[Thoracoscopic removal of upper thoracic sympathetic ganglia in treatment of Raynaud disease].
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Biomedical subjects
Publications and source records attributed to S N Shnitko.
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The experience in application of 24 videothoracoscopical operations in diseases and traumatic injuries of the organs of thoracic cavity (15-diagnostic and 9-curative ones) is reviewed. Histological verification of the diagnosis after the operative procedures was obtained in all 15 patients. The technique of TV thoracoscopic operations is outlined. Postoperation period in patients ran well, there were no substantial disturbances in function of external breathing, motor activity has restored on the second day after the operation.
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The paper analyzes histological findings of a number of bronchial sections made proximal the visible margins of a tumor in 54 patients operated on for central cancer of the lung. In coincidence of micro- and macroscopic limits of the extension of tumor cells was revealed in 29 (53.7%) patients. Statistical analysis revealed that the extension of tumor invasion obeys the exponential law of distribution. Probability of detecting tumor cells at various distances from the visible margin of the tumor was found. The findings suggest that one may predict that tumor cells can remain in the bronchial stump depending on the level of its elimination.
Results of a complex clinico-functional examination of 48 patients after resection for lung cancer 8-10 years ago are presented. The satisfactory pumping function of the heart was revealed with practically normal volumes of the cardiac output. Among patients subjected to resection of a lobe of the lung two groups were determined: with relatively satisfactory parameters of the function of external respiration and blood circulation and with a pronounced degree of strain of the functioning of these systems.
An estimation of changes of main hemodynamic, biochemical and laboratory indicators and the function of external ventilation was fulfilled when performing temporary endobronchial occlusion at the level of lobular and main bronchi in 37 patients with pneumothorax. Favorable changes were established in the systems of blood circulation and external ventilation in occlusion of lobular bronchi. Grounds are given for the necessity of intensive anti-inflammatory treatment, oxygenation and maintenance of cardiodynamics in occlusion of the main bronchus.
The article generalizes an experience with surgical treatment of lung cancer of low-differentiated structures in 108 patients. Extended and combined resections of the lung in such patients were shown to be expedient. From 83 patients who had had bronchial biopsy in the process of preoperative examination 35 patients (42.2%) had results of histological examinations of the biopsy and operative materials which did not coincide. Extended and combined resections for lung cancer of low-differentiated structure gave 5-year survival in 15.6% of the patients.
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Extensive combined resections were made on 190 of 705 patients operated upon for lung cancer. The results have shown a prognostic value of the factor of variability of resections for immediate results. Long-term results were better in patients with highly differentiated cancers and without a metastatic involvement of the regional lymphatic system. Favourable results with 5-year survival (20.2%) point to the expedience of the extensive combined resections in patients with the long-neglected stages of lung cancer.