[Paradigm of radiation-laser medical equipment and technology].

Based on quantum chemistry and chemical kinetics, the paper formulates basically new concepts of the possibility of controlling biochemical reactions in biological tissues by simultaneously making abnormal human visceral foci, in cancer diseases in particular, exposed to two rays via radiation and optic laser radiations. The paper also presents experimental findings of the channeling of X-ray and fluxes of charged particles along the fiber wave guides. It considers the circuit engineering of a medical endoscopic device that concurrently transmits optic laser radiation and fluxes of penetrating radiation into the viscera.

[Photodynamic therapy and fluorescent diagnosis of malignant tumors using preparation photogem].

From February, 1992 to May, 1993 photodynamic therapy (PDT) was applied at the State Scientific Center of Laser Medicine and the Moscow Scientific-Research Oncological Institute for the treatment of 60 patients with primary and metastatic malignant tumors of the breast, skin, respiratory and digestive organs, female reproductive organs, and urinary bladder. Forty-eight patients underwent one course of PDT, 11 patients received 2 courses, and one patient was given 3 courses. Russian-produced Photogem was used as the photosensitizer.

[Early postoperative adhesion ileus].

Under analysis were results of surgical treatment of 4908 patients with diseases of organs of the abdominal cavity obtained during the period from 1985 till 1990. In 57 patients relaparotomy was caused by early postoperative commissural ileus. Late diagnosis of the main disease, technical and tactical errors during operations and at the early postoperative period were responsible for the appearance of the commissural ileus.

[An analysis of the reasons for relaparotomy in the surgical clinic].

The results of surgical treatment of 4,078 patients who underwent operation in 1985-1989 were studied. Due to the occurrence of complications in the early postoperative period, 182 relaparotomies were carried out in 164 patients. The main indications for relaparotomies were advanced underlying disease, surgical errors (tactical, technical), changes of the patients' immune status.

Denervation of the gastric acid-producing zone by a gastric wall laser seromyotomy.

The application of various surgical laser devices offers the possibility for significant simplification of the technique of the selective denervation of a gastric acid-producing zone proposed by Tylor as the gastric wall seromyotomy. The application of laser technique results in decreased operative time, a wide range of surgical practice, less operative bleeding, and more reliable denervation. Operations performed in 38 patients provide a basis for recommending optimal parameters of laser energy for the gastric wall incision and reveal the advantages and disadvantages of different irradiation sources.

[Techniques of mechanical suture formation in Swenson's operation in children].

The authors describe briefly the design and method of working with a special suturing instrument in formation of an extraperitoneal anastomosis by a modification of Swenson's operation in children suffering from developmental anomalies of the large intestine. The instrument ensures one-stage stitching of the intestine along its entire circumference before its resection. The anastomosis is formed four times more rapidly and the manipulation is more aseptic.

[Laser seromyotomy of the stomach in duodenal ulcers].

The use of laser surgical equipment permits to simplify considerably a method of gastric seromyotomy. On the basis of the results of treating 38 patients, the optimal parameters of laser energy, used in dissection of the gastric wall, are recommended, the advantages and shortcomings of the different sources of radiation are studied.

[Use of carbon dioxide laser in emergency surgery of the extrahepatic bile ducts].

The principles of surgical techniques of operations with the use of carbon dioxide laser were developed on basis of the authors' personal experience of 8 years in surgical interventions on 65 patients. The stages of the operative approach, cholecystectomy, choledochotomy, +choledocho-duodeno-anastomosis, papillosphincterotomy, and sterilization of the operative wound and intraabdominal abscesses are illustrated by professionally drawn illustration-diagrams. Laser separation of the gallbladder from the liver takes 220 +/- 35 sec, laser hemostasis and cholestasis of the gallbladder bed--245 +/- 40 sec, laser choledochotomy--17 +/- 8 sec, laser duodenotomy--33 +/- 9 sec.

[Treatment of fissure in ano by the method of laser coagulation].

