[Endoscopic subfascial dissection of venous perforants in treatment of venous trophic ulcers of the legs].

Endoscopic subfascial dissection was performed in patients with chronic venous insufficiency of CEAP class 4-6. 76 surgeries were performed in 68 patients. Mean age of the patients was 56 years.

[Prophylaxis of thromboembolic complications in laparoscopic cholecystectomy].

A complex system of prophylaxis of thromboembolic complications (TEC) in laparoscopic surgeries based on study of hemodynamic disorders in cava vein bed and specific risk factors is discussed. System of TEC prophylaxis and prognosis of TEC risk degree was developed. Problems of prophylaxis of venous thrombosis in laparoscopic cholecystectomy in patients with chronic diseases of lower extremities veins are regarded in detail.

[Thermal trauma in a combination with respiratory tract burn].

The detection rate of microbial contamination of burn wounds after flame burn was studied in dynamics to 3 weeks in 56 patients forming 2 similar groups: basic--with thermo-inhalation lesions (TIL) and control--without TIL. General area of skin burns in all the patients was less than 50% of the body surface, on average it was 40%, the area of deep burns was 23%. Cytological and bacteriologic methods were used for study microphlora in the sputum and in bronchoalveolar lavage.

[Ultrasonic diagnosis of focal damages in thoracoscopic operations].

5-year experience of developed in PAMS A.V. Vishnevsky Institute of Surgery RAMS ultrasonic examination (USE) of the lung in thoracoscopic operations for focal lung lesions (FLL) is presented.

[Laparoscopic cholecystectomy in choledocholithiasis and stricture of the terminal part of the common bile duct].

The authors offer the treatment and diagnostic algorithm in choledocholithiasis, stricture of a terminal portion of the common hepatic duct and papilla stenosis revealed in laparoscopic cholecystectomy (LCE). With the purpose of intraoperative assessment of bile ducts states during LCE, the diagnostic system including laparoscopic and ultrasonic examinations, cholangiography and choledochoscopy was developed and applied. In intraoperative revealing of choledocholithiasis without bile outflow disorders and wide cystic duct the authors prefer to remove the concrements during choledochoscopy through cystic duct without intervention on Vater's papilla (VP).

[Videothoracoscopy in diagnosis and treatment of small peripheral pulmonary masses].

This study was devoted to examination of efficacy of modern methods of diagnosis and surgical treatment of patients with small peripheral pulmonary masses (SPPM) with the use of videothoracoscopy. The results of examination and treatment of 126 patients with SPPM (80 patients underwent videothoracoscopy) were analysed. This study demonstrated high-quality of modern complex of clinicoradiological investigations for diagnosis of SPPM.

[Diverticuli of duodenal papillar region and their role in development of choledocholithiasis and strictures of bile and pancreatic ducts].

Up to present time there is no common view on the role of diverticuli of the papillar region of the duodenum (DPRD) in development of the strictures of terminal parts of the common bile duct and major pancreatic duct. The main method for the diagnosis of DPRD is fibroduodenoscopy (FDS). Relaxational FDS is the most informative method for detailed examination of diverticulum and for assessment of its interrelations with longitudinal crease and the major duodenal papilla (MDP).

[Thoracoscopic splanchnic sympathectomy in pancreatic diseases].

Thoracoscopic splanchnicsympathectomy (TSSE) was performed in 8 patients with inoperable tumors of the corpus and tail of the pancreas and in 3 patients with painful syndrome of chronic pancreatitis. Severe painful syndrome in the upper abdominal region was the main indication for ISSE. Thoracoscopic resection of the lower thoracic sympathetic ganglia and splanchnic nerves was performed.

[Ultrasonic study in thoracoscopic operations].

Intraoperative ultrasound diagnosis (IOUSD) was made in several thoracoscopic interventions in 15 patients: diagnostic thoracoscopies (3) in patients with lymphogranulomatosis, carcinoid and peripheral lung cancer, enucleation and atypical resection of the lung (4) in patients with hamartochondromas, in excision of lung cyst (1), in removal of foreign body of the lung (1), in removal of celomic cysts (2) and in ablation of neurofibroma of the mediastinum (1), in atypical resection of the lung and enucleation of tuberculomas (2). Video thoracoscopy in combination with intraoperative ultrasound examination provides possibility for precisional diagnosis of focal disease of the lung and mediastinal organs, including local masses of small sizes, and is rather informative method of diagnosis. IOUSD allows to define the diagnosis more exactly and to determine the extent of pathological process, to prevent complications and locate intraparenchymal masses and foreign bodies in lung tissues, and thus enables to complete operation without thoracotomy.

