THORACIC SURGERY

From Big Medical Encyclopedia

THORACIC HIRURGYYa (Greek thorax, thorakos breast, thorax; surgery; a synonym chest surgery) — the section of surgery studying diagnostic methods and surgical treatment of damages and diseases of a breast, and also bodies of a chest cavity. In the USSR, as well as in many countries, from T. x. the cardiovascular surgery was allocated in the separate section (see Surgery cardiovascular), and the surgery of chest department of a gullet was more connected with abdominal surgery (see). In this regard main sections of modern T. x. the surgery of a chest wall, diaphragm, chest department of a trachea, bronchial tubes, lungs, mediastinums are. Specific weight of pulmonary surgery is most big, in to-ruyu also surgical treatment of a pulmonary tuberculosis enters (fti-ziokhirurgiya).

Main obstacle in a way of development of T. x. there was open operational pheumothorax (see) leading to heavy disorders of breath and blood circulation therefore T. x. began to develop only in process of development and improvement of methods of prevention of this complication. Work in this direction was promoted by the numerous researches on physiology of breath, pulmonary blood circulation and a pathophysiology of pheumothorax conducted at the end of 19 century. In 1896 Mr. Tyuffye and Allyon (Th. Tuffier, Hallion) in experiments showed that increase vnutritrakhealno-go pressure interferes with a pulmonary collapse after opening of pleural cavities. Then they designed the device for build-up of pressure in a trachea, to-ry used in clinic. In 1897 at a meeting of the XII International congress of doctors in Moscow E. L. Doyen showed the device for forcing and suction of air from lungs, and in 1900 D. Dobromys-lov with success applied in experiments a hardware artificial respiration at one - and bilateral operational pheumothorax. In 1904 F. Zauerbrukh and L. Brauer developed the principles of a gipopressiya and giperpressiya for intrathoracic operations, having created difficult cameras lowered and supertension. With 1909 Meltzer, Auer (S. J. Meltzer, J. Auer) in the conditions of operational pheumothorax suggested to apply an endotracheal insufflyatsionny anesthesia to operations. Under such anesthesia in 1913 Mr. F. J.A.Torek for the first time successfully resected chest department of a gullet at cancer.

In the late thirties — the beginning of the 40th of 20 century the Soviet surgeons developed a technique of local anesthesia (see. And a не-стезия local) at operations on bodies of a chest cavity. It allowed to overcome substantially the dangers connected with broad opening of a chest cavity.

During the Great Patriotic War the Soviet surgeons achieved great success in treatment of the gunshot getting wounds of a chest cavity. This problem was in details discussed at plenums of the Academic council of the Head military and sanitary department. In 1946 at the XXV All-Union congress of surgeons work on treatment of wounds of a chest cavity was summed up during war, aspects of treatment of effects of these wounds are discussed. Successful development of T. x. in the USSR after the Great Patriotic War it is directly connected with comprehensive development of local anesthesia and its practical development. However crucial importance for safety and expansion of opportunities of big operative measures and in conditions of one-II bilateral pheumothorax had development of anesthesiology (see) with development of an endotracheal anesthesia (see. Inhalation anesthesia).

In 1945. I. Kazansky with success carried out a transpleural esophagectomy across Dobromyslov — to F. J.A.Torek. In 1946 B. V. Petrovsky for the first time in the USSR executed a transpleural esophagectomy and cardial department of a stomach with imposing of an esophageal and gastric anastomosis. Same year V. N. Shamov successfully carried out a pneumonectomy at bronchiectasias, and A. N. Bakulev — at cancer of a lung. In 1947 B. K. Osipov made similar intervention at multiple abscesses of a lung,

V. I. Kazansky — at sarcoma, L. K. Bogush — at tuberculosis of a lung. By 1954, by data A. N. Bakuleva, lung operations made already more than in 100 cities of the Soviet Union. The wide experience was accumulated tumors and cysts of a mediastinum at a distance.

In development of T. x. in the USSR the outstanding role belongs to N. V. Anta lava, A. N. Bakulev, L. K. Bogush,

A. A. Vishnevsky, 10. To Yu. Dzhanelidze, V. I. Kazansky, I. S. Kolesnikov, B. A. Queen, P. A. Kupriyanova, B. of to Linberg, B. K. Osipov, B. V. Petrovsky, A. I. Savitsky, S. I. Spasokukotsky, N. G. Stoyko, V. I. Struchkov, F. G. Uglov.

Works of the Soviet surgeons in the field of pulmonary surgery in 1961 were noted by the Lenin award, and in 1949 and in 1974 — the State awards of the USSR.

Main centers T. x. in the USSR All-Union scientific center of surgery of the USSR Academy of Medical Sciences, the II N-t serdechpo-sos ud isty surgery of A. N. Bakulev of the USSR Academy of Medical Sciences, Ying t of surgery of A. V. Vishnevsky the USSR Academy of Medical Sciences, the Central scientific research institute of tuberculosis M3 of the USSR, All-Union scientific research institute of pulmonology M3 of the USSR, Kiev awards of the Labour Red Banner of scientific research institute of tuberculosis and chest surgery of the academician F. G. Yanovsky, the Kiev scientific research institute of clinical and experimental surgery M3 of USSR, Moscow research oncological in-t of G1 are. And. Herzen M3 of RSFSR, surgical clinics of VMA of S. M. Kirov, department of hospital surgery Gorky medical in-that, department of pulmonology of the Kiev GIDUV, Republican-tsa Riga.

In the socialist countries the large centers T. x. the Central clinic of heart troubles and lungs in Bud of Burke (GDR), Ying t Korani in Budapest are; in countries of Western Europe — Maria Lannelong's hospital in Paris, hospital Carlo Forlaninn in Rome, in the USA — clinics of Mayo in Rochester, the General Massachusetts hospital in Boston, the General hospital in Toronto.

In you flow 1946 — 1959 6 collections of scientific works and materials of all-Union conferences on chest surgery («Questions of chest surgery») were published, and since 1959 the scientific and practical magazine «Chest Surgery» began to appear. Questions T. x. are covered also in other domestic and foreign editions.

Importance for bystry development of T. x. had all-Union conferences on chest surgery (1947-1956). In 1949 at the II All-Union conference the constant commission on chest surgery under the chairmanship of B. E. Lpnberg soon transformed by ii constant bureau on chest surgery at the Scientist of copper-tsinekom council of M3 of the USSR was elected. In a crust, time as a part of All-Union scientific about-va surgeons there is a bronkho-iulmonologichesky section, as a part of Surgical about-va Moscow and the Moscow region — pulmonary section, as a part of the Moscow science foundation of phthisiatricians — section of chest surgery.

Bibliography: Bakulev A. N. An important stage in development of chest surgery, in book: Vopr. grudn. hir., under the editorship of B. E. Lin-berga, t. 6, page 3, M., 1959; L and N - e r of B. E. K of history of development of piles


would ache surgeries in the USSR, in the same place, of t. 3, page 5, M., 1949; Petrovsky B. V. Organization and perspectives of development of the surgical help in the USSR, Works of the 29th Vsesoyuz. congress hir., page 6, Kiev, 1975; Petrovsky B. V., Perelman M. I. and Koroleva N. S.

Tracheobronchial surgery, M., 1978; Works of the 30th All-Union congress of surgeons, Minsk, 1983; Glenn W. W. L., L i e-b about w A. A. a. L i n d s k o g G.

E. Thoracic and cardiovascular surgery with ^elated pathology, N. Y., 1975.

H. H. Malinovsky, M. I. Perelman.

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