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The creation of silicone endoprosthesis led to new approaches in solving the problems of plastic replacement of the breast after radical mastectomy. Two variants of reconstructive plastic operations with endoprosthetics of the breast were employed: group one--the formation of the seat of the endoprosthesis using a transposed musculocutaneous flap from the latissimus dorsi muscle; group two--the formation of the seat of the endoprosthesis by stretching the skin with a specially designed stretcher-expander and subsequent implantation of the endoprosthesis. The first method is rather injurious, sometimes cannot be performed because of anatomical contraindications, and is fraught with the development of necroses in the transposed tissues. Among 34 patients operated on by the first method two had marginal necrosis of the skin above the endoprosthesis. No complications were recorded among the 46 patients who underwent operation by the second method. The condition of the endoprosthesis and the tissues surrounding it was appraised in the immediate and late periods by radiological and ultrasonic examination. The variants of endoprosthetics of the breast which we applied may be employed with competence in clinical practice, but a reconstructive-plastic operation with the use of a skin expander is preferable.

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The purpose of this study was to evaluate the rats liver wound healing after liver resection and treatment by the "hemostopan", glue (MK-8) and traditional method. Each bile- and hemostatic means was marked with evolution of the morpho-functional changes at the liver wound tissue determined by the degree of the bile- and hemostatic method injure. The time healing, liver cell proliferation, 02 disorder level, ultrastructural changes have been studied. This examination indicates that "hemostopan" is more preferable for processing of the liver wound.

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The work deals with the study of the mosaic character of the hemostatic potential, connected with the development of a localized pathological process, taking postmastectomy edema in illustration. It is shown that this condition is an example of the manifestation of the RASK system mosaics in one organism in pathology. It should be pointed out that the degree of the development of the local DVS syndrome changes significantly some of the RASK system parameters at the level of the whole organism. This is evidence that normalization of the microcirculatory processes in the edematous extremity will be an important measure in complex treatment of postmastectomy edema. It will considerably lower the risk of general disorders of the RASK system. Parameters determined in the blood collected from the extremity on the side of the operation will serve as controls of the efficacy of the applied therapeutic measures.

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The authors elaborated a new approach to radical mastectomy which, combined with nonoperative measures makes it possible to prevent the development of postmastectomy-induced edema by means of a lympho-venous anastomosis (LVA). The choice of the level of LVA formation and their number is substantiated. With due regard for the conditions named, the cubital fossa and the lower third of the upper arm on the anterointernal surface is the most rational zone. To accelerate lymph drainage through the collaterals and reduce lymph loss, goal-oriented ligation of the lymph vessels which are divided during mastectomy is additionally carried out; this is successfully done when they have been stained. As a result, wound lymphorrhea ceases practically at days 4 to 5.

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Studies of the changes in the rat tail blood vessels in heating shows a considerable increase in slow oscillation frequency, apart from the rheographic index elevation. The hyperthermic effect became considerably lesser in elimination of these oscillations with ganglio- or adrenoblocking agents. The mechanism of hyperemia in heating associated with modulation of mechanic contractions of vascular smooth muscles, are discussed.

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Analysis of the clinical and experimental data has prompted the authors to try surgical correction of an impaired lymph drainage in the arm after radical mastectomy by effecting lymphovenous anastomoses. These anastomoses are intended to eliminate lymphostasis, the principal reason of a postmastectomy edema, by draining the lymph, outflowing from the arm, to the vein. The optimal sites for the formation of a lymphovenous anastomosis have been found the cubital fossa and the anterointernal surface of the lower third of the shoulder. The formation of such an anastomosis simultaneously with radical mastectomy eliminates operation lymphorrhea of the wound already by days 4-5 postoperation, this facilitating the wound healing. Such an approach to radical mastectomy technique may completely prevent the development and progress of a postmastectomy edema of the arm.

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At present the problem of bladder injuries and methods of their therapy are very urgent in view of a wide use of radiation therapy of cancer of the uterine body, bladder and rectum. None of the existing methods of therapy of local radiation cystitis is sufficiently effective. To obtain better therapeutic results and immobilized trypsin preparation on a powder-like cellulose matrix was used. Therapy was provided to 34 patients with symptoms of acute radiation cystitis. The therapy in all the cases proved to be effective. It was confirmed by the disappearance of clinical symptoms and cystoscopic findings.

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The authors have analyzed the course and outcome of the early postoperative period in 45 patients with carcinoma of the stomach who had been subjected to gastrectomy and proximal stomach resection. A lower number of postoperative complications, including those with lethal outcomes, earlier normalization of certain important parameters of homeostasis were recorded in the patients with decompressive-feeding jejunostoma established at the final stage of the operation (18 subjects). A variant of the diet based on enpits for feeding through jejunostoma has been presented. No complications associated with the establishment and functioning of the jejunostoma were observed. At the same time the jejunostoma makes possible a rapid diagnosis of certain complications and their conservative treatment without laparotomy. The results of the observation have evidenced that early dosed loading of the digestive tract promotes its more rapid adaptation to new functional conditions.

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