[Combined thoracoscopy in thoracoabdominal wounds using ultrasound, the CO2 laser and the plasma jet]. / Kombinirovannaia torakoskopiia pri torakoabdominal'nykh raneniiakh s ispol'zovaniem ul'trazvuka, CO2 lazers i strui plazmy.

Under analysis is an experience with treatment of 178 patients with thoracoabdominal wounds. The authors have developed a rational curative methods and original thoracoscopic techniques, which allowed to considerably reduce the amount of thoracotomies. Thoracoscopy was performed in 157 (88%) of 178 patients. Indications for thoracotomy were established in 7 patients, in 19 patients only drainage of the pleural cavity was made. Curative thoracoscopy was used in 131 patients, in 60 of them ultrasonic glue hermetization of the lung wound was made, 36 patients had laser photocoagulation of the lung wound, 21 patients had plasma coagulation of pleuro-pulmonary defects, in 14 patients--coagulated hemothorax was removed. Clinical effectiveness of thoracoscopic techniques was more than 90%. Thoracotomy was performed in 28 (15%) patients, in 11 patients it was supplemented with diaphragmotomy. Laparotomy was performed in 167 patients. Lethality was 6.8%.

[Surgical tactics in pleural empyema with regard to the use of a carbon dioxide laser and argon plasma]. / Khirurgicheskaia taktika pri émpieme plevry s uchetom ispol'zovaniia uglekislotnogo lazera i argonovoi plazmy.

The authors analyze the experience gained in treating 30 patients with acute and 23 with chronic pleural empyema. The management policy identified the following points. Laser thoracoscopic necrectomy and empyemic cavity sanitation are indicated in acute destructive pulmonitis. A combination of temporary bronchial occlusion and laser treatment of the empyemic cavity and bronchopleural fistula should be performed after debridement of a destructive pulmonitis area from necrotic tissues. Radical treatment of chronic pleural empyema should be better conducted in the early periods by employing a plasma scalpel at all the stages of surgical intervention for hemostasis, aerostasis and sterilization of the operation field.

[The use of a plasma scalpel during thoracoscopy for the treatment of traumatic and spontaneous pneumothorax]. / Ispol'zovanie plazmennogo skal'pelia vo vremia torakoskopii dlia lecheniia travmaticheskogo i spontannogo pnevmotoraksa.

The authors suggest performing thoracoscopic coagulation of pleuropulmonary defects with a plasma stream (VSVU-160 apparatus) in patients with traumatic and spontaneous pneumothorax. A special nozzle and a manipulation trocar were designed for this purpose. Such combined thoracoscopy was used successfully in 31 patients with open and closed chest injury with rupture of the subpleural bullae. The manipulation makes it possible to reduce the number of emergency thoracotomies undertaken for hemo- and aerostatic indications.

[The thoracoscopic use of the CO2 laser in the combined treatment of pleural empyema]. / Torakoskopicheskoe primenenie CO2-lazera v kompleksnom lechenii émpiemy plevry.

A new method for treating acute pneumothorax with a bronchopleural fistula was experimentally developed and clinically tested. It is based on thoracoscopic use of CO2 laser radiation. The laser beam energy is employed for evaporation of necrotic tissues in the area of pulmonary destruction, "welding" of the bronchopulmonary fistulae, and general irradiation of the empyema cavity with a defocused beam. Nineteen patients with various disease duration were treated. In 16 patients the bronchial fistulae and the empyema cavity were eliminated and the lung re-expanded. The purulent inflammation in the pleural cavity was acute in these cases.