[POSSIBILITIES OF MODERN TECHNOLOGIES IN THE TREATMENT OF PLEURAL EMPYEMA].

The data, concerning videothoracoscopic operations application in the acute pleural empyema treatment in 462 patients, were adduced. Efficacy of videothoracoscopic operations, using electrowelding and radiofrequency surgical complexes with possibility to eliminate pulmonary-pleural fistulas, was shown. Positive clinical effect was noted in 443 (95.9%) patients, duration of stationary treatment have constituted 11.1 days at average. The complications have had occurred in 19 (4.1%) patients. All the patients are alive.

[APPLICATION OF RADIOFREQUENCY ABLATION WHILE PERFORMANCE OF VIDEOTHORACOSCOPIC OPERATIONS FOR PULMONARY AND PLEURAL TUMORS].

In the clinic radio­frequency ablation (RFA) in videothoracoscopic operations (VTHO) was performed in 56 patients. Primary peripheral pulmonary cancer (PC) was revealed in 7 patients, metastatic pulmonary affection ­ in 12, pleural affection with exudate ­ in 37. Small­cell PC was diagnosed in 11 patients, a squamous­cell one ­ in 18, and glandular ­ in 27. VTHO, using RFA technology, is indicated in primary or metastatic PC without possibility to perform radical intervention due to the process spread, patient's age, presence of severe concurrent diseases; refusal of patient from surgical treatment. Positive result was achieved in 54 patients. Duration of pleural drainage was 3 days at average, the patient stationary stay ­ 4 days. Insufficient experience of application of VTHO with RFA do not permit to estimate late follow­up results objectively. Yet, 25 patients, in whom metastatic pleurisy was revealed, have survived more than 9 mo, in peripheral PC one patient died as a result of pulmonary thromboembolism, and the rest of patients have survived from 1 yr to 1.5 yrs.

[APPLICATIONS ENDOVASCULAR HEMOSTASIS TREATMENT OF PULMONARY HEMORRHAGE].

Rentgenoendovascular embolization of bronchial arteries was performed in 222 patients about pulmonary hemorrhage (PH) of different nature. Resistant hemostasis was achieved in 198 (89.9%) patients. The possibility of endovascular hemostasis in patients in advanced lung cancer complicated by PH. Hemostasis was ineffective in 24 (10.8%) patients. Died 5 (2.2%) patients due to unresectable lung cancer. The reasons for ineffective hemostasis were analysed.

[Videothoracoscopic atypical pulmonary resection, using various surgical technologies].

Atypical videothoracoscopic pulmonary resection was conducted in 943 patients, using mechanical and electrowelding suture. Various variants of the intervention conduction are adduced. Duration of the patients stationary treatment have constituted at average 6.1 days, lethality--0.6%, complications have occurred in 38 (4%) patients.

[POSSIBILITIES OF THE RAOIOFREQUENCY ABLATION METHOD IN TREATMENT OF PULMONARY AND PLEURAL MALIGNANCIES].

Various methods of radiofrequency ablation, using FOTEK-150 apparatus, were applied in 74 patients for pulmonary and pleural malignancies. Immediate positive effect was achieved in 92% observations, complications have occurred in 13% patients. It is expedient to use the method in patients, suffering pulmonary and pleural malignancies, when radical surgery is impossible. Radiofrequency ablation may be applied as a palliative method of treatment of pulmonary and pleural malignancies.

[Experience of application of nonsuture electrowelding technologies in thoracic surgery].

Experience of application of nonsuture electrowelding technologies (NEWT) was analyzed while performing open and miniinvasive thoracoscopic operations in 116 patients. No essential differences were revealed while comparing domestic and foreign electrowelding surgical instruments. Possibility of wide application of NEWT in miniinvasive videothoracoscopic surgery was demonstrated.

[Application of electrowelding technologies in videothoracoscopic pulmonary surgery].

Experience of videothoracoscopic pulmonary resection, using nonsuture electrowelding technology in 42 patients, was summarized. Using such technology application have guaranteed the lowering of prime cost of endoscopic intervention, in several patients it made possible to avoid a mechanical suturing application. After the operation all the patients are alive, the morbidity rate was 7.1%, a stationary treatment of a patient have constituted 5.7 days at average.

[Application of roentgenendovascular embolization of the bronchial arteries in the treatment of pulmonary hemorrhage].

