[Surgery in the treatment of metastatic lesions of the lung and pleura]. / Khirurgiia v lechenii metastaticheskikh porazhenii legkikh i plevry.

An experience with treatment of 53 patients with intrapulmonary metastases of malignant tumors of different nature included 65 surgical interventions, among them there were bilateral operations and reoperations. During the postoperative period complications took place in 5 cases (9.1%). After the operations there were no lethal outcomes. Long-term results of the surgical treatment of intrapulmonary metastases insignificantly differed from those of surgical treatment of primary lung cancer. The surgical treatment is thought to be an expedient method of treatment of intrapulmonary metastases in patients without recurrent tumors, late metastasis of another localization, satisfactory condition of the patient. High effectiveness of thoracoscopic methods for treatment of metastatic lesions of pleura is also noted.

[Surgical treatment of synchronous bilateral lung tumors]. / Khirurgicheskoe lechenie dvustoronnikh sinkhronnykh opukholevykh porazhenii legkikh.

An experience with treatment of 29 patients with bilateral malignant tumors includes primary tumors and those of metastatic origin. When large bilateral lung resections are necessary, the consecutive operations are considered to be expedient with intervals of 4-6 weeks. When the operation volume is not more than lobectomy in one side and an atypical or segmental resection in the other side, it is possible to fulfill a one-step intervention from the transsternal access. The surgical treatment for bilateral tumors should be supplemented by radio- and chemotherapy. Surgical treatment for bilateral tumors of the lungs is permissible but in the side of the maximal lesion followed by treatment of the rest of the tumor by nonsurgical methods.

Some problems of tracheobronchoplasty for lung cancer in a Regional Hospital in Russia.

Tracheobronchoplastic procedures formed part of the operation for lung cancer in 41 patients of a Regional Hospital in Russia over the past 2 and a half years. Twenty-nine patients underwent sleeve lobectomy; in a further 12 patients, right pneumonectomy was combined with resection of other mediastinal structures. In 16 patients, sleeve lobectomy was indicated by the high risk of pneumonectomy. Involvement of the carina in the tumour indicated its resection. High frequency jet ventilation was a particular feature of anaesthesia for carinal resection. Omentopexy was used in 10 patients to prevent dehiscence of the bronchial anastomosis. Postoperative complications were encountered in 10 patients. The most frequent, in patients, was dehiscence of the tracheobronchial anastomosis after resection of the carina. Five patients died after operation, the causes of death being dehiscence of anastomosis, pneumonia, empyema, and acute heart failure. Despite the frequency of complications, tracheobronchoplastic operations are often the only possible option in the surgery of extensive lung cancer.