hexobarbital (Evipan) using a modified Sanders' technique to ventilate the patients. Complications occurred in 235 procedures (5.1 percent). Major complications that threatened the patient's life and required intensive medical treatment, surgical intervention, or resuscitative measures occurred in 51 procedures (1.1 percent); deaths occurred after 6 procedures (0.1 percent). A comparison of the complications of rigid bronchoscopy and flexible fiberoptic bronchoscopy revealed significantly higher rates of complications of fiberoptic bronchoscopy attributable to toxic effects of tetracaine and of complications of rigid bronchoscopy associated with insufficient general anesthesia. With rigid bronchoscopy, the number of major complications induced by diagnostic manipulations through the bronchoscope and the total number of major complications were significantly higher than with flexible fiberoptic bronchoscopy.

Chromobronchoscopy in the diagnosis of bronchial tumors.

Staining of the bronchi with methylene blue was performed during bronchoscopy in 140 patients with various bronchopulmonary diseases. It was found that malignant bronchial tumors selectively stain dark blue; normal mucous membranes remain unstained. On this basis one can judge rather accurately how far the cancerous growth has spread along the bronchus, and so reach the target area by biopsy in those cases where visual signs of abnormality are indistinct or absent.

Endoscopical biopsy in the differential diagnosis of lung diseases.

The results of endoscopical sampling methods, as described in this study, were performed on 5276 patients with different pulmonary lesions. Illustrations were made of the diagnostic possibilities of biopsy methods and their dependence on size and localization of pulmonary lesions. Most appropriate sequence was outlined for the use of different sampling methods.