[Interscapular-thoracic amputation]. / Mezhlopatochno-grudnaia amputatsiia.

An analysis of results of treatment and prostheses of 89 patients with malignant tumors of the upper extremities and shoulder girdle has shown that among the tumors there were osteogenous sarcomas, chondroid sarcomas, nonclassified sarcomas, reticulosarcomas, angiosarcoma, fibrohistocytic sarcoma, Euring's sarcoma, solitary myeloma, giant cells tumors. Interscapular-thoracic amputations were performed in all the patients. The overall survival rate was (28.6 +/- 8.3)%. An orthosis and a modified prosthesis developed at the research institute of prostheses named after prof. G. Albrekht are recommended for rehabilitation of invalids.

[Treatment of lung metastasis in patients with soft-tissue sarcoma]. / Lechenie legochnykh metastazov u bol'nykh sarkomami miagkikh tkanei.

The study group included 104 patients with soft-tissue sarcoma and metastases into the lung, treated at the Institute Clinic in 1960-1992. Surgery for lung metastasis was given to 10 and chemotherapy-to 48 patients; the remaining 48 cases received treatment for symptoms only. Overall 5-year survival was 13.5% (after surgery-30.0%; chemotherapy-19.1%). All the 46 patients treated for symptoms died within two years after detection of lung metastasis. Chemotherapy proved effective in the treatment of multiple metastasis when detected shortly after removal of the first lesion.

[Our experience with surgical treatment of soft tissue neoplasms]. / Nash opyt khirurgicheskogo lecheniia opukholei miagkikh tkanei.

On the basis of the data on 650 cases of soft-tissue sarcoma, improvements to surgical treatment of these tumors have been made versus localization, local extension and histological pattern. Optimal size of area to be excized has been determined. Procedures for organ-saving surgery involving resection of nerves, vessels and underlying bones, in cases of locally-extended tumors, have been evolved. Optimal procedures for skin reconstruction have been suggested. The rationale has been given for indications to amputation. The 5-year survival in patients with soft-tissue sarcoma was 52,6%, while local recurrence incidence-23%.

[The treatment and prosthesis after an interilioabdominal amputation for sarcomas of the bones and soft tissues]. / Lechenie i protezirovanie posle mezhpodvzdoshno-briushnoi amputatsii po povodu sarkom kostei i miagkikh tkanei.

According to data of the Research Institute of Oncology named after N. N. Petrov, progress was achieved in treatment of patients who were subject to interilioabdominal amputation for malignant tumors. Five years survival after such operations was 19.7 +/- 3.4%. The prosthesis for patients subjected to interilioabdominal amputations was developed in Research Institute of Prosthesis (Saint Petersburg). It was successfully used in 11 patients in the age from 8 to 51 years. The original construction of the prosthesis gives the patients possibility to walk without crutches, move along staircases with 25-cm-high footsteps and to use urban transport.

[A comparative analysis of the current methods for the outpatient diagnosis of soft tissue tumors]. / Sravnitel'nyi analiz sovremennykh metodov ambulatornoi diagnostiki opukholei miagkikh tkanei.

Data of examinations of 1176 patients with different diseases of soft tissues have shown that the arsenal of diagnostic methods which can be used under laboratory conditions has become wider. Of special value is the method of aspiration biopsy which must be introduced into medical practice. In obscure and doubtful cases the examination must be complex, including soft-tissue roentgenography, echography, thermography and radionuclide examination. Angioscintigraphy of soft tissues is an important method in differential diagnostics when the tumor is localized on extremities. Fairly promising is the method of magnetic resonance computed tomography.

[Interscapular-thoracic resection in the treatment of patients with tumors of the musculoskeletal system]. / Mezhlopatochno-grudnaia rezektsiia v lechenii bol'nykh opukholiami oporno-dvigatel'nogo apparata.

Data of 13 patients with tumors of the locomotor system subjected to +interscapular-thoracic resection (ITR) are presented. Main technical aspects of ITR are described. Complications took place in 6 patients, including marginal necrosis of the skin in 4 patients. As a whole the 5-year survival made up 49.9% +/- 13.8%. Data are presented on rehabilitation measures which allow to widen the functional possibilities of the extremity.

[The choice of the extent of the surgical intervention in patients with soft tissue sarcomas of the extremities]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s sarkomami miagkikh tkanei konechnostei.

