[Functional studies in the prediction of postoperative complications in the presence of lung diseases]. / Funktsional'nye issledovaniia v prognoze posleoperatsionnykh oslozhnenii pri zabolevaniiakh legkikh.

Data on the functional status of the cardiorespiratory system are required to identify patients at risk for postoperative complication in the presence of lung diseases. Very many factors influence the course of an operation and the postoperative period so there is no golden standard or the only parameter for predicting how the postoperative period runs. Patients with normal spirographic values (FEV1, more than 80%??) and without cardiovascular comorbidity are at a slight risk for postoperative complications. These patients do not need to be additionally examined. A less than one-month history of myocardial infarction, instable angina pectoris, decompensated heart failure, severe valvular disease are contraindications to planned surgery. The risk of cardiovascular events is high when the signs of myocardial ischemia occur with low exercise (less than 4 MET). Stress echocardiography, loading tests, and radioisotopic study are used as auxiliary techniques, FEV1, under 60%; ppo-FEV1, and ppo-DC, under 40%; VO2max, under 15 ml/kg/min are the values of a high risk for respiratory complications.

[Videothoracoscopy in diagnosing and treating exudative pleuritis]. / Videotorakoskopiia v diagnostike i lechenii ékssudativnykh plevritov.

Telethoracoscopy (TT) was performed in 76 patients with exudative pleurisy of unclear etiology. A correct diagnosis was made in all (100%) cases. Tuberculosis was detected in 41 (54%) patients. In this group of patients, the results were analyzed by taking into account the duration of disease, the nature of an operation, and morphological findings. In tuberculous pleurisy, TT may be conducted at any time; however, it is most effective when an acute period subsides and an exudate begins forming. At this time (2-3 months after the onset of the disease), surgery is not diagnostic, but also remedial as sanitation of the pleural cavity with partial pleurectomy.

[Pancreatobronchial fistulae]. / Pankreatobronkhial'nye svishchi.

The authors followed up 2 patients with pancreatobronchial fistulas in the period between 1963 and 1990. On the basis of the data in the literature and the results of their own observations the authors analyse the etiology, pathogenesis, and methods for the diagnosis and treatment of the rare pathological condition. Patients with a recognised pancreatobronchial fistula were subjected to complex therapy including drainage of the pleural or abdominal cavity and, whenever necessary, an operation, which made it possible to achieve good results.

[Endoprosthesis of the trachea in the treatment of cicatricial stenosis with tracheomalacia]. / Endoprotezirovanie trakhei v lechenii rubtsovykh stenozov s trakheomalatsiei.

The authors discuss the results of the first experience in the clinical use of nitinol spiral endoprostheses as an artificial supporting framework of the trachea in local destruction of the tracheal cartilages and loss of rigidity of the tracheal wall. Tracheal endoprosthetics was carried out in 6 patients with cicatrical stenoses and tracheomalacia. The causes of possible complications (growth of granulation tissue into the tracheal lumen and displacement of the endoprosthesis) are analysed and the means of their prevention are suggested. It was established that the nithinol spiral endoprosthesis may be covered by epithelialized tracheal mucosa and provide an adequate rigid lumen for the tracheal area devoid of the framework. The diameter of the implanted prosthesis must be 2-3 mm larger than the diameter of the normal tracheal lumen. Temporary introduction of a protector tube into the repaired trachea may shorten the duration of treatment significantly.

[Endoscopic electro- and laser surgery in diseases of the trachea and bronchi]. / Endoskopicheskaia elektro- i lazernaia khirurgiia zabolevanii trakhei i bronkhov.

Endoscopic interventions with the use of a AIH-laser and high frequency currents were carried out in 72 patients with tumors and cicatricial stenoses of the trachea and bronchi. Intraoperative complications occurred in 4 patients. The immediate results were good and satisfactory in 92.8% of patients. The authors conclude that the use of a polypectomic loop is advisable in removal of tumors on a narrow base, those on a wide base are best destroyed with a laser; the use of an AIH-laser beam in the treatment of cicatricial stenosis is undesirable.