[The laryngeal condition in the patients presenting with euthyroid multinodular goiter as evaluated by direct laryngoscopy]. / Sostoianie gortani u bol'nykh éutireoidnym mnogouzlovym zobom po dannym priamoi laringoskopii.

The objective of the present study was to improve diagnostics of disturbances in the laryngeal condition of the patients presenting with euthyroid multinodular goiter with special reference to the condition of the upper respiratory passages. The preoperative characteristic of 398 patients included the description of the predominant clinical syndrome (the neoplastic and compressive variants) and specification of the morphological type of the disease to promote the decrease of operative activity with respect to colloidal proliferative goiter. Direct laryngoscopy was employed in addition to the traditional diagnostic techniques during both the surgical operation and the follow-up observation. Hoarseness developed in the postoperative period in 13.4% to 16.9% of the patients. Postoperative transient and persistent laryngeal paresis was documented in 1.5% and from 1.5% to 4.2% of the cases respectively. Direct laryngoscopy revealed the symptoms of laryngitis and laryngotracheitis as well as foci of leukoplakia, laryngeal cysts and nodules, besides disturbances in the mobility of the vocal chordae. It is concluded that the above pathological changes in the laryngeal structures should be identified during the preoperative examination of the patients presenting with euthyroid multinodular goiter while direct laryngoscopy must be included in the program of postoperative supervision.

[Programmed relaparotomy in generalized purulent peritonitis]. / Programmirovannaia relaparotomiia pri rasprostranennom gnoinom peritonite.

Efficacy of programmed relaparotomy in combined treatment of 51 patients with generalized peritonitis is analyzed. Based on evaluation of surgical data, basic clinical and laboratory markers of endotoxicosis algorithm of programmed relaparotomy has been developed. Comparative analysis of the results of treatment of 36 patients after 1-2 programmed relaparotomies (1.6+/-0.5 surgeries) and 15 patients after repeated relaparotomies (3.4+/-0.3 surgeries) demonstrated that these methods were more effective before development of significant polyorganic disturbances. Nine (17.6%) patients died.