RESUMEN
The authors have carried out 296 transthoracic and endoscopic YAG-laser operations in various diseases of bronchopulmonary system. Sapphire and quartz applicator-tips were used as a contact scalpel. The procedures of laser operations with the use of the contact mode are described in detail and comparative evaluation of both types of thermal applicator-tips is given. The combination of cutting and coagulation properties of the contact laser scalpel enables its use in various operations on the lung and pleura including thoracoplastic interventions as well as accomplishment of an endoscopic photoresection of endobronchial tumors.
Asunto(s)
Terapia por Láser , Enfermedades Respiratorias/cirugía , Procedimientos Quirúrgicos Torácicos/instrumentación , Endoscopios , Diseño de Equipo , Humanos , Reproducibilidad de los Resultados , Resultado del TratamientoAsunto(s)
Adenocarcinoma/cirugía , Neoplasias de los Bronquios/cirugía , Tumor Carcinoide/cirugía , Carcinoma de Células Escamosas/cirugía , Endoscopía , Terapia por Láser , Adulto , Anciano , Neoplasias Óseas , Neoplasias de los Bronquios/secundario , Broncoscopía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Osteosarcoma/secundario , Neumonectomía , Factores de TiempoAsunto(s)
Artritis Reumatoide/patología , Granulomatosis con Poliangitis/patología , Enfermedad Aguda , Adulto , Artritis Reumatoide/complicaciones , Diagnóstico Diferencial , Granulomatosis con Poliangitis/complicaciones , Humanos , Pulmón/patología , Absceso Pulmonar/etiología , Absceso Pulmonar/patología , Masculino , Necrosis , Neumonía/etiología , Neumonía/patologíaRESUMEN
Results of treatment of 130 patients with diabetic gangrene, whom the lower limb amputation on various levels was conducted, are adduced. In 58 patients the surgical treatment together with combined use of laser was conducted: intravascular irradiation of blood, high-powered laser Application while amputation performance and after it--percutaneous irradiation of amputation stump. Laser use promotes the improvement of immediate results of treatment and decrease of its duration.
Asunto(s)
Complicaciones de la Diabetes , Gangrena/terapia , Terapia por Láser , Pierna/irrigación sanguínea , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica , Sangre/efectos de la radiación , Terapia Combinada , Diabetes Mellitus/radioterapia , Diabetes Mellitus/cirugía , Femenino , Gangrena/radioterapia , Gangrena/cirugía , Humanos , Pierna/cirugía , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , ReoperaciónAsunto(s)
Amputación Quirúrgica/métodos , Pierna/cirugía , Anciano , Amputación Quirúrgica/rehabilitación , Muñones de Amputación , Arteriosclerosis Obliterante/cirugía , Angiopatías Diabéticas/cirugía , Gangrena/cirugía , Cadera , Humanos , Isquemia/cirugía , Pierna/irrigación sanguínea , Persona de Mediana EdadAsunto(s)
Epiplón/trasplante , Osteomielitis/cirugía , Costillas/cirugía , Esternón/cirugía , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , ReoperaciónRESUMEN
The results of treatment of 84 sufferers with a complicated thoracic trauma, using irradiation of the YAG-neodymium, argon, helium-neon and arsenide-gallium lasers, are presented. The techniques for the use of lasers for photocoagulation of defects of the lung and thoracic wall through a thoracoscope, endobronchial laser therapy and laser puncture is described. The expediency to use laser irradiation in the complex of treatment of a complicated thoracic trauma is shown.
Asunto(s)
Coagulación con Láser , Terapia por Láser , Traumatismos Torácicos/terapia , Puntos de Acupuntura , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios de Evaluación como Asunto , Femenino , Hemotórax/etiología , Hemotórax/terapia , Humanos , Coagulación con Láser/instrumentación , Masculino , Persona de Mediana Edad , Fracturas de las Costillas/etiología , Fracturas de las Costillas/terapia , Traumatismos Torácicos/complicaciones , Toracoscopía , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/terapiaRESUMEN
Within a decade, the authors performed 484 thoracoscopies in patients with spontaneous pneumothorax, open and closed thoracic trauma, pleuritis, pleural empyema. High diagnostic possibilities of the method permitted to choose a rational therapeutic tactics. In 228 cases, different endothoracic interventions under the guidance of a thoracoscope were performed. With the use of thoracoscopy, diathermocoagulation, laser and ultrasound irradiation were performed, medical glue was introduced. This permitted in most cases to eliminate intrapleural injuries and achieve stable smoothing of a lung.
Asunto(s)
Cirugía Torácica/métodos , Toracoscopía/estadística & datos numéricos , Diagnóstico Diferencial , Humanos , Enfermedad Iatrogénica , Enfermedades Pleurales/diagnóstico , Enfermedades Pleurales/cirugía , Neumotórax/diagnóstico , Neumotórax/cirugía , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/cirugía , Toracoscopios , Toracoscopía/métodos , UcraniaRESUMEN
The paper provides the results of treating 118 patients aged 16 to 78 years who had complicate bullous emphysema. The most frequent complication was spontaneous pneumothorax (n = 107). Chronic respiratory failure was observed in 8 patients with bullous formations occupying 1/3-2/3 of the hemithorax volume. Two patients had recurrent hemoptysis. Eighty patients with spontaneous pneumothorax underwent thoracic operations: endoscopic bullectomy, endoscopic pleurodesis with MK-7 and MK-8 medical glues, endoscopic electro- and laser coagulation of pulmonary bullae through infrared gallium arsenide and argon lasers. Thoracotomy with marginal resection of the lung, bullectomy, parietal pleurectomy was performed in 29 (25%) patients. The paper shows indications and contraindications for endoscopic and surgical operations, methods for applying IGA laser for marginal resection of the lung, bullectomy, pleurectomy, endoscopic coagulation of the bullae, complications of endoscopic and surgical treatments.