The analysis of data on 446 patients with soft tissue malignancies showed overall five-year survival rate to be 48.9%. The extent of tissue to be removed during sparing surgery is specified. In case of intramuscular location of tumor, it is enough to leave a 4-5-cm margin above and below the tumor border, as assessed by palpation. Indications for limb amputation at various levels were developed. Limb-sparing surgery could be employed on a larger scale if advances of modern plastic (skin, bone and vascular) surgery were adopted wider. A complex of rehabilitative measures was developed. Patients undergoing limb amputation need early prosthetics.

[The choice of the extent of the surgical intervention in patients with soft-tissue tumors of the trunk]. / Vybor ob''ema operativnogo vmeshatel'stva u bol'nykh s opukholiami miagkikh tkanei tulovishcha.

Data on 145 cases of soft-tissue tumor of the trunk were analysed. Tumor was located on the chest or back in 81 patients and deep in the anterior abdominal wall--in 64. When intramuscular sarcoma is removed, a 2-3-cm margin should be left around the palpable mass. Five-year survival in the entire group of patients with tumors of the chest and back was 59.4% +/- 2.4. Five out of ten cases with tumor of the abdominal wall survived over 5 years.

[Combined treatment of soft tissue sarcoma]. / Kombinirovannoe lechenie sarkom miagkikh tkanei.

The five-year results of surgical and combined (irradiation + operation) treatment of 451 patients with sarcoma of the soft tissues are analysed with due account for the principal prognostic factors. It is shown that the survival of patients may be prolonged if the operation is supplemented by irradiation. Comparison of three variants of combined treatment showed the advantages of combined treatment with subsequent postoperative irradiation. Radiotherapy does not increase the number of postoperative complications.

[Direct angioscintigraphy of soft tissue sarcomas in outpatient diagnosis]. / Priamaia angiostsintigrafiia sarkom miagkikh tkanei v ambulatornoi diagnostike.

Direct angioscintigraphy was carried out in 80 patients suspected for soft-tissue tumors in the extremities. Relevant procedure, predictive value of the diagnostic test, relationship between scintigraphic patterns and those of tumor histology as well as factors adversely affecting examination results are discussed. The method was shown to be sufficiently accurate (0.79) and may find effective application in examination of outpatients.

[Comparative analysis of clinical data on pigmented villonodular synovitis and sarcoma of the soft tissues of the legs]. / Sravnitel'nyi analiz klinicheskikh dannykh pigmentnogo vorsinchato-uzelkovogo sinovita i sarkom miagkikh tkanei nizhnikh konechnostei.

Pigmentary villonodular synovitis was isolated in an independent nosological unit in 1941. A comparative analysis of data on 278 patients with soft tissue sarcomas of lower extremities (262 observations) and pigmentary villonodular synovitis (16 observations) is presented. Clinico-historical data, results of instrumental methods of examination evidence the absence of any definite symptoms of these diseases. Findings of punctures are most informative.

[Medical care for patients with cancer of the upper thoracic segment of the esophagus]. / Lechebnaia pomoshch' bol'nym rakom verkhnegrudnogo otdela pishchevoda.

Out of 350 hospitalized cases of esophageal carcinoma in the upper thoracic segment, stage III-IV tumors were identified in 82.8%. A retarded seeking of medical advice was chiefly responsible for the advancement of tumors. Radical surgery was performed in 32 (9.1%) patients only. The percentage of radically-treated cases could have been greater, if there had been fewer refusals to operate and to be operated on both on the part of patients and doctors who would object to surgery on the grounds of concomitant pathology or the patient's age. Radiotherapy, used in 197 (72.7%) patients as a sole method of treatment, was followed by remission in 68%.

[Medical rehabilitation of patients after amputation of the leg in sarcoma]. / O meditsinskoi reabilitatsii bol'nykh posle amputatsii nizhnei konechnosti po povodu sarkomy.

An analysis of data of 348 patients with malignant tumors of soft tissues has shown that 128 of them had been subjected to the amputation of extremities at different levels. The use of microsurgical techniques favours the improvement of the method of amputation of lower extremities, in particular the transplantation of a calcaneoplantar flap onto the stump end. In order to make the treatment of phantom limb pains more effective acupuncture should be included into the complex of therapeutic measures in addition to traditional methods. Close contacts with prostheses-makers can facilitate earlier prosthesis which can give positive effects on the following rehabilitation of such patients.