[Results of laparoscopic cholecystectomy].

Laparoscopic cholecystectomy (LCE) was performed in 410 patients with calculous cholecystitis. Acute phlegmonous cholecystitis was in 14 patients. The indications for the LCE were similar to the indications for "open" cholecystectomy.

[Choice of surgical approach in laparoscopic cholecystectomy].

A definition of a surgical access in laparoscopic interventions is formulated. The importance of use of various surgical accesses is stressed. The results of treatment of 410 patients with calculous cholecystitis are analysed.

[Bronchoscopy in inhalation burns].

The treatment of burns of various depth and location which are combined with thermoinhalation affections of the respiratory organs is a serious problem during the entire course of burn disease. Despite advances in modern treatment of burns, the death rate of pulmonary complications is still high. Pulmonary disorders encountered in inhalation of chemical toxic products of burning, smoke and its finely divided components increase the fatal outcomes by 30-100% in different periods of the burn disease.

[Current possibilities in the diagnosis and treatment of appendiceal mucocele].

The authors present an original experience of using an ultrasonography and a computer scan for a preoperative diagnosis of VP mucocele. The laparoscopy has been used as a method for the final diagnosis as for an appendectomy. The authors also describe their understanding of VP mucocele pathogenesis and their opinion about diagnosis and treatment of such kind of a case.

[Results of laparoscopic cholecystectomy].

The paper provides the results of two-year use of laparoscopic cholecystectomy as a treatment of calculous cholecystitis in patients with various clinical and morphological types of calculous cholecystitis. Less intraoperative trauma, a mild postoperative period, and early activization of patients, good cosmetic effect are indisputable advantages of this therapeutical method which is an alternative to an open operation for calculous cholecystitis.

[Results of various treatment modalities in the calculous cholecystitis].

Two alternative methods for the treatment of calculous cholecystitis are evaluated: extracorporeal lithotripsy was performed in 284 patients, laparoscopic cholecystectomy--in 130 patients. Even in strict selection of patients, lithotripsy was ineffective in 32 of them and they were subjected to an operation; in another group of patients elimination of the fragments from the gallbladder was incomplete. Therefore, extracorporeal lithotripsy may be used in no more than 10% of patients with cholelithiasis.

[Extracorporeal ultrasonic lithotripsy of biliary calculi].

The article analyses the efficacy of extracorporeal lithotripsy by a LT-01 piezoelectric lithotriptor (EDAP, France). A total of 72 lithotripsy sessions were performed on 37 patients, in 2 of them who suffered from chronic calculous cholecystitis the procedure was conducted on the day before the operation. As a method for treatment, extracorporeal lithotripsy was applied in 35 patients for the following indications: solitary and multiple stones measuring in sum no more than 3 cm in the satisfactory functioning of the gallbladder and patency of the bile ducts.

[Results of endoscopic interventions in large and giant epithelial neoplasms of the large intestine].

The paper presents the analysis of the results obtained for 319 patients at endoscopic interventions for large and giant tumors of the colon. Altogether 415 neoplasms were removed: 207 nodular, 126 creeping and 82 flat. The latter two were removed using specially developed technique of endoscopic electroresection of the intestinal mucosa along with the tumor.

[Endoscopic polypectomy in the surgical treatment of diffuse polyposis of the large intestine].

The article analyses experience in the treatment of 81 patients with diffuse polyposis who underwent subtotal resection of the colon with abdominoanal resection of the rectum and downward displacement of the right parts into the anal canal. It is shown that growth of the remaining occasional polyps and appearance of new polyps are encountered in the maintained parts of the colon and upper parts of the gastrointestinal tract in the postoperative period. The authors found that endoscopic polypectomy allows the right colon to be preserved in 92.

[Hyperplastic changes in the mucosa in colon cancer].

67 segments of rectum and sigmoid removed surgically because of carcinoma were examined: the surface of intestinal mucosa stained with methylene-blue was studied in order to determine the number and localization of focal changes in the macroscopically unchanged areas. Colon microscopy was performed clinically in 24 patients with carcinoma of the rectum and in 24 control individuals. 28 hyperplastic polyps and 1037 microscopic hyperplastic foci were found in operative material.