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Background. Solitary fibrous tumor (sFT) is a rare mesenchimal neoplasm of fibroblastic origin. There is no generally accepted classification for sFT. Surgery is the main treatment modality. Disease recurrence occurs in 2-14 % of patients. Re-surgery is recommended to treat recurrence because alternative treatment options are ineffective. Persistent hypoglycemia is observed in less than 5 % of patients, and values return to normal 24 days after tumor removal.Case description. A 53-year-old woman was admitted to the Thoracic Department of PA. Gertsen Moscow Research Institute of Oncology with consciousness disorder at the level of spoor. The severity of the disease was caused by the syndrome of compression and displacement of the mediastinal structures to the left and respiratory failure: anemia, glycemia 1.2 pmol/ml. Immunohistochemical examination revealed solitary fibrous tumor with evidence of malignancy. In the preoperative period, to maintain the glycemia level within the normal range, continuous infusion of 10 % glucose solution was administered. The total infusion volume was 10 liters per day. Tumor in the right hemithorax was removed and atypical resection of the middle and lower lobes of the right lung was performed. In the postoperative period, glucose levels were in normal limits and additional treatment was not required.Conclusion. SFT is a rare neoplasm of mesenchymal origin. The lack of clear diagnostic criteria and diagnostic standards for the description of individual cases remains relevant. Clinical manifestations of disease occur mainly in cases with large tumors. Early timely surgical excision of the tumor in case of suspicion of a solitary fibroid tumor is recommended, since over time, benign neoplasm may acquire a malignant behavior and metastasize.

Purpose: Improving efficiency of treatment mixed tubercular and ps.aeruginosa pleural empyema.Materials and methods: The results of treatment of 65 patients with mixed tubercular and ps.aeruginosa pleural empyema have been analyzed. Local ozone therapy was used in 29 cases.Results: The strict keeping of procedure allows to have expressed local and systemic activity with absence of side effects.Conclusions: Application of ozonated solutions is effective and economic method of sanitation empyemic pleural cavities. So, ozone therapy can be recommended in the complex treatment of pleural empyema produced by mixed flora.

Soft tissue emphysema (including subcutaneous emphysema) is common in pneumothorax. In most cases, this condition is of little clinical significance and regresses under standard medical procedures. However, progressive soft tissue emphysema poses a threat to the patient's life in case of compression of the upper respiratory tract in some cases. The world literature describes various approaches to the treatment of these patients. Standard medical care for progressive soft tissue emphysema following pneumothorax is pleural drainage with active aspiration. Despite unequivocal treatment tactics, this may not be enough in case of massive air release. Surgical treatment may be accompanied by surgical and anesthetic difficulties including difficult intubation. The authors present persistent tension pneumothorax and soft tissue emphysema, features of surgical and anesthetic management, as well as current treatment options.

Objective: Optimization of diagnosis and treatment of patients with solitary fibrous tumor of pleura, analysis of overall survival and disease-free survival, predictors of recurrence., Material and Methods: There were 66 patients with solitary fibrous tumor of pleura (26 men and 40 women) aged 57.6 years (range 26-80 years). Asymptomatic course was found in 29 (44%) patients, various symptoms - in 37 (56%) patients. Thoracotomy was applied in 36 patients, thoracoscopy - in 30 patients. Immunohistochemical examination included analysis of definition of Stat6 expression., Results: Benign variant of SFT was diagnosed in 50 (75.7%) patients, malignant variant - in 16 (24.3%) patients. STAT6 expression was observed in all cases. Postoperative morbidity was 9%, mortality - 1.6%. Recurrence was diagnosed in 2 (4%) patients with benign variant of disease and in 5 (31.2%) patients with malignant variant (2 of them died from progression of disease). Progression-free survival was 89.4%, overall survival - 95.4%. Predictors of recurrence are tumor dimension over 10 cm, necrosis and/or hemorrhagic component of tumor, mitotic count of at least four per 10 high-power fields., Conclusion. S: Olitary fibrous tumor of pleura is a rare mesenchymal fibroblastic neoplasm growing from submesothelial layer. Differential and preoperative morphological diagnosis of SFT is difficult and demands a special immunohistochemical examination with analysis of Stat 6 expression. Surgery is preferred for tumor de novo and recurrent neoplasm.

