[Injuries and spontaneous ruptures of thoracic esophagus]. / Povrezhdeniia i spontannye razryvy grydnogo otdela pishchevoda.

The results of treatment of 23 patients with injuries of thoracic part of the esophagus are analysed; in 10 cases spontaneous ruptures were detected. In 20 patients suturing of the esophagus was carried out, as a rule wia transthoracic approach. Lavage-washing system in the area of injury was widely used. Insufficiency of esophageal sutures was detected in 35% of cases. Total postoperative lethality made up 26.0%, and in spontaneous rupture of the esophagus-50%.

[The principles of the delivery of specialized surgical care in wounds of the heart]. / Printsipy okazaniia spetsializirovannoi khirurgicheskoi pomoshchi pri raneniiakh serdtsa.

The article presents results of treatment of 84 patients with wounds of the heart. Of great importance is to shorten the time from getting the injury to rendering specialized surgical aid. A wider volume of care at the prehospital stage is developed. The creation of a regional program of treatment of patients with chest wounds is thought to be expedient. Lethality was 13%. It was stressed that better results of treatment of patients with heart wounds was dependent not only on using the adequate diagnostic and medical methods but also on the improvement of organization of aid to such people.

[Atherosclerotic aneurysm of the iliac arteries]. / Ateroskleroticheskkaia anevrizma podvzdoshnykh arterii.

Operations were performed on 5 patients with isolated atherosclerotic aneurysms of the iliac arteries, who accounted for 10.9% of patients with aneurysms of vessels treated at the Vascular Department of the Novgorod Regional Hospital from 1983 to 1990. In 4 patients the aneurysm of the iliac artery was an operative finding, in one patient it was found only on postmortem examination. The diagnostic errors and causes of a fatal outcome in 2 patients are discussed. The authors claim resection of the aneurysm with reconstruction of the aorto-ilio-femoral segment to be the operation of choice in aneurysm of the iliac artery.

[The role of clinical x-ray studies in posttraumatic coagulated hemothorax]. / Rol' kliniko-rentgenologicheskikh issledovanii pri posttravmaticheskom svernuvshemsia gemotorakse.

An examination of 89 patients with posttraumatic coagulated hemothorax has shown that the definite roentgen picture corresponds to the characteristic clinical picture of the disease. These clinico-roentgenological signs of coagulated hemothorax are the determining factors in selection of the rational method of treatment. The data obtained show the necessity of early thoracotomy in cases of coagulated posttraumatic hemothorax.

[Ways of reducing mortality in injuries of the heart]. / Puti snizheniia leta'lnosti pri raneniiakh serdtsa.

Based on an analysis of literature and 45 personal observations the authors make a conclusion that reduction of lethality following wounds of the heart can be reached by introducing certain changes into traditional approaches to the problem. In order to approximate the moment of medical aid to the victims thoracotomy for the liquidation of heart tamponade, arrest of bleeding should be performed at the place of accident or in the admission department of the hospital, even to the detriment of traditional requirements of asepsis. For the prevention and treatment of early and late complications the patients must be directed to specialized centers (thoracal departments of the hospitals). The introduction of counterpulsation of the aorta, pacemakers, auxiliary blood circulation should be considered as requirements of time.