[Paradigm of radiation-laser medical equipment and technology]. / Paradigma radiatsionno-lazernoi meditsinskoi tekhniki i tekhnologii.

Based on quantum chemistry and chemical kinetics, the paper formulates basically new concepts of the possibility of controlling biochemical reactions in biological tissues by simultaneously making abnormal human visceral foci, in cancer diseases in particular, exposed to two rays via radiation and optic laser radiations. The paper also presents experimental findings of the channeling of X-ray and fluxes of charged particles along the fiber wave guides. It considers the circuit engineering of a medical endoscopic device that concurrently transmits optic laser radiation and fluxes of penetrating radiation into the viscera.

[Photodynamic therapy and fluorescent diagnosis of malignant tumors using preparation photogem]. / Fotodinamicheskaia terapiia i fliuorestsentnaia diagnostika zlokachestvennykh opukholei preparatom fotogem.

From February, 1992 to May, 1993 photodynamic therapy (PDT) was applied at the State Scientific Center of Laser Medicine and the Moscow Scientific-Research Oncological Institute for the treatment of 60 patients with primary and metastatic malignant tumors of the breast, skin, respiratory and digestive organs, female reproductive organs, and urinary bladder. Forty-eight patients underwent one course of PDT, 11 patients received 2 courses, and one patient was given 3 courses. Russian-produced Photogem was used as the photosensitizer. It was infused intravenously 24, 48, or 72 hours before exposure to laser beam. The dose of Photogem ranged from 2.5 to 6.0 mg/kg. The density of laser radiation power during PDT sessions ranged from 100 to 1,600 mVt/cm2, energy exposure from 80 to 600 J/cm2, duration of irradiation from 3 to 45 minutes. After treatment the patients were studied in follow-up periods of 4 weeks to 17 months. Complete regression of the tumor verified morphologically was found in 62%, partial regression in 34%, and limited response or absence of an effect in 4% of cases. Fluorescent-diagnostic examination of patients was conducted at the Moscow Scientific-Research Oncological Institute. It demonstrated the reliability of this diagnostic method with the use of the preparation Photogem as the photosensitizer.

[Early postoperative adhesion ileus]. / Ranniaia spaechnaia posleoperatsionnaia neprokhodimost' kishechnika.

Under analysis were results of surgical treatment of 4908 patients with diseases of organs of the abdominal cavity obtained during the period from 1985 till 1990. In 57 patients relaparotomy was caused by early postoperative commissural ileus. Late diagnosis of the main disease, technical and tactical errors during operations and at the early postoperative period were responsible for the appearance of the commissural ileus. Of special significance in getting better results of treatment of patients with this complication are: timely diagnosis (with contrast enterography), obligatory decompression and intubation of the gastrointestinal tract, valuable intensive therapy with the ultraviolet laser intravascular photomodification of blood.

[An analysis of the reasons for relaparotomy in the surgical clinic]. / Analiz prichin relaparotomii v khrirugicheskoi klinike.

The results of surgical treatment of 4,078 patients who underwent operation in 1985-1989 were studied. Due to the occurrence of complications in the early postoperative period, 182 relaparotomies were carried out in 164 patients. The main indications for relaparotomies were advanced underlying disease, surgical errors (tactical, technical), changes of the patients' immune status. Early diagnosis, timely operation with the use of technically correct manipulations, and the application of a full complex of intensive therapy measures in the postoperative period are important in the prevention of complications.

[Techniques of mechanical suture formation in Swenson's operation in children]. / Tekhnika formirovaniia mekhanicheskogo shva pri operatsii svensona u detei.

The authors describe briefly the design and method of working with a special suturing instrument in formation of an extraperitoneal anastomosis by a modification of Swenson's operation in children suffering from developmental anomalies of the large intestine. The instrument ensures one-stage stitching of the intestine along its entire circumference before its resection. The anastomosis is formed four times more rapidly and the manipulation is more aseptic. Eight children were operated on with the use of the instrument and no complications occurred.

Denervation of the gastric acid-producing zone by a gastric wall laser seromyotomy.

The application of various surgical laser devices offers the possibility for significant simplification of the technique of the selective denervation of a gastric acid-producing zone proposed by Tylor as the gastric wall seromyotomy. The application of laser technique results in decreased operative time, a wide range of surgical practice, less operative bleeding, and more reliable denervation. Operations performed in 38 patients provide a basis for recommending optimal parameters of laser energy for the gastric wall incision and reveal the advantages and disadvantages of different irradiation sources. Early results of of the operation are not worse than after the proximal selective vagotomy.

[Laser seromyotomy of the stomach in duodenal ulcers]. / Lazernaia seromiotomiia zheludka pri iazve dvenadtsatiperstnoi kishki.

The use of laser surgical equipment permits to simplify considerably a method of gastric seromyotomy. On the basis of the results of treating 38 patients, the optimal parameters of laser energy, used in dissection of the gastric wall, are recommended, the advantages and shortcomings of the different sources of radiation are studied.

[Use of carbon dioxide laser in emergency surgery of the extrahepatic bile ducts]. / Primenenie uglekislotnogo lazera v ékstrennoi i neotlozhnoi khirurgii vnepechenochnykh zhelchnykh putei.

The principles of surgical techniques of operations with the use of carbon dioxide laser were developed on basis of the authors' personal experience of 8 years in surgical interventions on 65 patients. The stages of the operative approach, cholecystectomy, choledochotomy, +choledocho-duodeno-anastomosis, papillosphincterotomy, and sterilization of the operative wound and intraabdominal abscesses are illustrated by professionally drawn illustration-diagrams. Laser separation of the gallbladder from the liver takes 220 +/- 35 sec, laser hemostasis and cholestasis of the gallbladder bed--245 +/- 40 sec, laser choledochotomy--17 +/- 8 sec, laser duodenotomy--33 +/- 9 sec. No specific complications were encountered after laser interventions.

