[The efficiency of complex treatment of tuberculous spontaneous pneumothorax and its complications].

The incidence of spontaneous pneumothorax and pleural empyema and the outcomes of their medical and surgical treatments in 1982 to 2003 were studied in 541 patients with destructive pulmonary tuberculosis. In the past decade, the incidence of spontaneous pneumothorax and pleural pneumonia has increased from 2.6 to 12.1% due to the aggravated epidemic situation and the worse structure of pulmonary tuberculosis. The clinical severity of the disease and the extent of a pulmonary-and-pleural process did not allow radical reparative operations to be performed in 11.3%. Complex medical and surgical treatment for pulmonary tuberculosis complicated by spontaneous pneumothorax and pleural empyema could yield good and fair results in 71.5% of patients with severe pulmonary-and-pleural comorbidity despite high hospital mortality (17.2%).

[Pulmonectomy in disseminated destructive tuberculosis complicated by spontaneous pneumothorax and pleural empyema]. / Pul'monéktomiia pri rasprostranennom destruktivnom tuberkuleze, oslozhennnom spontannym pnevmotoraksov i émpiemoi plevry.

The results of pulmonectomy performed in 75 patients with disseminated destructive pulmonary tuberculosis complicated by spontaneous pneumothorax and pleural empyema were analyzed. The long course of the disease, the extent and progression of tuberculous and purulent processes in the lung and pleura caused its grave condition of patients and lower functional parameters of respiration and cardiac performance. After 2-4-month comprehensive preoperative preparation, pulmonectomy and pleuropulmonectomy were made in 78.7% of the patients after stabilization of their pulmonary and pleural process and in 21.3% of the patients in the active phase of the disease. Good results of treatment were achieved in 70.7% of the patients, death occurred in 18.6%. In the late postoperative period among 60 patients, clinical cure was noted in 80% and death rates were 13.3%.

[Use of autologous blood for elimination of the residual pleural cavity after pneumonectomy]. / Primenenie autokrovi dlia likvidatsii ostatochnoi plevral'noi polosti posle rezektsii legkikh.

The authors describe a method of liquidation of a postresectional residual cavity by the introduction of the patient's autoblood with antibiotics. When using this method all the factors of the coagulating system of blood are involved in the formation of fibrin and the following formation of fibrothorax, which accelerates the formation of fibrothorax. The proposed method was used in 26 patients with residual pleural cavities after resection of the lungs and facilitated their liquidation and formation of fibrothorax.

[Transpleural reamputation of the stump of the primary bronchus in bronchial fistulae following pulmonectomy]. / Chresplevral'naia ramputatsiia kul'ti glavnogo bronkha pri bronkhial'nykh svishchakh posle pul'monéktomii.

The authors describe the technique and analyze results of the transpleural reamputation of the major bronchus stump in 22 patients with bronchial fistulas after pulmonectomy. Good long-term results were achieved in 19 patients.

[Surgical treatment of multiple pulmonary echinoccocosis]. / Khirurgicheskoe lechenie mnozhestvennogo ekhinokokkoza, legkikh.

Clinical observations concerning the surgical treatment of multiple pulmonary echinococcosis in 54 patients are set forth in the paper. Various surgical interventions were carried out upon 46 patients: 16--for unilateral multiple echinicoccosis, 30--for bilateral multiple echinococcosis; in 8 patients pulmonary echinococcosis was combined with liver injury. From the authors' experience the surgical treatment of multiple pulmonary echinococcosis is an effective method. Good clinico-roentgenologic results were found in 44 out of 46 patients operated upon. 2 patients died from cardio-pulmonary insufficiency in the early postoperative period.

[Blood autotransfusion in the surgical treatment of pulmonary tuberculosis]. / Autogemotransfuziia pri khirurgicheskom lechenii tuberkuleza legkikh.

Clinical observations in 250 patients with different forms of tuberculosis have shown that blood autotransfusion during operations on the lungs is a safe and effective curative method allowing to considerably reduce the amount of donor blood and to maintain stable indices of central hemodynamics during operation and in the postoperative period.

[Use of carbon dioxide laser in the surgery of pulmonary tuberculosis]. / Primenenie uglekislotnogo lazera v khirurgii tuberkuleza legkikh.

Results of 120 operations for pulmonary tuberculosis performed by using a carbon dioxide laser were analyzed. Eighty patients were subjected to saving resection of the lung. Lobectomy, pulmonectomy and pulmonary cystorhaphy were carried out in 15, 6 and 8 patients, respectively. Thoracoplasty with myoplasty of the residual pleural cavity was applied to 11 patients. The early results of the surgical treatment of pulmonary tuberculosis in all the patients were satisfactory.