[Application of the standardized protocol for fast track recovery after lung cancer surgery]. / Rezul'taty primeneniia standartizovannogo protokola uskorennogo vyzdorovleniia posle onkologicheskikh operatsii na legkom.

OBJECTIVE: To assess standardized protocol for fast track recovery after lung cancer surgery. MATERIAL AND METHODS: There were 201 patients. Patients underwent VATS lung resection, VATS lobectomy and various open resections of lungs. Patients had either primary lung cancer or metastatic lung lesion with indications for surgical treatment. Management of patients was divided into 3 periods: preoperative, intraoperative and postoperative. The protocol of fast track recovery was developed considering literature data and own experience. Requirements of this protocol were applied in perioperative management. RESULTS: Application of the protocol was successful in all patients. Minimum number of complications (6%) and length of postoperative hospital-stay of 4 days were observed after VATS resection of lung. VATS lobectomy was followed by complication rate 25% and postoperative hospital-stay of 6 days. In the group of open resections these values were 29% and 7 days.

[Thoracoscopic pulmonary resection for metastatic lesion without pleural drainage: initial experience]. / Torakoskopicheskie rezektsii legkogo pri metastaticheskom porazhenii bez ustanovki plevral'nogo drenazha: nachal'nyi opyt.

AIM: To analyze the possibility of thoracoscopic pulmonary resection for metastatic lesion without pleural drainage. MATERIAL AND METHODS: There were 10 patients aged 53.8 years. Most of patients had solitary lung injury within 3 cm from the visceral pleura on the average. Surgical treatment was performed in standard fashion: hardware atypical pulmonary resection within healthy tissues. Pleural cavity was drained with 24 Fr tube. After that lung was inflated under visual control. Since wounds were closured residual air was evacuated by active aspiration and drainage tube was removed. Control chest X-ray was performed in 2 hours and 1 day after surgery. RESULTS: The technique was successful in all patients. Mean surgery time was 52 minutes. There was no blood loss in all patients. Pneumo- and/or hydrothorax were absent according to control chest X-ray in postoperative period. Mean length of postoperative hospital-stay was 3 days (median 2 days). There were no cases of repeated hospitalization.

[Experience of 100 transthoracic needle biopsies of the lung under CT navigation].

The aim of this study was to investigate and analyze the results of transthoracic needle biopsy of lung tumors under CT navigation. There were carried out more than 100 transthoracic needle biopsies of lung tumors. The analysis of immediate results of the applicability of this technique was performed. The average period of hospitalization after the puncture was 1.4 days (1-7). A number of pneumothorax that required drain- ing the pleural cavity was 8. The median of duration of drain- ing the pleural cavity was 6 of 8 patients (5-6.5) days. More severe complications and deaths were not. The histological conclusion was obtained in 100% of cases, in 72 patients the diagnosis of a malignant lung tumor was firstly verified, 12 cases showed a false-negative result. Diagnosis of lung cancer was excluded in 16 patients. The sensitivity of the method was 86%, specificity - 100% and accuracy - 88%. Therefore transthoracic needle biopsy of lung tumors with minimal risk to the patient allows receiving the morphological verification of peripheral lung tumors.