The results of application of roentgenendovascular enbolization of bronchial arteries in the treatment of 67 patients, suffering pulmonary hemorrhage of various etiology, are adduced. Immediate hemostatic effect was achieved in 64 (95.6%) patients. The pulmonary hemorrhage recurrence while follow-up to 1 yr have occurred in 5 (7.5%) patients. Angiographic signs of the bronchial arteries affection were adduced. The possibility of the method application in the treatment of complicated forms of malignant pulmonary and mediastinal tumors was shown.

[Possibilities of improving of videothoracoscopic operations for spontaneous pneumothorax].

A 15-years experience of videothoracoscopic operations in the treatment of 616 patients, suffering spontaneous pneumothorax, was summarized. The methods of videothoracoscopic operations, depending on the volume and localization of pathological process in pulmonary tissues, were depicted. The stages of endoscopic surgical intervention for spontaneous pneumothorax were analyzed. The disease recurrence, while using videothoracoscopic operations, have occurred in 3.6% of patients. All the patients are alive.

[Treatment of post-traumatical coagulated hemothorax. Videothoracoscopy or open surgery].

Comparative estimation of videothoracic and open surgery efficacy in the treatment of post-traumatic coagulated hemothorax have been shown in 612 patients. According to the achieved results, effectiveness of videothoracoscopy (92.4%) is better than open surgeries. Apart from that, reduction in the hospitalization days (9.6 days compared to 11.5 days in open surgeries), frequency of complications (4.5% and 13.8%), traumatic intervention and rehabilitation time. All the patients alive. Best results are achieved using videothoracoscopical operations at the earliest in posttraumatic coagulated hemothorax.

[Application of combined videothoracoscopic resection in thoracic surgery].

The method of combined videothoracoscopic atypical pulmonary resection, permitting to apply endostaplers and standard staplers in one intervention procedure, was elaborated. The method was applied in 47 patients in various pulmonary diseases without severe complications, all the patients are alive. Economic expedience of the method application, permitting to reduce usage of endostaplers, was shown.

[Video-assisted thoracoscopic surgeries for thoracic diseases and trauma].

The experience of videothoracoscopic operations, performed for various diseases of the thoracic organs, was summarized. The reduction of the operation traumaticity, the complications rate, lethality, the patients rehabilitation duration permits to consider videothoracoscopic operations as the method of choice in many thoracic diseases and trauma.

[Application of early videothoracoscopic pulmonary decortication in the treatment of an acute pleural empyema and suppurated clotted hemothorax].

There was presented the experience of performance of videothoracoscopic pulmonary decortications in 22 patients, suffering suppurated clotted hemothorax, and in 188--an acute pleural empyema. In 97.3% patients the cessation of purulent process and pulmonary volume restoration were achieved. Residual cavities with the pulmonary nonairtightness signs were revealed in 3 (1.4%) patients, the empyema recurrence--in 1 (0.5%), suppuration of the wound, made by thoracic port--in 1 (0.5%), all the patients are alive.

[The performance of video-assisted thoracoscopic operations for later complications of thoracic trauma].

There was presented the experience of videothoracoscopic operations performance in 62 patients, suffering late complications of thoracic trauma, which had occurred after perforating woundings--in 16 and the closed trauma--in 46. Good clinical effect was achieved in 98% of injured persons. All the patients are alive.

[Endoscopic operations on the trachea and bronchi].

The experience of performance of 1425 endoscopic recanalization operations, done in 864 patients for the tumor and cicatricial stenosis of trachea and bronchi, was summarized. The methods were depicted of endoscopic destruction as a definite treatment or as a successful stage of the combined treatment. The possibility there was shown of the lasers and electrocoagulation application for the respiratory ways stenosis recanalization. The passability of respiratory ways restoration was achieved in 85.2% of patients. Lethality after endoscopic operations had constituted 1.6%.

[Role of video-assisted thoracoscopic operation in the treatment of later complications of the chest injury].

The experience reported of videothoracoscopical operations in 62 patients with late complications of chest trauma occurring after penetrating open wounds of chest--in 16 patients and in 46 one--with closed trauma. Good clinical effects achieved in 98% of the patients. The reported complications after video-assisted thoracoscopical operations--4 purulent inflammation of thoracoportal incisions, 3--marginal pleuritis. After the operation all the patients are alive.

[Surgical treatment of non-tumorous stenosis of the esophagus].

Experience of different types of esophagoplasty at nontumours stenosis of esophagus at 61 patient is resulted. Possible variants of esophagoplasty are described by both a stomach and a colon, and also stages of implementation. The analysis of postoperation complications, probability of their origin depending on the method of esophagoplasty, possibility of prophylaxis is conducted. Good results are attained at 78.5% of patients, lethality make 3.3%.