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The article analyses the results of pylorus-preserving resections of the stomach in 116 patients among whom 80 had gastric ulcer, 29 ad duodenal ulcer, and 7 had gastroduodenal ulcers. Changes of acidity and motor-evacuation function of the gastric stump were studied according to the method of pylorus-preserving resection. The late-term results of treatment in follow-up periods of 2 to 5 years are shown, they were found to be good in 96.6% of patients treated by operation and poor in 1.7%. It is noted that the function of the gastric stump is better when the vagus innervation of the pylorus is preserved. Mediogastric resection with selective proximal vagotomy in patients suffering from duodenal ulcer with a superacidic stomach led to stable normalization of acid production, which was a reliable measure for the prevention of a recurrent ulcer.

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YAG-laser radiation was used for endoscopic hemostasis in 33 patients with bleeding endobronchial carcinomas and in 4 patients with chest injury complicated by bleeding from wounds of the lung and chest wall. For conducting laser photocoagulation, the authors prefer a rigid bronchoscope and a thoracoscope and pulsed laser radiation with a power of up to 40 Wt. As the results of treatment, hemostasis was achieved in 24 patients with lung carcinoma and in 4 patients with trauma of the chest. In some patients with pulmonary carcinoma laser photocoagulation creates conditions for successful surgery or chemoradiotherapy. The performance of thoracoscopic laser operations in chest injuries and traumas allows wide thoracotomy to be avoided in some patients. Complications were not registered in endoscopic laser operations.

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A total of 320 endoscopic yttrium-aluminum-garnet laser and electrosurgical operations were carried out on 186 patients with tumors of the trachea and bronchi. Most operations were performed with the use of Friedel's respiratory bronchoscope and general anesthesia. Optimization of the methods of endoscopic laser and electrosurgical interventions made it possible to achieve a positive clinical result in the form of recanalization of the stenosis and arrest of bleeding in 143 (75.3%) patients. Laser and electrosurgical endothoracic operations performed through a thoracoscope in 81 patients with traumatic and spontaneous pneumothorax removed the cause of the pneumothorax in most of them and allowed endoscopic hemostasis to be conducted and thoracotomy to be avoided in some of them.

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The certain indices of morphofunctional state of the cellular membranes and mass of the stress-competent organs of rats in acute stress and its prophylaxis by means of lithonit--a new native atypical tranquilizer with a neotropic action were studied. The immobilization-cold stress caused a statistically significant adrenal hypertrophy and deep degradation of the thymico-lymphatic system. Prophylactic administration of lithonit for 7 days had a protective action on the organs studied. In prophylactic administration of lithonit, the accumulation of membranotoxic products of peroxide oxydation of lipids reduced considerably.

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Endoscopic laser operations were conducted in 156 patients with various tumors of the trachea and bronchi. The indications for laser operations were neoplastic stenosis of the respiratory tract, bleeding from the tumor, and recurrent carcinoma in a bronchial stump after previous operations. Neodymium laser with a monofiber quartz light guide was the source of laser radiation. Laser photodestruction was performed through a fiberoptic bronchoscope in 34 patients and by a Fridel respiratory bronchoscope in 122 patients. Some new methods are suggested which make laser photodestruction of endobronchial tumors easier. The lumen of the respiratory tract was restored and bleeding arrested in 71 patients, partial recanalization occurred in 52 patients, and no therapeutic effect was achieved in 32 patients. Complications in the form of perforation of the respiratory tract, bleeding, and laryngospasm were encountered in 7 (4.5%) patients. Laser therapy in lung carcinoma creates favorable conditions for chemotherapy and radiotherapy.

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224 thoracoscopies were performed to patients with spontaneous and traumatic pneumothorax. Curative thoracoscopy (diathermocoagulation, laser coagulation) was performed in 93 patients, in 42 patients medical glues were used. Out of 93 patients who had been subjected to curative thoracotomy endoscopic operations gave no effect in 5 patients only. Complications after thoracoscopy were noted in 4 patients (2 patients had exudative pleurisy, 2 patients had subcutaneous emphysema).