[Use of Nichrome suture material]. / Ispol'zovanie shovnogo materiala iz nikhroma.

The suture material and the method of its application play an important role in the prevention of wound complications. With the use of Nichrome wire thread as the suture material in surgical interventions, the number of postoperative complications significantly was decreased. The Nichrome thread is also used expediently in operative interventions on patients with purulent diseases of the soft tissues, including cases after primary surgical treatment of purulent foci by carbon dioxide laser.

[Treatment of fissure in ano by the method of laser coagulation]. / Lechenie treshchin zadnego prokhoda metodom lazernoi foto- koaguliatsii.

The article analyses the results of treatment of acute and chronic anal fissures with the use of the method of laser photocoagulation in 181 patients, in 87 of them the fissures were combined with other proctological diseases. The essence of the operation is three-fold laser treatment (CO2 laser) of the edges and floor of the fissures. The pathologically changed tissues are evaporated and coagulated in this case with the formation of a coagulation film on the wound surface. Histological examination of bioptic material collected from the zone exposed to the effect of the laser shows complete disappearance of the pathological tissue. The operation is simple and sparing in the treatment of anal tissues, ensures improvement of the immediate results, as well as a decrease of the frequency of a recurrence to 1.4%. The method may be introduced successfully into outpatient surgical practice.

[The pharmacokinetics of hematoporphyrin, its derivative and fluorescein during the development of carcinosarcoma]. / Farmakokinetika gematoporfirina, ego proizvodnogo i fliuorestseina pri razvitii kartsinosarkomy.

The pharmacokinetics of fluorescein, hematoporphyrin and a derivative of hematoporphyrin was studied microspectrofluorometrically on rats with transplanted carcinosarcoma. It was shown that in the rats in contrast to intact animals the tissue concentration of fluorescein exhibits a general tendency towards an increase, that of hematoporphyrin towards a decrease and that of hematoporphyrin derivative towards an increase in all parenchymatous organs and a decrease in the skin and mucosae of the hollow organs. At the equally short period of the maximal accumulation of luminophores, the tumour tissue differs from the normal one by a pronounced delay of excretion only of hematoporphyrin derivative.

[Comparative evaluation of the results of traditional and laser papillosphincterotomy]. / Sravnitel'naia otsenka rezul'tatov traditsionnoi i lazernoi papillosfinkterotomii.

The techniques of papillosphincterotomy were improved on the basis of CO2 laser and special laser tools. The results of 212 routine and 114 laser papillosphincterotomies were appraised. With the laser techniques, the incidence of postoperative complications reduced to 14% as compared to 23.6% with the routine method. The incidence of postoperative pancreatitis decreased from 7.5% to 4.3%, the destructive pancreatitis mortality, from 4.7% to 0.9%. The long-term results provide evidence for laser papillosphincterotomy.

[A method of laser seromyotomy of the stomach]. / Tekhnika lazernoi seromiotomii zheludka.

A technique of laser seromyotomy was developed as a method for vagus denervation for the treatment of gastroduodenal ulcers. Soviet Raduga neodymium YAG laser and foreign Medilaz and Flexilas units were employed as sources of laser irradiation. The operation was performed in the 'contact scalpel' mode with the use of Soviet sapphire tips. The developed technique permits seromyotomy that results in better hemostasis and lower risk of gastric submucosal layer involvement vs. electronomo suggested earlier by Taylor, an English surgeon. Twelve patients were operated on; one developed intraperitoneal hemorrhage that ceased independently.

[Co2 laser treatment of epithelial passages and cysts of the coccyx]. / Lechenie épitelial'nykh khodov i kist kopchika s primeneniem Co2-lazera.

The article analyses treatment of 312 patients among which 156 were treated with the use of a CO2 laser and 156 by the traditional method. Study of the results showed that with the use of the CO2 laser the duration of in-patient treatment after radical operation was reduced by 5 days and out-patient rehabilitation by 13 days. the number of postoperative complications reduced considerably, single-stage radical operation could be carried out in the acute period of the disease, an operation for excision of a suppurating cyst could be completed by applying primary sutures with complete closure of the wound in 71.7% of cases, and that a recurrence of the disease could be prevented. Wide introduction of CO2 laser in surgical treatment of epithelial passages and cysts of the coccyx is recommended.

[Experience in the use of laser instruments in surgery of the anorectal region]. / Opyt primeneniia lazernykh instrumentov v khirugii anorektal'noi oblasti.

The article discusses experience in surgical treatment of 480 patients with the most common diseases of the anorectal region (acute and chronic haemorrhoids, acute and chronic paraproctitis, polyps, chronic fissures of the anal canal) in which special laser tools were used. The carbonic acid laser Skalpel-1 with a wave length of 10.6 microns and power of 30 W was used as the source of laser radiation. Methods of operations with the use of these tools are described in detail. The advantages of laser instruments in the treatment of patients with the above listed diseases are shown on a rich clinical material.

[Carbon dioxide laser in the surgical treatment of proctologic diseases]. / Uglekislotnyi lazer v khirurgicheskom lechenii proktologicheskikh zabolevanii.

Results of the surgical treatment of 556 patients with different diseases of the anorectal area with the help of CO2 laser are presented. Functional results were good, the amount of postoperative complications was 1.5 times less, recurrences were half less, the time of intrahospital treatment was 1.5 day shorter, the period of ambulatory rehabilitation 3.8 days shorter.