The article analyses the results of treatment of acute and chronic anal fissures with the use of the method of laser photocoagulation in 181 patients, in 87 of them the fissures were combined with other proctological diseases. The essence of the operation is three-fold laser treatment (CO2 laser) of the edges and floor of the fissures. The pathologically changed tissues are evaporated and coagulated in this case with the formation of a coagulation film on the wound surface.

[Use of Nichrome suture material].

The suture material and the method of its application play an important role in the prevention of wound complications. With the use of Nichrome wire thread as the suture material in surgical interventions, the number of postoperative complications significantly was decreased. The Nichrome thread is also used expediently in operative interventions on patients with purulent diseases of the soft tissues, including cases after primary surgical treatment of purulent foci by carbon dioxide laser.

[The pharmacokinetics of hematoporphyrin, its derivative and fluorescein during the development of carcinosarcoma].

The pharmacokinetics of fluorescein, hematoporphyrin and a derivative of hematoporphyrin was studied microspectrofluorometrically on rats with transplanted carcinosarcoma. It was shown that in the rats in contrast to intact animals the tissue concentration of fluorescein exhibits a general tendency towards an increase, that of hematoporphyrin towards a decrease and that of hematoporphyrin derivative towards an increase in all parenchymatous organs and a decrease in the skin and mucosae of the hollow organs. At the equally short period of the maximal accumulation of luminophores, the tumour tissue differs from the normal one by a pronounced delay of excretion only of hematoporphyrin derivative.

[Comparative evaluation of the results of traditional and laser papillosphincterotomy].

The techniques of papillosphincterotomy were improved on the basis of CO2 laser and special laser tools. The results of 212 routine and 114 laser papillosphincterotomies were appraised. With the laser techniques, the incidence of postoperative complications reduced to 14% as compared to 23.

[A method of laser seromyotomy of the stomach].

A technique of laser seromyotomy was developed as a method for vagus denervation for the treatment of gastroduodenal ulcers. Soviet Raduga neodymium YAG laser and foreign Medilaz and Flexilas units were employed as sources of laser irradiation. The operation was performed in the 'contact scalpel' mode with the use of Soviet sapphire tips.

[Co2 laser treatment of epithelial passages and cysts of the coccyx].

The article analyses treatment of 312 patients among which 156 were treated with the use of a CO2 laser and 156 by the traditional method. Study of the results showed that with the use of the CO2 laser the duration of in-patient treatment after radical operation was reduced by 5 days and out-patient rehabilitation by 13 days. the number of postoperative complications reduced considerably, single-stage radical operation could be carried out in the acute period of the disease, an operation for excision of a suppurating cyst could be completed by applying primary sutures with complete closure of the wound in 71.

[Experience in the use of laser instruments in surgery of the anorectal region].

The article discusses experience in surgical treatment of 480 patients with the most common diseases of the anorectal region (acute and chronic haemorrhoids, acute and chronic paraproctitis, polyps, chronic fissures of the anal canal) in which special laser tools were used. The carbonic acid laser Skalpel-1 with a wave length of 10.6 microns and power of 30 W was used as the source of laser radiation.

[Carbon dioxide laser in the surgical treatment of proctologic diseases].

Results of the surgical treatment of 556 patients with different diseases of the anorectal area with the help of CO2 laser are presented. Functional results were good, the amount of postoperative complications was 1.5 times less, recurrences were half less, the time of intrahospital treatment was 1.

[Treatment of pigmented skin lesions with argon laser irradiation].

The article gives an account of material concerning treatment of 60 patients with pigmented lesions of the skin (capillary hemangiomas, pigmented nevus, tattoos) by exposure to argon laser radiation. The optimal regimens and doses of laser radiation for discoloration of pigmented skin lesions are stated. Methodological recommendations for applying three methods fo laser treatment of extensive capillary hemangiomas are suggested.

[Characteristics of the blood supply of suppurative wounds treated by a defocused beam of a CO2 laser].

In examination of 57 patients with the use of a method of complex polarography, by oxygen and hydrogen, the increase in volumetrical rate of blood flow and oxygen tension in the purulent wounds treated by a defocused beam of the CO2 laser was established. This contributed to more favourable course of the wound process and accelerated healing. Complex polarography can be used as a diagnostic method in the purulent surgery.