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The article discusses 6-year experience in the treatment and prevention of esophageal hemorrhage by endoscopic sclerotherapy using 96% and 70% ethanol as the sclerosant. There were 99 patients under observation whose ages ranged from 27 to 70 years, 74 were admitted to the clinic with profuse hemorrhage. Sclerotherapy arrested the bleeding in 65 (90%) patients. Seven patients died from persisting bleeding, 5 from increasing hepatic insufficiency, and one patient from perforation of the esophagus and purulent mediastinitis. After discharge from the clinic 54 patients were kept under observation for periods of 6 to 20 months; 16 episodes of bleeding occurred in 13 of them. Repeated sclerotherapy proved effective in 10 patients, 3 patients died from continuing bleeding and hepatic insufficiency.

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Thoracoscopy was conducted in 223 patients with spontaneous and traumatic pneumothorax; 26 of them were treated by diathermal coagulation of the lungs, thoracic wall, and bleeding vessels, 34--by laser photocoagulation. Nd-laser with a wave length of 1.06 mcm was used as the source of laser radiation. The indications for thoracoscopy and the techniques of using laser radiation in thoracoscopy are described. Diathermal coagulation of the lung failed to produce an effect in 2 patients with spontaneous pneumothorax, laser photocoagulation was ineffective in 3 patients with spontaneous pneumothorax and in one patient with a knife injury of the right lung. Laser photocoagulation has advantages over diathermal coagulation.

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Treatment of a purulent wound by means of a 400-500 J/cm2 power density CO2-laser after preliminary ordinary debridement improves the results of the last-named by reducing the level of microbial dissemination in the tissues to minimum (10(1) microbial bodies per 1 g tissue). This improves the conditions for the development of the wound process and leads to sharp shortening of the duration of its phases and wider indications for the application of primary and primary-postponed sutures to the purulent wound. If primary sutures cannot be applied in the first postoperative days due to unfavourable conditions, open management of the wound is indicated to prepare it for application of primary-postponed sutures. Closure of a purulent wound with primary-postponed sutures after its treatment with a CO2-laser creates favourable conditions for its healing by first intention.

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A total of 155 women with acute lactation mastitis were followed up. The patients were divided into 3 groups: Group 1 included 53 patients in whom purulent wounds were treated with CO2 laser followed by primary and primary-delayed sutures; Group 2-52 patients were treated with primary-delayed sutures without laser therapy; Group 3-50 women were treated by the traditional open method. In 50 (94.3%) Group 1 patients the wounds healed by primary tension with the mean bed-day being 9.6. In Group 2 primary healing was achieved in 46 (88.4%) patients, with the mean bed-day being 11.8. In Group 3 patients the mean bed-day made up 8.2. The wounds healed by secondary tension on days 28-34 after surgery followed by outpatient treatment.

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The immediate results of surgical treatment of 134 patients with colonic obstruction of tumour nature were studied. The indications for the choice of a method for operative intervention, depending on peculiarities of the tumor process and state of a patient were established. In operable tumour, the radical removal of the damaged portion of the intestine is indicated. However, the obligatory aiming at creation of primary anastomosis in colonic obstruction is unexpedient because of high postoperative lethality. The necessary condition for the one-stage resection is a good preoperative decompression of the intestine.

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The results of surgical treatment of giant duodenal ulcers in 104 patients are analysed. The peculiarities of the clinical picture and diagnosis of the disease were revealed. In 53 (51.0%) patients, the organ-perserving operations with vagotomy were performed, in 47 (45.2%)--different modifications of gastric resection, in 4 (3.8%)--gastroenterostomy. In treatment of the critically ill patients, the organ-preserving operations are preferable.

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Under investigation there were 223 patients with mechanical jaundice, 132 patients were subjected to percutaneous transhepatic cholangiography, 102 patients--to percutaneous transhepatic cholangiostomy. The preoperative drainage of bile ducts was established to be efficient in order to reduce lethality. High diagnostic value of cholangiography is shown. Indications and contraindications to the application of cholangiostomy depending on etiology of jaundice, localization of the tumor, and its spread, degree of hepatic insufficiency and risk of operative procedures are formulated.

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