An apparatus for automatic lung straightening may be used in medical technologies employed in thoracic (lung) surgery in the postoperative rehabilitation of a patient. This apparatus may automatically (without a physician's or a nurse observance) maintain tension relief in the pleural cavity in the patient on an individual basis, which is required for complete lung strengthening. Its use greatly reduces the number of postoperative complications in the lung, such as residual cavities, edema, and empyema of the pleura. This apparatus is to go into quantity production as a cheap, expendable device to prevent AIDS and hepatitis.

The results of 3 observations concerning the gastric fundus ulcers penetration into the pleural cavity after pulmonectomy conduction are adduced.

An experience with 139 radical one-step surgeries for esophagus cancer using transpleural or transmediastinal plasty with a gastric tube is presented. This type of surgery is a method of choice for malignant tumours of the esophagus since it provides the best radical operation and good functional results. The standardized approach to the anesthesiological maintenance of these surgeries and to postoperative intensive therapy is substantiated. The total postoperative mortality made up 26.2%; mortality from surgical complications-20.9%; 3-years survival was 24.5%; 102 patients (73.3%) were discharged from the clinic with good functional results.

The pathogenetic substantiation and technique of intrapleural sorption detoxication (IPSD) based on the use of high-dispersed silicone dioxide (trade mark "AEROSIL") are presented. Use of IPSD in the complex of treatment of 25 children with complicated forms of acute destructive pneumonia permitted to shorten the duration of intoxication syndrome, sanation of suppurative foci, stay of the patients at a hospital.

The article discusses the causes of intraoperative and postoperative bleeding from vessels forming in the adhesions between the mantle of the lung, the costal pleura, the mediastinum, and the diaphragm. The authors applied successfully temporary tamponade of the pleural cavity with hemostatic sponge, collagen film, and gauze tampons in 25 patients who underwent pulmonary pleuropulmonectomy. The method is simple and may be successfully applied under any conditions, both in specialized and in ordinary surgical departments.

The article describes the method of drug pleurodesis and determines the indications for its application. Study of the late-term results and the drawn conclusions provide evidence that the method of drug pleurodesis may de an alternative to operative treatment of spontaneous pneumothorax.

The analgesic effect of intrapleural administration of local anesthetics (lidocaine, trimecaine, azocaine) has been studied in 180 patients after thoracic surgery and with chest trauma. The effect was assessed on the basis of subjective (visual analogue 10-score scale) and objective findings (hemodynamic parameters, spirograms, ECG). In control patients analgesia was performed by intramuscular promedol administration. It has been shown that fractionated intrapleural administration of local anesthetics is an effective and safe analgesic technique after thoracic surgery and in chest trauma.

A system of individual prediction of postoperative pyothorax was elaborated from analysis of the case records of 347 patients with carcinoma and chronic pyogenic diseases of the lungs. The authors identified 10 groups of risk factors which may aggravate the course of the postoperative period. Prognostic coefficients were determined for each one of them and their role in the development of pyothorax was specified. The complex of preventive measures in patients at a high risk of postoperative pyothorax was reinforced by intraoperative treatment of the pleura by ultrasonics, which improved the results of surgical treatment of patients with pulmonary diseases.

The foreign bodies of the lungs and pleural cavity were the cause of non-specific suppurative pulmonary diseases in 0.4% of the patients. They are conditioning pneumonia, blood spitting, pulmonary hemorrhage, circumscribed pleural empyema. The removal of foreign bodies is necessary, because the risk of their remaining is not justified.

Chronic venous hypertension in rats was provoked by injection of polymethyloxane into the pleural cavity. Hypertrophy of muscular tissue was accompanied by reconstitution of adrenergic nervous structures. In the early stages (up to 40 days), the changes in the latter are reactive in nature: first there occurs a weakening of luminescence, rare-fraction of the network and then "hyperneuria". Pulmonary heart formation was followed by marked hypertrophy of SMC, increased density of adrenergic fibers, convergence of SMC and nerve terminals (synapse formation).

The authors describe a method of liquidation of a postresectional residual cavity by the introduction of the patient's autoblood with antibiotics. When using this method all the factors of the coagulating system of blood are involved in the formation of fibrin and the following formation of fibrothorax, which accelerates the formation of fibrothorax. The proposed method was used in 26 patients with residual pleural cavities after resection of the lungs and facilitated their liquidation and formation of fibrothorax.

The authors suggested and employed in 34 patients a balloon-devise, that is inflated in the pleural cavity following a removal of the lung. This lessens plasma and hemorrhages, thus contributing to the prophylaxis of postoperative empyemas.