[Experience of surgical treatment of patients with arterial aneurysms]. / Opyt khirurgicheskogo lecheniia bol'nykh s arterial'nymi anevrizmami.

Incidence rate of arterial aneurysms is 3.4-4.6% of that of vascular diseases and has a tendency towards further increase. In National Research Center of Surgery, RAMS, 410 patients with arterial aneurysms of various localization were treated. The majority of the patients were men--221 (65.4%). Surgical procedures were performed in 338 (82.4%) patients. Reconstruction surgeries were performed in 273 (80.8%) patients, ligature surgeries--in 65 (19.2%) patients. In early postoperative period good results (recovery and improvement) were seen more often (p < 0.05) after reconstruction surgeries (89.8% patients) than after ligature ones (47.7% patients). Long-term results (follow-up > 10 years) were also better after reconstruction than after ligature surgeries.

[Forty years of experience with reconstructive operations for vasorenal hypertension]. / 40-letnii opyt rekonstruktivnykh operatsii pri vazorenal'noi gipertenzii.

Presented herein is an experience gained with 1356 reconstructions for vasorenal hypertension, performed at the RSCS, RAMS, over the period 1961 to 2001. The authors defined the criteria for the diagnosis of the given disease and the indications for surgical treatment. Also, the others demonstrate specific features of surgical treatment of patients presenting with different variants of renal artery lesion, provide the short- and long-term results of the main types of reconstructions accomplished for vasorenal hypertension, and emphasize the importance of the use of roentgenendovascular techniques. Based on the experience gained the conclusion is made about the advantages of surgical management versus conservative treatment methods.

[Surgery of some diaphragm diseases]. / Khirurgiia nekotorykh zabolevanii diafragmy.

The authors analyze 127 rare diaphragm diseases. Among them, the rate of true diaphragmatic hernias does not exceed 1%. The congenital through diaphragm defects were encountered three times more often than false hernias, equally frequently on the left and on the right. The majority of the patients (51.97%) had hernia of Larrey's fissure. The rate of true hernia (Morgagni's) was 3 times less than of false hernia (Larrey's). In Bochdalek's hernia (3.15%) false hernias were found three times more often than true hernias. Relaxation of diaphragm was found in 40.94% of the patients. Right-sided complete diaphragm's relaxation occurred 4 times less often than on the left, partial--10 times more often on the right than on the left. Duplication of diaphragm with inserting kapron net, velours or teflon between it layers remains the dominant way of surgical correction of total relaxation of diaphragm's cupula.

[Pulmonary artery embolism]. / Emboliia legochnoi arterii.

The authors have an experience in diagnosis and treatment of pulmonary embolism in 194 patients. Much attention is paid to diagnosis of thrombosis of the deep veins, phlebography and duplex scanning as the most informative methods. Due to regular unspecific and specific prophylaxis of deep phlebothrombosis in operated patients, pulmonary artery embolism occurred only in 2 patients for 12 years. Valid diagnosis of pulmonary artery embolism is thought possible only in application by pulmonary scanning and angiopulmonography. Mostly conservative method of treatment was used, only in 2 patients successful embolectomy was performed. Anticoagulation (heparin) and fibrinolytic (streptase) therapy was carried out. The results of streptase administration were superior to those of heparin injections. Recovery rate after fibrinolytic therapy made up 86.4%.

[35 years of experience in reconstructive operations in surgery of vasorenal hypertension]. / 35-letnií opyt rekonstruktivnykh operatsií pri khirurgicheskom lechenii bol'nykh vazorenal'noí gipertenzieí.

Reconstructive surgery was performed in 1148 patients with renal hypertension in the period from 1961 to 1996. Extracorporeal microsurgical correction with subsequent kidney autotransplantation was used in case of the lesions of the renal arteries branches. In 161 (14%) of the patients the result was unsatisfactory. The reasons of unsatisfactory results were the following: uncorrected stenosis of the contralateral renal artery (43%), nephrosclerosis of the contralateral kidney (26%), unknown reasons (31%). The long-term results have been followed up in 769 (67%) of the patients in the period for 135 +/- 4 months after the surgery. In 546 (71%) of the patients positive results persisted. The average time of symptomatic recurrence was 74 +/- 6 months after the surgery. Restenosis was the reason of recurrence in 61 (57%) of the patients. Based on these results the following recommendations are postulated: in atherosclerosis--the transaortic endarterectomy from the opening of the renal artery; in fibromuscular displasia--renal artery resection with end-to-end anastomosis; in nonspecific aorcic arteritis--bypass operations.

[Results of surgical treatment of chronic abdominal ischemia]. / Rezul'taty khirurgicheskogo lecheniia khronicheskoi abdominal'noi ishemii.

The immediate results of surgical treatment for chronic abdominal ischemia were studied in 112 patients. The late-term results were studied in follow-up periods of 6 months to 20 years in 105 (95.5%) patients treated by operation and in 45 patients who were not operated on. In the immediate postoperative period, positive results were recorded in 104 (92.8%), no changes were found in 4 (3.6%) patients, and fatal outcomes occurred in 4 cases (3.6%). In the late-term postoperative period the results were positive in 79 (75.2%) patients, no changes were produced in 3 (2.9%), the disease recurred in 21 (20%) patients, and 2 (1.9%) patients died. Actuarial analysis showed the late-term results of surgical treatment to be higher by 40.8% in a 5-year follow-up period and by 27.7% in a 10-year follow-up period (69.93 +/- 5.8% in a 5-year period and 36.69 +/- 9.43% in a 10-year period) than in nonoperative treatment (29.16 +/- 6.75% and 8.97 +/- 4.27%, respectively) in P less than 0.01.

[Progress in current vascular surgery]. / Progress sovremennoi angiokhirurgii.

Vascular surgery, one of the main fundamental parts of angiology, is an important rapidly developing clinical specialty. The author discusses the experience in many thousand operations in injuries, atherosclerosis, and thrombosis of arteries and veins in the light of new advancements in plastic microsurgery and the use of laser, ultrasound, glue, and various types of vascular sutures. He suggests organizing adequately equipped vascular surgery departments and teams of emergency vascular surgery, wider training of vascular surgeons++, and discusses new methods for the reconstruction of vessels and use of vascular prostheses.