[ENDOSCOPIC MUCOSAL RESECTION AND ENDOSCOPIC DISSECTION IN THE SUBMUCOSAL LAYER FOR EARLY GASTRIC CANCER].

The development of endoscopic techniques of surgery of patients with early gastric cancer (high and moderately differentiated adenocarcinoma) by endoscopic mucosal resection and endoscopic submucosal dissection with regard to their minimally invasion, high efficiency and quality of life after treatment allowed seriously establishing itself and be accepted for use in worldwide.

[Diagnosis and treatment strategy of malignant pleural effusions in outpatient conditions].

According to results of the study, which included 52 patients with malignant pleural effusion of unknown etiology, it could be concluded that the method of choice in differential diagnosis of pleural effusion is the immunocytochemistry as the most informative method (efficacy 94,2%). Based on own experience of treatment of 137 patients with recurrent malignant pleural effusions, we can say that the first stage of treatment of pleural effusions is carrying out pleurodesis in outpatient conditions. The choice of pleurodesis method, first of all, depends on the aggressiveness of tumor pleurisy: in a case of daily exudation till 300 ml we choose talc pleurodesis, from 300 to 700--bleomycin pleurodesis, more than 700--combined (talc and bleomycin pleurodesis). The overall efficiency of produced pleurodesis is 64.5%.

[Clinico-morphological substantations of parenchyma-preserving operations performance in surgery of chronic pancreatitis].

There was presented a comparative analysis of the surgical treatment results of 86 patients, suffering chronic pancreatitis, in whom resection and parenchyma-preserving elaborated operations were done, aimed for pancreatic and biliary ducts hypertension elimination. According to histological and histochemical data obtained, there are uniform changes, localized in pancreatic head, corpus and tail: the extended periductal fibrosis with the immune-cell infiltration foci and periductal connective tissue sheath formation. According to the immunohistochemical data obtained, in a fibrous zone there was obtained a big quantity of activated alpha-SMA-positive collagen producing star-like cells and a significant expression of a type IV collagen. Indications for surgical treatment, using parenchyma-preserving procedures, were substantiated, taking into account morphological and clinical data present. The patients quality of life in a late follow-up period (5 years) after performance of a proposed operative procedure (the main group), according to all scales of international questionnaires MOS SF-36 applied, were trustworthy better (P < 0.05), than after resection procedures (control group).

[Complex endoscopy-assisted treatment for pleural malignancies with concomitant exudative pleuritis].

The paper deals with complex treatment for pleural malignancies with concomitant effusions. Cytoreduction and abatement of effusion, protein loss, inflammation, intoxication and pain syndrome were reported after argon-plasma electrocoagulation of the pleura followed by photodynamic therapy and hyperthermal intrapleural chemoperfusion. Stable effusion abatement effect was confirmed in all eight cases by X-ray examination and changes in homeostatic indices and breathing function as well as lowered severity of intoxication and pain. No emergency repeat intervention or pleural puncture was reported.

[Video-assisted thoracoscopy for diagnosis and therapy of pulmonary, mediastinal and pleural neoplasia in children and adolescents].

Data are presented on 30 cases of video-assisted thoracoscopy for different intrathoracic neoplasms in children and adolescents. Indications and contra-indications for use for diagnostic and therapeutic purposes as well as possible complications and their prophylaxis are discussed.

[Combined endoscopic treatment of malignant tumorous lesions of the pleura accompanied with exudative pleurisy].

The article is devoted to a combined method of treatment of malignant tumorous lesions of the pleura accompanied by exudative pleurisy. The main result of using the method is cytoreduction, discontinuation of exudation and loss of protein, reduction of inflammation, intoxication and pain syndrome. It results from argonoplasmic electocoagulation of the pleura followed by photodynamic therapy. The treatment was used in 10 patients with a palliative aim. In all cases persistent discontinuation of the accumulation of pleural exudates was obtained that was confirmed by better state of the patient, normalization of homeostasis indices, X-ray examination data, reestablished functions of external respiration, reduced intoxication and pain syndrome. No reoperations or pleural punctures were needed.

