[Topographic-anatomical aspects of nerve-saving operations in the temporal area and in the lateral part of a face].

Bicoronary access is now considered as optimal for performance of operative interventions in the upper part of face. At the same time, this access is associated with the probability of damaging the innervation of the frontal muscles. Thus, the objective of this investigation was to study the individual variability of topography of facial nerve branches in temporal and parotid areas, with specification of projections of temporal branches of a facial nerve to frontal muscle in order to define a safe zone for dissection. The material was obtained from 36 corpses of adult persons, and precision preparation method was used together with the recording and mathematical processing of the results obtained. It was established, that in objects with a size of tragoorbital line less than 8 cm, a single frontal branch of a facial nerve was present, and its safety zone was about 1 cm to the front from tragus auris. In objects with the size of tragoorbital line equal to 8 cm and more, a common trunk of frontal branch of facial nerve was present together with a branch to m. orbicularis oculi, while its safety zone was equal to 1.5 cm and it was located to the front of tragus auris.

[Prospects for saving vegetative nerves during operations for cancer of the lower rectum]. / Vozmozhnost' sokhraneniia vegetativnykh nervov taza pri operatsiiakh po povodu nizkogo raka priamoi kishki.

The aim of the work was to investigate the possibility to isolate and preserve the vegetative nerve of the pelvis in operations for low rectal cancer. In preparation of 17 corpses of people dead from causes not associated with a pathology of pelvic organs, mainly two forms of the structure of the superior hypogastric plexus were isolated--with many branches and with few branches. The pelvic promontory is taken as a reference-point. Frontal resection and extirpation of the rectum were fulfilled in 17 patients with low rectal cancer using the nerve-preserving technique of operation. Saving the vegetative nerves of the pelvis does not result in greater number of postoperative complications and positively influences the genitourinary function of the patients.

[Some regularities of morphological changes in liver tissue exposed to electricity]. / Nekotorye zakonomernosti morfologicheskikh izmenenii tkani pecheni pri élektrovozdeistvii.

An experimental investigation of the character and spread of morphological and histological alterations in the liver was performed in order to follow their dependence on the regimen of using an electrosurgical apparatus for resection and coagulation of the liver tissue.

[Significance of features of the projection of the cervical part of the thoracic duct onto the left sternocleidomastoid muscle for performing operations involving video support]. / Znachenie osobennostei proektsii sheinoi chasti grudnogo protoka na levuiu grudinokliuchichno-sostsevidnuiu myshtsu dlia vypolneniia operativnykh vmeshatel'stv s videopodderzhkoi.

To work out practical recommendations for using videosupport projection of cervical part of the thoracic duct on sternoclaidomastoid muscle was determined in 158 corpses of adults. Surgical access to the thoracic duct is available using common macrosurgical equipment until the moment of visualization of major lymphatic corrector, although it is reasonable to involve videosupport at following stage with the camera of videoendosurgical kit adjusted in inferior margin of the wound. This allows to perform all the necessary actions to expose cervical part of the thoracic duct and to correct them according to video information on the monitor.

[Anatomic characteristics of relatively inaccessible zones of thoracic duct and principles for improving surgical approaches]. / Anatomicheskie kharakteristiki zon otnositel'noi nedostupnosti grudnogo protoka i printsipy ulucheniia operativnykh podkhodov.

The analysis of data obtained from investigation of 158 cadavers of adults with the use of complex of anatomic methods and from experiments on video-endosurgical installation revealed that the following ways should be combined to expose thoracic duct relatively inaccessible zones: a method of opened access to thoracic duct using high traumatism elements (clavicotomy and pericardium dissection), video-endosurgical method of access to thoracic duct regions located on the bottom of infundibular recess and use of mechanical clipping for faster block of thoracic duct lumen.

[Individual variability in the topography of the thoracic duct and its significance for the treatment of chylothorax by a video endosurgical method]. / Individual'naia izmenchivost' topografii grudnogo protoka i ee znachenie dlia lecheniia khilotoraksa videoéndokhirurgicheskim metodom.

A possibility for clipping the ends of the damaged thoracic duct in chylothorax treatment by video endosurgical method was supported by the experiment performed in 10 dogs and topographoanatomical study carried out in 158 corpses of adults. The correlation found allows to forecast the possible position of thoracic region of the thoracic duct both by the thoracic cage shape and topography of the adjacent large anatomic elements.

[The surgical anatomical characteristics of the ureteral arteries and veins in nephroptosis and defects requiring surgical correction]. / Anatomo-khirurgicheskie osobennosti arterii i ven mochetochnikov pri nefroptoze i nekotorykh porokakh, trebuiushchikh khirurgicheskoi korrektsii.

Specific features of blood supply and topography of the ureters in patients with nephroptosis, multiple arteries of the kidneys and ureteral duplication were established on the material of 42 preparations of the kidneys and ureters taken from corpses of people who died at the age from 20 to 78 years. Standard anatomical methods were used. It was shown that in people with nephroptosis at the sites of the approach of the upper ureter vessels, of cross of the ureters and the testicular (ovarian) and iliac vessels there are points of fixation around which the ureters undergo greatest deformities and might be responsible for disturbances of the urine outflow. The ureteral vessels are often involved in adhesions in the sites of deformities of the ureters. In cases with a duplication of the renal arteries as a rule have their beginning from the renal artery located below (72,2i%). With a greater distance between the beginning of the doubled renal arteries the upper ureteral arteries on one side, the lower artery of the kidney is located atypically (behind the inferior vena cava) and is not a source of blood supply of the ureter. In cases with a partial duplication (split) of the ureters in the abdominal part they are supplied with blood from the common source.

[Clinico-anatomical substantiation of bringing down the colon along the lateral wall of the pelvis for the creation of colorectal and coloanal anastomoses]. / Kliniko-anatomicheskoe obosnovanie nizvedeniia obodochnoi kishki po bokovoi stenke taza dlia nalozheniia kolorektal'nykh i koloanal'nykh anastomozov.

A method for the descending of the mobilized colon along the lateral wall of the pelvis into the anal sphincter is proposed as the most optimal one. The left lateral length is 7,5 cm shorter than that behind the rectum. The restorative operations for the descending of the colon along the left lateral wall were fulfilled in 31 patients. No complications resulting from the technique of the operation were noted.