Biomedical subjects
Publications and source records attributed to E I Sigal.
Immediate and long-term results of treatment of 132 patients with hiatal hernias are analyzed. Indications for surgery are determined. Complications during and after laparoscopic antireflux surgeries are analyzed.
14 biopsies were performed in patients with non-palpable tumors of the breast with stereotaxic automated system (ABBI) and disposable "pistol-needle" ("Auto-Suture") whose needle-harpoon penetrates into pathologic focus under local anesthesia (four fold digital stereotaxic control guarantees the precision of biopsy). Non-palpable breast cancer in the tissue areas of 4, 7 and 11 mm in horizontal section was diagnosed in 3 patients. Biopsy was performed outpatiently, there were no complications. The procedure is like a diagnostic sectoral resection of the breast.
The study was concerned with application of the stereotactic automated surgical biopsy breast with the ABBI (USSC) device for verification of non-palpable breast lumps. It included 13 females, aged 34-72 (mean age--54) and lasted 6 months (1999). Microcalcinates were detected in 3 (22.8%), local cordlike tissue structures--3 (22.8%), focal shadows--7 (53.2%). Lesion size: (5 mm (16%), 5.1-10 mm (25%) and 10.1-20 mm (59%). Malignancy was diagnosed in 3 cases (22.8%), dia. 7-10 mm; atypical ductal hyperplasia--2 (8.3%), and miscellaneous benign pathology--53.2%. Adequate removal of lesions was histologically confirmed in all cases. The procedure was carried out with ambulatory monitoring, under local anesthesia, and lasted 1.5 hrs. No complications were reported. The cosmetic results were good; no analgetics were dispensed. The ABBI system proved an effective means of stereotactic surgical biopsy of the breast because it removed the entire radiologically-suspicious site as a complete tissue preparation. It provided all histological data without crushing or segmenting the preparation. Since tissue texture and, particularly, the preparation edges remained intact, the latter could be examined too, if needed. All this ruled out inaccurate interpretation, repeat biopsy and unjustified lumpectomies.
Since extended mastectomy after Urban involves an unjustifiably high level of trauma, this method has limited application. We have evolved a procedure of video-assisted thoracoscopic parasternal lymphadenectomy (VATPL). On completion of the experimental part using cadavers to work out the rationale for extent of surgery, clinical trials started. A total of 120 operations in patients aged 27-73 were performed (left-sided--64, right-sided--56), with the number of lymph nodes removed in each case ranging 1-10. Metastases were detected in 23 (19.2%), isolated lesions (metastases to parasternal lymph nodes alone)--6 (5.0%). With volume of removed tissue being identical, the findings on level of pain, amount of narcotic analgetics, hospital stay duration, intra- and postoperative complication incidence and cardiointervalography and pneumotachometry for VATPL patients were significantly better than for those treated by traditional (open-chest) procedure. It is concluded that VATPL is a highly effective and low-traumatizing diagnostic method. It may be recommended as an operation of choice for parasternal lymph collector involvement of central or medial localization.
Comparative analysis of the results of videothoracoscopic parasternal lymphadenectomy and standard mastectomy by Urban--Holdin is presented. In November 1995 to December 1999 205 videothoracoscopic parasternal lymphadenectomies were performed (96--on the left, 104--on the right). Central and medial location of breast cancer was indication for this operation. Age of the patients ranged from 23 to 73 years. Surgery was performed under intravenous anesthesia in the conditions of artificial lung ventilation with separate lung intubation. Mastectomy was performed as the first stage. Further, thoracoports were introduced into pleural cavity in the 5th intercostal space along medioclavicular and mediaxillar lines and in the 4th intercostal space along anterior axillar line. Parietal pleurotemy was performed parallely to internal thoracic vessels, parasternal fat and lymph nodes were removed en-block. Parasternal lymph nodes were involved in 40 (19.5%) patients. The spirometry, cardiomonitoring which were used pre-, intra-, postoperatively demonstrated that parasternal thoracoscopic lymphadenectomy is less traumatic and effective as diagnostic method than mastectomy by Urban--Holdin. Parasternal thoracoscopic lymphadenectomy can be recommended as a method of choice in medial and central breast cancer.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: In recent times thoracoscopy has been used for diagnoses and treatment of mediastinal masses. This study is a preliminary review of indications, complications, and limitations in this field of surgery. METHODS: Twenty-eight patients with mediastinal masses were operated in the Clinical Oncological Centre, Kazan. Twenty-two of them had anterior mediastinal growths; six had posterior mediastinal tumors. Thoracoscopy was diagnostic in 14 cases; it was therapeutic in 14 cases. RESULTS: The definite diagnosis was achieved in all patients. In cases of benign lesions the operations were successfully completed thoracoscopically. All patients underwent a postoperative period with low pain and short postoperative time. CONCLUSIONS: Video-assisted thoracoscopy is indicated in cases of mediastinal masses, both for diagnosis and treatment. It has significant advantages compared to normal thoracoscopy and mediastinoscopy.
Under study is the incidence of nonlymphogranulomatous lymphomas in the Moldavian SSR for a 10-year period depending on sex, age and nationality. Nonlymphogranulomatous lymphomas are more frequently observed among the urban population, and more often in males, the age peak among persons of both sex being over 60. There is a tendency to the increased incidence of this affection. It may be due to a longer patients' survival as a result of introducing some new more effective methods of treatment for the given lesion.
A correlation is given between the actual figures of lung cancer incidence in the Moldavian SSR and those prognosticated for the peiod of 1972--77. The former were found to coincide with the latter. Based on some additional observations the rate of lung and stomach cancer incidence has been prognosticated till 2000.
The results of studies on the morbidity and incidnece of lymphogranulomatosis in Moldavian SSR during 10-year period depending on sex, age and type of the population are described. It is emphasized that lymphogranulomatosis is a comparatively rare lesion, more frequently it is encountered among urban population, in males in particular, with an age peak among persons of both sex older than 60 years. No tendency to any rise in the morbidity indices was noted. Whereas a longer survival of patients due to new effective methods of treatment for lymphogranulomatosis may account for more high incidence of this affection.
Lung cancer morbidity in MSSR is analysed on the basis of statistical data for 1966-1972. The rate of lung cancer incidence is found to be higher than in cancer of the stomach. As a result of extrapolation of average tendencies in the morbidity and mortality of main cancer localizations, it was found that provided the observed tendencies are remained, lung cancer will occupy the first place in the structure of oncological morbidity (to 1976--1977) and mortality (to 1979--1980).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.