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Biomedical subjects

S R Dobrovol'skiĭ

Publications and source records attributed to S R Dobrovol'skiĭ.

At least 19 recordsLinked to original sources
PubMed2006

[Long-term results of bronchial resection and plastic repair in patients with lung cancer].

Thoracic units perform plastic operations on the bronchi in 5-10% of all radical interventions for lung cancer. This figure was 7.5% at our unit. A total of 184 patients were operated on, with a mortality rate of 9.7% (18 patients died). Lobectomy with circulatory resection of the main bronchus is the optimal plastic operation on the bronchi in lung cancer. Long-term results following bronchial resection and plastic repair suggest the oncological rationale for these operations. These operations make it possible to preserve functionally significant lung tissue, thus assuring the high quality of life in the patient.

Adult↗
PubMed2000

[Radiofrequency electrostimulation of sympathetic nerve boundary trunk in patients with bronchial asthma].

In 7 patients aged from 43 to 64 years with severe infectious allergic forms of bronchial asthma with curative aims radiofrequency electrostimulator for the boundary trunk of the sympathic nerve (BTSN) has been implanted in the neck. Daily sessions of electrostimulation (ES) by the current with parameters 1-100 Hz, 0.1-0.4 m/s, 0.1-2.0 V adjusted individually by maximal broncholytic and clinical effects were performed for 5 years. It was established that ES of BTSN can produce both bronchial dilatation and bronchial spasm. Application of ES of BTSN has resulted in a decrease of bronchial hyperreactivity, frequency of asthmatic attacks 2.6-3.2 fold in consumption of antiasthmatic drugs 2.4-2.7 fold. The only complication has been detected--rejection of the electrostimulator due to the defect of its capsule. This method can be applied as an adjuvant in therapy of severe forms of bronchial asthma resistant to drug treatment.

Adult↗
PubMed1999

[Radiofrequency electrostimulation of carotid sinus nerves for the treatment of bronchial asthma].

Electrostimulators of synocarotid nerves (SCN) were implanted in 30 patients aged from 18 to 62 years for the treatment of bronchial asthma. The procedures of SCN stimulation (from 1 to 10 daily) were carried out with parameters of 30-100 Hz, 0.1-0.8 ms, 0.5-2.0 V. The external respiration function was examined by pneumotachometry and spirography, and cardiovascular system by the method of rheography. The attacks of apnea were effectively eliminated and prevented by electrostimulation (ES) of SCN. The frequency of the attacks 2 and 5 years after the procedures decreased 2.8 fold, and the duration of the attacks--3.5 fold. Daily consumption of antiasthmatic drugs decreased by 2.7 times. Some complications were detected: rejection of the electrostimulator (1 patient), paresis of n. hypoglottis (1), suppuration of the wound (3), abnormal mobility of the electrostimulator (1). ES of SCN can be applied in patients with complicated forms of bronchial asthma and severe drug addiction.

Adolescent↗
PubMed1998

[Rare complications and procedural errors in thoracic surgery].

Analysis of postoperative mortality is carried out by the authors on the basis of studying case records, operation records, follow up lists of complicated patients, results of autopsy as well as clinico-anatomical conferences and personal cases of 418 operated patients. It was established that methodical and technical defects during the operation on the lungs contributed to lethal outcomes in 13.8% of all dead patients. Majority of methodical and technical defects in their basis resulted from errors in anatomical orientation. Among the causes of these defects of great importance are some elements of carelessness and inattentiveness in working with large vessels and in performing hemostasis. Prophylaxis of fatal defects during the operation is based on a good anatomical and surgical school, personal experience, knowledge and abilities of surgeons.

Adolescent↗
PubMed1992

[Combined resections in the surgery of lung cancer].

