[Extracorporeal connection of a donor xenospleen in the multimodality therapy of postoperative pleural empyema in patients with pulmonary tuberculosis].
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Biomedical subjects
Publications and source records attributed to E I Al'tman.
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A technique of a dynamic cavernoscopy permitting one to conduct diagnostic and therapeutic manipulations for several months has been suggested. The given procedure was conducted in 36 patients with disseminated fibrous-cavernous pulmonary tuberculosis. An important role in defining management tactics belongs to the direct bacteriological and histological examination of the cavern contents. Local treatment by means of antituberculous drug solution instillation was administered in 29 patients. A positive effect was registered in 26 cases. The above technique can be used for the process prognosis and the treatment modification.
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A rare, badly known diffuse pulmonary lesion--multifocal hyalinizing intravascular "bronchiolo-alveolar" tumour in a woman of 22, is described. The lesion was revealed at fluorography, diagnosed by means of mediastinopleuroscopy, in lung biopsy; there were no clinical manifestations. A hyalinized compact and branching node, poor in cells, intruding at the periphery into the alveolar septa in the form of micropolyps was found histologically.
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The authors suggest a clinical procedure of parasternal mediastinopleuroscopy which assures intercostal examination, instrumental palpation and biopsy of neoplasms of the anterior mediastinum without causing considerable trauma. The procedure makes it possible to assess operability and to determine optimal access for surgical removal of tumor. The procedure was used in clinic in 35 cases; in 23 of them, intervention was limited to biopsy, while 12 cases underwent radical surgery.
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The technic of extensive mediastinoscopy is described, which enables visualization of anatomical structures of the mediastinum and lung hilus inaccessible for an examination while using mediastinoscopy after the Carlens technic. An experience with the extensive mediastinoscopy performed in 116 lung cancer patients is reported. This kind of investigation does not increase the incidence of complications as compared with the Carlens mediastinoscopy. The mediastinoscopy was performed immediately before thoracotomy.
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An experience with 371 mediastinoscopies in lung cancer patients is analysed. The enlargement of intrathoracic lymph nodes revealed roentgenologically or bronchoscopically is considered by the authors to be the basic indication to mediastinoscopy. Among 270 such patients the positive result of mediastinoscopy was noted in 128 (47.3%). Among the remaining 101 patients, in whom none of the methods concerned revealed lymph nodes enlargement, the positive results of mediastinoscopy were noted only in 3 (2.97%).