The article showed the results of ultrasonic assessment of topographic and functional diaphragm indices in patients with severe diffuse emphysema. They passed the selection for lung volume reduction surgery. The comparison of diaphragm indices was presented in patients with diffuse emphysema and control group of healthy volunteers. Dynamics of diaphragm condition was studied after surgical treatment. There wasn’t noted any statistical difference of diaphragm topographic indices as compared with the control group. There wasn’t shown a correlation between respiratory function indices and functional diaphragm indices, but it was noted a positive tendency in characteristics during quiet breathing.
OBJECTIVE. The authors developed methods and assessment of efficacy of infrared fluorescence imaging of pleural carcinomatosis using indocyanine green (ICG). MATERIAL AND METHODS. The prospective study included 14 patients with malignant pleural carcinomatosis. All patients underwent standard thoracoscopy with pleural biopsy, then pleural cavity was examined under fluorescence control using ICG solution. Comparison of accuracy of biopsy materials obtained in white light and fluorescence was made. RESULTS. Signs of malignancy had 21 biopsy specimens out of 28, which were obtained in white light (in 12 patients out of 14). Research of biopsy specimens using fluorescence allowed doctors to make the precise diagnosis in all 14 patients, with 33 out of 34 biopsy materials being informative. CONCLUSIONS. Intraoperative application of infrared ICG fluorescence developed accuracy of biopsy and histological verification of the diagnosis.
OBJECTIVE. The research evaluated efficacy of combined treatment of initially nonresectable and inoperable cases of non-small cell lung cancer. The treatment consisted of preoperative endobronchial and intraoperave photodynamic therapies. MATERIAL AND METHODS. The prospective investigation included patients with central non-small cell lung cancer. These cases were initially considered as nonresectable (the trachea was involved in tumor) or inoperable (functional intolerance of pneumoectomy/ bilobectomy). Neoadjuvant chemotherapy (2-6 courses) and endobronchial photodynamic therapy (PDT) were conducted for these patients in preoperative period. PDT of resection edge was carried out during the operation and it was straight away after specimen removal and ipsilateral lymphodissection. RESULTS. The research was made on 38 patients. Lung resections underwent 30 (79 %) patients. Surgeries included 20 pneumoectomies and 10 lobectomies. Bronchial resection was performed by crossing an initially affected zone. It was noted that 5-year survival consisted of 68 %. CONCLUSIONS. Photodynamic therapy was important in combination with chemotherapy and surgical treatment of central non-small cell lung cancer. These measures allowed doctors to decrease the resection volume in part of inoperable patients or patients with initially nonresectable tumors.
The objective was to investigate the efficiency of the preoperative rehabilitation for patients with planned anatomical lung resections.Methods and materials.The study included 92 patients aged 27 to 87 years (mean age (63±10.8) years), 25 women (27.2 %) and 67 men (72.8 %) who underwent anatomical lung resections (79 patients, 85.9 % for lung cancer). Group 1 (39 patients – 42 %) included patients who did not smoke or quitted smoking at least 2 months before the operation. Also, they complied with the recommendations regarding respiratory gymnastics and the use of exercise and induction spirometers in full for at least 14 days. All patients who continued smoking or abandoned it less than 2 weeks before the operation, did not use breathing exercises, were included in group 2 (53 patients – 58 %).Results. Significant difference was found in the number of complications in the studied groups (the average number of complications in one patient in group 1 was (0.46±0.8), in group 2 – (1.47±1.5), p = 0.03). The difference was found in the duration of hospitalization (19.7 days in group 1 and 25.3 days in group 2, p <0.017), in the length of stay in the ICU ((1.6±0.9) days in group 1 versus (3.4±5.9) days in group 2, p = 0.011). The early postoperative period for patients of group 1 was more favorable regardless of the presence and severity of the course of concomitant chronic obstructive pulmonary disease.Conclusions. Comprehensive preoperative rehabilitation helps to reduce the number and severity of manifestations of complications after anatomical lung resections.
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