Operations were performed on 3,313 patients for lung carcinoma in the Department of Surgery of the Lungs and Mediastinum of the National Research Center of Surgery, AMS USSR, from 1963 till 1.01.90. Among these patients 263 (7.9%) were treated by combined operations (resection of the lung together with part of the chest wall, trachea and its bifurcation, pericardium, diaphragm, superior vena cava, pulmonary artery, aorta, and atrium, and also with removal of metastatic lymph nodes of the contralateral lung). Three types of combined resections were carried out--vasculo-atrial, tracheo-bronchial, and parieto-diaphragmatic. Postoperative complications developed in 38.6% of patients. Intraoperative mortality was 1.5%, 13.9% of patients died after the operation. More than 5 years survived 21.8% of patients who underwent operation, more than 10 years 10.2%, and more than 15 years 5.6% of patients.

Age Factors↗
PubMed1992

[Repeat uni- and bilateral operations in surgery for multiple primary cancer of the lungs and intrathoracic metastases].

Repeated uni- and bilateral resections of the lungs conducted from 1963 to 01.01.91 at the Department of Surgery of the Lungs and Mediastinum of the National Research Center of Surgery, USSR AMS for primary multiple carcinoma (13 patients) and metastatic lesions (32 patients) accounted for 1.3% of all operations in lung carcinoma. Such interventions are more justified in differentiated forms of primary multiple carcinoma and in solitary and occasional metastases of malignant tumors of various localization to the lungs. Morphological signs are the main differential diagnostic criteria of primary multiple carcinoma and intrapulmonary metastases. The main principle of surgical treatment of patients with primary multiple carcinoma and metastatic involvement of the lungs is an economical character of the operation with maximally admissible, from the oncological standpoint, preservation of functionally valuable pulmonary tissue. The combined method of treatment (operation + drug antineoplastic therapy) should take the leading place in the management of patients with intrapulmonary metastases of malignant tumors.

Adult↗
PubMed1992

[Surgical treatment of lung cancer extending into the thoracic wall].

In the Department of Surgery of Lungs and Mediastinum, National Research Centre of Surgery, USSR AMS, 88 patients underwent operation for lung carcinoma extending into the thoracic wall (which accounted for 2.6% of all patients who were operated on for carcinoma of the lungs) from 1963 to December 1990. Surgical treatment of such patients is the method of choice. The performance of both radical and palliative operations is expedient. The survival of patients after operation is determined by the depth of invasion of the thoracic wall by lung carcinoma and the condition of intrathoracic lymph nodes.

Adult↗
PubMed1992

[Reoperation in primary malignant tumors of the lung operated earlier].

Retrospective analysis of 3,441 operations carried out in the Department of Pulmonary and Mediastinal Surgery, National Research Centre of Surgery, USSR Academy of Medical Sciences, from 1963 to 1990 for carcinoma and other malignant tumors of the lung showed that in 19 (0.6%) patients surgical interventions had been conducted on the same lung. Nonspecific pulmonary diseases, tuberculosis, and localized pneumosclerosis proved to be the most common diseases for which the first thoracotomy was performed. The number of such patients is continuously growing, in view of which the authors set them apart into an independent group of patients subjected to repeated operations in lung carcinoma. Approximately in half of these patients (47.4%) the malignant tumor occurred in the lung 8 years and more after the operation carried out for a benign disease; in the others (52.6%) the tumor existed in the lung at the first operation but was not removed due to diagnostic and tactical errors or was a latent carcinoma. It is concluded that timely and proper use of diagnostic methods and a high oncological alertness even during an operation for a benign disease may facilitate improvement of the results of surgical treatment of this category of patients with lung carcinoma.

Aged↗
PubMed1991

[Economic operations in the surgical treatment of cancer of the lung].

Retrospective analysis of case records of 75 patients who were subjected to resection of a lung in a volume less than lobectomy showed that 2 types of economical operations are carried out today on patients with lung carcinoma: atypical resection and segmentectomy. According to the authors, such operations accounted for 2.4% of all lung resections for this disease. The main indication for radical resection of the lung in a volume less than lobectomy is stage I peripheral non-small-cell carcinoma (T1N0M0) in patients with serious concomitant diseases. Economical resection of the lung may be carried out in occasional cases with stage II of the disease (T2N0M0) and as a palliative measure. The late-term results provide evidence of the oncological expediency of economical operations in stage I peripheral carcinoma: for instance, 5- and 10-year survival of patients in such cases is 68.4 and 38.4%, respectively.

Adult↗