Evaluation of cross-bar and parallel-bar techniques in MIRPE surgery in different countries: a multicenter study.

Parallel- and cross-bar techniques are surgical methods used in the pectus excavatum. While the parallel bar is used in many centers, the cross bar is a new technique. The aim of the study is to evaluate the data of centers using cross bar and parallel bar.

Surgical correction of pectus arcuatum.

Background: Pectus arcuatum is a rear congenital chest wall deformity and methods of surgical correction are debatable.

Methods: Surgical correction of pectus arcuatum always includes one or more horizontal sternal osteotomies, resection of deformed rib cartilages and finally anterior chest wall stabilization. The study is approved by the institutional ethical committee and has obtained the informed consent from every patient.

[The efficacy of hand desimpatization after sympatectomy by complex regional pain syndrome].

64 patients operated on the reason of complex regional hand pain syndrome were examined with the use of laser spectral Doppler flowmetry and thermography. 33 patients had thoracoscopic Th3 ganglion clipation; 16 patients had brachial artery and vein perivascular sympathectomy; 15 patients periarterial sympathectomy on the level of brachial artery. Desympathisation (microcirculatory hemodynamic improvement and trophotropic microcirculation regulatory changes) was mostly apparent after thoracoscopic clipation and perivascular desympatisation in comparison with isolated periarterial sympatectomy.

[New facilities in management of complex regional pain upper limb syndrome with thoracoscopic sympathectomy].

26 patients (21 females and 5 males, aged from 40 to 70 years) with complex regional pain syndrome (CRPS) who underwent thoracic sympathectomy at the Th3-4 level on the damaged side, were examined 1,5-2 months since trauma. After an operation all patients showed pain management, improvement of motor and trophic functions, positive dynamics of laser Doppler flowmetry and computer thermography. The given method was demonstrated to be effective and mostly successful at the early stages of CRPS.

[Age characteristics of the bile duct system functioning in the norm and in the gastrointestinal system pathology].

At the present the age-specific particularities of many organs and systems used in diagnostics are determined. The function--morphological state of the biliary system in different age groups is poorly studied. The age-specific particularities of biligenesis in norm (control group--90 persons) and in pathology were studied by the following traditional methods: multifractional chromatic duodenal catheterization, dynamic scintigraphy of gallbladder, dynamic ultrasonic cholecystography.

[Lymph node dissection in patients with cancer of the proximal part of the stomach].

The authors describe 694 patients who underwent operation in 1985-1993 for carcinoma of the proximal part of the stomach with various degree of involvement of the adjacent parts of the stomach and esophagus. The tumors differed in histological structure. The main principles of classification of the groups of regional lymph nodes, taking into account the localization of the tumor in the stomach, are shown.

[Treatment of postoperative complications after surgery for esophageal cancer and cancer of the cardioesophageal junction].

Out of 108 patients with gastric and cardiac cancer and surgical complications, 49 were treated in the routine manner and 59 operatively. The immediate results were equal in either cases: 17 (34.7 +/- 6.

[Comparative study of the quality of domestic albumin solution and foreign analogs].

The quality and standards of albumin solutions (5, 10 and 20%) made in this country meet the requirements of national specification documentation. This, however, lacks some standards included into European Pharmacopoeia and mandatory for foreign manufacturers (Na and K ions, hemipigments, polymers, thermostability). The comparative tests of the albumin solutions made in Russia and abroad by conventional European standards showed that Russian solutions by some parameters are inferior to foreign samples.

[The surgical and combined treatments of locally disseminated cardioesophageal cancer].

The article deals with the experience in the treatment of more than 1,000 patients with cardioesophageal carcinoma in 1965-1989. The authors note increase of surgical activity and widening of indications for operative treatment at the cost of patients of the old age groups and those with locally-extending forms of the neoplastic process. In distinguishing the term cardioesophageal carcinoma the authors insist on the community of the surgical tactics and operative methods in carcinoma of the cardia extending to the esophagus and in esophageal carcinoma spreading to the stomach.

[Effects of surgical complications on trace element metabolism in patients with cardio-esophageal and esophageal cancer].

The homeostatic features of trace elements were studied in 48 patients with cardio-esophageal and esophageal carcinoma in development of incompetence of the anastomosis sutures (17), peritonitis (19), and intestinal fistulas (12). The level of the trace elements was determined in the red cells, blood plasma, and urine by emission plasma spectrometry. With the development of surgical complications after operation on the stomach and esophagus, the metabolism of trace elements was sharply disturbed, catabolic processes prevailed and were manifested by the escape of essential trace elements from the cells and their excretion in the urine.

[Substantiation of the expediency of performing extensive lymph node dissection in surgical treatment of esophageal cancer].

The performance of extensive lymph node dissection+ in esophageal carcinoma is substantiated. From their own data the authors conclude that squamous cell carcinoma of the esophagus possesses high lymphatic metastatic activity and point to the statistically significant increase of the incidence of involvement of the superior perigastric lymph nodes in localization of the tumor in its infrathoracic part. At the same time, the frequency of affection of the mediastinal lymph collector does not depend on the localization of the tumor.

[Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia].

Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation.

[Disorders of trace element metabolism and their correction using artificial nutrition in patients with cancer of the esophagus in the preoperative period].

Findings of research into disorders of the micronutrient exchange in esophageal carcinoma patients are overviewed. The micronutrient level in the plasma, erythrocytes, and urea was estimated by means of emission plasma spectroscopy. Patients with esophageal carcinoma were found to have pronounced changes in the micronutrient exchange on their admission into the clinic.

[Garlock's operation in cancer of the esophagus].

Experience in 88 Garlock-type operations carried out in carcinoma of the esophagus allows a certain opinion to be formed on the advantages and shortcomings of this surgical intervention. In esophageal carcinoma with its proximal boundary within the range of the retropericardial segment of the esophagus, a left abdominothoracic approach (Garlock's operation) is adequate in resection of the esophagus in conformity with the oncological principles and allows the formation of the esophagogastric anastomosis at the level of the arch of the aorta without particular technical difficulties. Reduction of the time needed for the operation, determination of the resectability of the esophageal tumor before mobilization of the stomach are obvious advantages of the abdominothoracic approach.

[The effect of parenteral feeding on the metabolism of arachidonic acid in patients with cancer of the esophagus and the stomach].

Blood plasma and erythrocyte level of arachidonic acid (C20:4) and blood plasma level of its two metabolites (6-keto-PGF1 alpha and TXB2) have been investigated in 24 patients with esophageal and gastric cancer. In the preoperative period and during 8-10 days postoperatively 12 patients were on "glucose" energy supply (group I) and 12 patients were on "lipid" energy supply (group II). Daily calorie intake was 30-35 kcal/kg.

[Some peculiarities of pyrimidine isoplyth methylation of newly synthesized DNA from human blood lymphocytes in normal conditions and chronic lymphoycytic leukemia].

Methylation of pyrimidine isoplythes of newly synthesized DNA from activated human blood lymphocytes was studied under normal conditions and in chronic lymphocytic leukemia. The analysis of distribution of labelled 5-methylcytosine in DNA pyrimidine oligonucleotides, differing in their lengths, showed a considerable increase in the methylation of pyrimidine oligonucleotide fragments of DNA from lymphocytic leukemia lymphocytes as compared to normal. The greatest differences were observed in methylation with respect to longer fragments, e.