[Aspects of pulmonologists' and thoracic surgeons' training in the Ukraine].
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Biomedical subjects
Publications and source records attributed to P P Sokur.
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The results of treatment analysis of 314 patients with benign bronchogenic tumor was conducted. All the lung was preserved in 84% of patients due to the application of the bronchial resection and plasty methods, its partial resection was conducted in 15.4%, pulmonectomy-in 0.6%. All the patients have survived.
The author have conducted endoscopic ablation in 16 patients, including papilloma-in 8, bronchus wall carcinoid-in 7, fibroma-in 1 while performing observation and treatment in 221 patients with benign tumor of bronchus. Radical excision was done in 9 patients. All carcinoid tumors have recurred. All of this patients have undergone subsequently radical surgical intervention, including bronchoplastic procedure in 5. All the patients survived.
Complications have occurred in 30 (9.4%) of 318 patients, operated on for benign pulmonary tumor. In 5 patients rethoracotomy was conducted for haemothorax within 1-2 days, not influencing the duration of treatment. All the patients are alive.
The pathogenetic substantiation and technique of intrapleural sorption detoxication (IPSD) based on the use of high-dispersed silicone dioxide (trade mark "AEROSIL") are presented. Use of IPSD in the complex of treatment of 25 children with complicated forms of acute destructive pneumonia permitted to shorten the duration of intoxication syndrome, sanation of suppurative foci, stay of the patients at a hospital.
Reconstructive operations on the bronchi in benign (15) and malignant (17) tumors were performed in 32 patients over 60. There were no lethal outcomes. Fourteen variants of bronchoplastic operations were employed.
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On the basis of their experiences with the treatment of 1306 children the authors discuss problems of diagnostics and treatment of different congenital and acquired diseases of the lungs and esophagus.
The experience of treatment of 253 cases of benign tumors and cysts of the mediastinum is summarized. Complex X-ray and endoscopic examination was used for diagnosis. Due to application of thoracoscopy, topical and morphologic diagnosis was improved. Surgery was the main method of treatment. Radical operations were carried out in 98.9% and in 6.3% they involved resection of the rib, lung, pericardium, the membranous part of the trachea and bronchus, esophageal diverticulum or removal of diaphragmatic hernia. The complicated and life-threatening nature of the procedure is mirrored in the postoperative lethality rate (1.57%) and pattern of complications and requires a strict observance of the suggested principles of surgery.
On the basis of an experience with 24 reoperations on the lungs in children at late terms, indications have been developed for such operations and for their volume. A rational complex of treatment in the period of preoperative management was determined. Technical and tactical errors occupied the main place in the structure of causes resulting in reoperations. Recovery was achieved in all the 24 patients.
The method described was used in 70 patients with acquired esophago-respiratory fistulas. All the patients were treated by radical operations. The etiology, localization, complications of the fistulas and previous operations determined the character of surgery: there were isolated (in 8 patients), associated (in 43 patients) and reconstructive-restorative (in 19 patients) operations. Postoperative lethality was 4,28% (three patients died).
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