Prolonged peridural anesthesia after operations on the chest cavity organs in elderly patients]

From the analysis of 126 observations of the longlasting peridural anesthesia in elderly patients following operations on the lungs and thoracic organs the author notes a high effectiveness of the method. Anatomical peculiarities of the spine structure in elderly individuals make for a more frequent occurrence of such complications as impossibility to perform the puncture of the peridural space, puncture of the dura mater, drop of the arterial pressure etc. The frequency of complications was 23%; in 7.9% of them the medicamental treatment was needed. The use of the longlasting peridural anesthesia favoured an early motor activity of the elderly patients, a rapid normalization of the bronchial motor function and decrease of the rate of postoperative pulmonary complications. The longlasting peridural anesthesia should be widely applied in geriatric surgery.     

Periosteal osteosarcoma--a European review of outcome

Periosteal osteosarcoma is a rare primary malignant bone tumour. Treatment is by surgical excision, but controversy remains about the value of chemotherapy. The members of the European Musculo Skeletal Oncology Society (EMSOS) collaborated to produce a dataset of 119 patients. The predominant site for the tumour was the femur, followed by the tibia. All but 2 patients underwent surgery, with 9 requiring amputation and the others having limb salvage. A total of 81 patients had chemotherapy, of whom 50 had neoadjuvant chemotherapy. There was no standard chemotherapy regime, but all patients receiving chemotherapy were given doxorubicin combined with at least one other agent. The overall survival was 89% at 5 years and 83% at 10 years. Eight patients developed local recurrence, of whom 5 died. Survival was related to appearance of local recurrence (P < 0.0001) but no other single factor. The use of chemotherapy was not shown to be a prognostic factor, but was used in two-thirds of the patients in this study.     

Laser obliteration in the treatment of varicose disease of the lower limbs

Experience of endovenous laser coagulation in the treatment of the varicose disease of the lower extremities is presented. This method was used in 107 patients. Surgical technique of isolated endovenous laser coagulation and combined phlebectomy was described in detail. Morphologic data on laser injury of a venous wall are presented. Short- and long-term results were evaluated with clinical and ultrasonic methods. It is demonstrated that endovenous laser coagulation may be regarded as alternative to traditional saphenectomy. This method decreases surgical trauma, number of complications and hospital stay.