Asunto(s)
Enfisema Pulmonar/cirugía , Adolescente , Adulto , Anciano , Enfermedad Crónica , Electrocoagulación , Femenino , Hemoptisis/etiología , Humanos , Coagulación con Láser , Terapia por Láser , Masculino , Persona de Mediana Edad , Neumonectomía , Neumotórax/etiología , Enfisema Pulmonar/complicaciones , Enfisema Pulmonar/diagnóstico , Recurrencia , Insuficiencia Respiratoria/etiología , Toracoscopía , ToracotomíaRESUMEN
Endobronchial laser therapy was employed in the complex of treatment of 90 patients with tumorous pulmonary diseases. An LG-75 helium-neon laser with the output power of 20 mW was used. A pronounced therapeutic effect was noted in 75 patients. Preoperative recanalization of the bronchi was performed in 25 patients. The YAG-laser based plant "Raduga-1" was used as a source of radiation. No complications after the operation were noted. An antineoplastic effect of the high-energy laser radiation was noted.
Asunto(s)
Bronquios/efectos de la radiación , Terapia por Láser , Neoplasias Pulmonares/cirugía , Neumonectomía , Adulto , Anciano , Femenino , Helio , Humanos , Neoplasias Pulmonares/radioterapia , Masculino , Persona de Mediana Edad , Neón , Cuidados Posoperatorios , Cuidados Preoperatorios , Dosificación RadioterapéuticaAsunto(s)
Terapia por Láser/instrumentación , Neoplasias Pulmonares/cirugía , Enfermedades Pleurales/cirugía , Neumonectomía/instrumentación , Atelectasia Pulmonar/cirugía , Broncoscopía , Diseño de Equipo , Humanos , Cuidados Intraoperatorios , Terapia por Láser/métodos , Neumonectomía/métodos , Toracoscopía , U.R.S.S.Asunto(s)
Absceso/radioterapia , Braquiterapia/métodos , Mama/efectos de la radiación , Terapia por Láser , Mastitis/radioterapia , Absceso/cirugía , Adolescente , Adulto , Mama/cirugía , Femenino , Humanos , Mastitis/cirugía , Cuidados Posoperatorios , Cicatrización de Heridas/efectos de la radiaciónRESUMEN
Emergency thoracoscopy was undertaken in 111 patients with complicated closed chest trauma and in 67 persons with penetrating knife wounds of the chest. Thoracoscopy in patients with closed chest trauma revealed pneumohemothorax in 53, pneumothorax in 42, and hemothorax in 10 cases, in 4 patients the hemothorax was coagulated. Penetrating injuries were complicated by pneumohemothorax in 30, by pneumothorax in 21, and by hemothorax in 16 cases. From the results of thoracoscopy, emergency thoracotomy was found to be indicated in 11 patients with penetrating chest wounds. Endoscopic electrocoagulation of the wounds of the lung and thoracic wall was conducted in 28 patients with a closed trauma and in 26 persons with penetrating injuries, laser coagulation was performed in 10 cases with closed trauma and in 8 patient with knife wounds, medical glue was applied for occlusion of surface ruptures of the lung in 11 cases. No complications of thoracoscopy occurred. The therapeutic methods of thoracoscopy with the use of high frequency electric current, NIAH-laser radiation are described. It is concluded that the inclusion of thoracoscopy in the complex of therapeutic and diagnostic measures in patients with complicated chest trauma is expedient.
Asunto(s)
Traumatismos Torácicos , Toracoscopía , Adolescente , Adulto , Anciano , Electrocoagulación/métodos , Urgencias Médicas , Femenino , Humanos , Coagulación con Láser/métodos , Persona de Mediana Edad , Neumotórax/diagnóstico , Neumotórax/etiología , Neumotórax/cirugía , Traumatismos Torácicos/complicaciones , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/cirugía , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/cirugía , Heridas Penetrantes/complicaciones , Heridas Penetrantes/diagnóstico , Heridas Penetrantes/cirugíaRESUMEN
The results of treatment of 256 patients with complicated closed chest injury are discussed. Multiple fractures of the ribs were found in 178, closed pneumothorax in 127, pneumohemothorax in 71, isolated hemothorax in 55, and rupture of the diaphragm in 3 patients. Most patients received nonoperative treatment, 5 patients (6.1%) needed emergency thoracotomy. Early drainage of the pleural cavity, endoscopic (thoracoscopy, bronchoscopy) methods of treatment, mechanical stabilization of floating rib fractures made it possible to improve the results and reduce the terms of treatment. Two (0.8%) persons died from shock and cardiopulmonary insufficiency.
Asunto(s)
Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/terapia , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Traumatismos Torácicos/epidemiología , Ucrania/epidemiologíaRESUMEN
The technique of use of a neodymium YAG-laser for surgical treatment of diseases of the lungs and pleura in 25 patients is described. The experience accumulated is indicative of good aero- and hemostatic properties of the laser, which permit to reduce the incidence of postoperative complications.