[Direct suprarenoscopy in the precise determination of the operability of lung cancer patients]. / Priamaia renoskopiia v utochnenii operabel'nosti bol'nykh rakom legkogo.

A new procedure for establishing the operability of lung cancer patients--direct suprarenoscopy--is discussed. The procedure was used in examining 6 patients with lung cancer. A detailed discription as well as indications and contraindications are given. A clinical case is reported. The method proved to be highly effective and promising.

[Feasibility of differential diagnosis of isolated lesions of mediastinal lymph nodes]. / Vozmozhnosti differentsial'noi diagnostike izolirovannykh porazhenii mediastinal'nykh limfaticheskikh uzlov.

Surgical procedures such as mediastinoscopy (101 cases) and parasternal mediastinotomy (6 cases) were used for improvement of diagnosis of lesions in mediastinal organs. As a result of complex examination including histological methods, malignant lymphoma was diagnosed in 12 cases, Boeck's sarcoidosis--75, mediastinal form of lung cancer--8, tuberculosis of mediastinal lymph nodes--6 and other lesions of organs of the mediastinum--in 6 cases.

The potentialities and prospects for surgical methods of diagnosis of cancer of the lung.

Surgical methods of diagnosis make it possible to determine in patients with lung cancer the actual local extension of tumour and its metastatic foci. The diagnostic thoracotomy plays an important role in the complex diagnosis of lung cancer. Diagnostic thoracotomy has been performed in 109 out of 1215 patients with lung cancer and other lung lesions suspicious for cancer. Primary lung cancer, mostly at early stage, was detected in 50 out of 109 patients. Among 308 patients who had been subjected to Daniels operation, metastases were revealed in 130 cases (42.2%); prescalene lymph nodes were found inpalpable in 12.4% and palpable in 64.4% of cases. Mediastinoscopy carried out in 262 patients revealed metastases in 36.2% of cases. Parasternal mediastinotomy allowed definition of the degree of tumor extension in 49.5% of cases. Application of laparoscopy and laparotomy revealed metastases in the organs of the abdominal cavity and retroperitoneal space in 13.5% of patients. Results of studies show a definite relationship between the frequency of metastases development in the lymph nodes and distant organs and tumor site as well as clinico-anatomical forms and morphological structure of tumor. Application of surgical diagnostic methods should be done according to strict indications.

[Importance and prospects of surgical study methods in lung cancer]. / Znachenie i perspektivy khirurgicheskikh metodov issledovaniia pri rake legkogo.

More than 20 years' experience with surgical exploration in cancer of the lung is generalized in this article. The use of prescalene biopsy allowed to find out metastases in 130 out of 308 patients (42.2%), mediastinoscopy helped to refine the degree of the propagation of the process in 36.2%, and parasternal mediastinotomy--in 49.5%. Due to laparoscopy and laparotomy metastases in the abdominal organs (liver, adrenal glands, retroperitoneal nodes) were found in 22 out of 162 patients. The diagnostic thoracotomy carried out upon 109 patients revealed tumors of the lungs in 50 patients, in 47 out of them it was an early stage of primary cancer.

[Importance of mediastinoscopy and parasternal mediastinotomy in the accurate determination of the operability of lung cancer patients]. / Znachenie mediatinoskopii i parasternal'noi mediastinotomii v utochenii operabil'nosti bol'nykh rakom legkogo.

The authors give a comparative estimation of the results of 217 mediastinoscopies, 58 parasternal mediastinotomies, performed in 274 patients with pulmonary cancer to determine precisely their operability. Positive findings in mediastinoscopy were noted in 66 (33.4%) of 217 patients, especially in cancer of median localization (in 42 of 153 patients or in 32%) and of the right lung predominantly (in 51 of 134 patients or in 45.5%). Parasternal mediastinoscopy yielded positive findings in 30 (51.7%) of 58 patients. This method proved to be mostly reliable in examining patients with peripheral bronchus cancer, especially in left lung localization of the tumor. The results of mediastinoscopy and parasternal mediastinotomy are similarly conditioned by the morphological structure of the tumor. Due to mediastinoscopy and parasternal mediastinotomy 57 (26.6%) of 222 patients, previously referred to as being "operable," proved to be inoperable. These methods also would aid in avoiding tentative thoracotomy or nonradical surgery in 78 (30.7%) of 254 patients, primarily considered to be "operable" or "doubtfully operable".

[Clinical evaluation of local and regional spread of lung cancer]. / Klinicheskaia otsenka mestnoto i regionarnogo rasprostraneniia raka legkogo.

The author has given a clinical estimation of 205 azygo-and hemiazygographies, 252 prescalene biopsies, 118 mediastinoscopies and 79 thoracotomies, performed to determine the boundaries of local and regional cancer spread. An associated study was used in 135 patients. In 390 of 473 patients (or in 82.4% of cases) the diagnosis of lung cancer was supported histologically and cytologically. By means of prescalene biopsy metastases in deep lower jugular lymph nodes were detected in 81 (32.1%) patients. Application of azygography allowed the recognition of azygous vein block in 28 of 205 patients. Mediastinoscopy made it possible to reveal the presence of metastases in 33 (27.9%) of 118 patients. Thoracotomy employed in 79 patients to pinpoint further the spread of the process allowed a conclusion as to inoperability in 19 of them.