[Use of video-assisted thoracoscopy in diagnosis and therapy of single circular formations in the lung].

An evaluation is presented of the data on use of video-assisted thoracoscopy in the diagnosis and therapy of 45 patients with single circular formations in the lung. Indications and contraindications for the management of benign and malignant single tumors of the lung are discussed alongside a review of the Russian and foreign literature.

[Video thoracoscopy in the diagnosis and treatment of pulmonary, mediastinal and pleural neoplasia]. / Videotorakoskopiia v diagnostike i lechenii novoobrazovanii legkogo, sredosteniia i plevry.

Video-assisted thoracoscopy for differential and improved diagnosis was successful in 245 out of 249 patients (98.3%) with various chest neoplasms. Video-assisted surgical procedures were performed in 50 (20%). Complications were reported in 4 (1.6%). The method proved highly-effective as well as fairly safe and sparing.

[Role of video-assisted thoracoscopy in diagnosis of neoplasms in mediastinal organs]. / Znachenie videotorakoskopii v diagnostike novoobrazovanii organov sredosteniia.

Diagnostic potential of video-assisted thoracoscopy was evaluated in 66 patients (36 males and 30 females) with neoplasms (aged 24-68 yrs). When used in conjunction with biopsy, it confirmed the following diagnoses: lymph proliferative disease (23), mediastinal malignancies (11), sarcoidosis (21), benign mediastinal tumors (7), Castleman's benign lymphoma (2) and mediastinal cyst (2). Clinical diagnosis was substantially changed in 40 (61%) cases as a result of videothoracoscopy application. It has proved precise, fairly safe and conservative; it has a potential in diagnosis of mediastinal tumors.

[The effect of ticlid on the late result after the surgery of the brachiocephalic trunk arteries]. / Vliianie tiklida na otdalennyi rezul'tat posle vypolneniia operatsii na arteriiakh plechegolovnogo stvola.

No ischemic insult, myocardial infarction, death due to cardiovascular pathology was observed in 138 patients, to whom after the operation on the arteries of truncus brachiocephalicus the ticlid was administered. At a comparison group (120 patients) in 3 the myocardial infarction have occurred (one patient died), in 2--an ischemic insult. After the ticlid application the positive late follow-up result was noted in 93.1% patients, without it--in 70.5%. The preparation compliance is good.

[Pharmacologic protection of brain in surgery of the brachiocephalic arteries]. / Medikamentoznaia zashchita golovnogo mozga pri vypolnenii operatsii na plechegolovnykh arteriiakh.

On the basis of experimental and clinical data, the subclinical ischemic brain damage resulting from temporary clamping of the carotid artery during performance of the reconstructive operation has been established. The changes were revealed in sufficient, according to the existing criteria, collateral circulation. Before placing the clamp onto the carotid artery as a preventive method for intraoperative medicamental brain protection, intraarterial administration of piracetam, which possesses anti-ischemic, membrane stabilizing and antioxidant properties, has been suggested.

[Medial approach to the proximal section of the vertebral artery]. / Medialnyi dostup k nachalnomu otdelu pozvonochnoi arterii.

An access to the initial portion of the vertebral artery which is distinguished by medial relative to the internal jugular vein approach to the subclavian-vertebral arterial segment is described. In its use in 34 patients, no complications which occur in conventional access with the lateral relative to the internal jugular vein approach (diaphragmatic nerve paresis, plexitis, injury to the thoracic duct) were noted.

[The choice of a method of treating chronic disorders of the cerebrovascular circulation]. / Vybor metoda khirurgicheskogo lecheniia khronicheskogo narusheniia mozgovogo krovoobrashcheniia.

The results of surgical treatment of 106 patients with occlusive lesions of the brachiocephalic trunk vessels have been analysed. A necessity of reorientation of the conservative approach to the treatment of patients in favour of surgical angioneurology is stressed.