НОВЫЕ ВОЗМОЖНОСТИ РАЗДЕЛЬНОЙ ИНТУБАЦИИ ПРИ ТОРАКАЛЬНЫХ ОПЕРАЦИЯХ У ПАЦИЕНТОВ С ИЗМЕНЕННОЙ ТРАХЕОБРОНХИАЛЬНОЙ АНАТОМИЕЙ

The current development of oncological surgery requires maximum possible radical interventions both for the patients with concurrent conditions and those with large tumors. In thoracic surgery, provision of the adequate surgical access by the anesthesiologist is crucial, and first of all, it requires the full collapse of the operated lung for the whole time of surgery. A chest tumor often results in the changes of the trachea and main bronchi anatomy, compression of their lumen, which can make lung separation difficult. Introduction of double lumen tube with an integrated video camera into clinical practice is aimed to provide easy and reliable separation and isolation of the lungs in case of pathological changes in the trachea and main bronchi without control bronchoscopy. The article analyses 17 cases when double lumen tubes with video monitoring were used for oncological thoracic surgeries, assesses the results and opportunities for their use in the patients with the changed anatomy of the tracheobronchial tree. Video monitoring provides safe and fast intubation of the left main bronchus reaching the required depth, reduces the time of preparation for surgery and its duration providing good working conditions for surgeons. Развитие онкохирургии в современных условиях требует выполнения оперативного вмешательства с максимально возможным радикализмом как у пациентов с выраженной сопутствующей патологией, так и с опухолями больших размеров. В торакальной хирургии многое зависит от обеспечения анестезиологом адекватных условий для хирургического доступа, прежде всего коллапса оперируемого легкого на весь требуемый период вмешательства. Опухоль, растущая в грудной клетке, часто приводит к изменению анатомии трахеи и главных бронхов, сдавлению их просвета, что может осложнить разделение легких. Внедрение в клиническую практику двухпросветных интубационных трубок с интегрированной видеокамерой призвано легко и надежно обеспечить разделение и изоляцию легких при патологических изменениях в трахее и главных бронхах без использования контрольной бронхоскопии. В статье анализируются 17 случаев использования двухпросветных интубационных трубок с видеоконтролем при онкологических операциях на органах грудной клетки, оцениваются результаты и возможности их применения у пациентов с измененной анатомией трахеобронхиального дерева. Наличие видеоконтроля позволяет безопасно и быстро установить интубационную трубку в левый главный бронх на необходимую глубину, сокращает время подготовки к операции и ее продолжительность за счет создания хороших условий для хирургов.

Hydrocarbon biomarkers and isotopic composition of carbon from bitumoids and oils of Mesozoic sediments in the western part of the Yenisei-Khatanga oil and gas region

Based on analyzes of carbon isotopic composition, distribution and composition of hydrocarbon biomarkers of oils and bitumoids from source rocks of the Mesozoic sediments in the western part of the Yenisei-Khatanga oil and gas region and the northeast of the West-Siberian plate, two groups of oils and bitumoids are identified, genetically associated with organic matter, mainly sapropel type (I group) and mainly humus type (II group). The genetic correlation of oils and bitumoids has been made. Possible foci of generation, which participated in the formation of hydrocarbon deposits, have been determined

NEW OPPORTUNITIES OF INTUBATION WITH A DOUBLE LUMEN TUBE DURING THORACIC SURGERY IN THE PATIENTS WITH ABNORMAL TRACHEOBRONCHIAL ANATOMY

The current development of oncological surgery requires maximum possible radical interventions both for the patients with concurrent conditions and those with large tumors. In thoracic surgery, provision of the adequate surgical access by the anesthesiologist is crucial, and first of all, it requires the full collapse of the operated lung for the whole time of surgery. A chest tumor often results in the changes of the trachea and main bronchi anatomy, compression of their lumen, which can make lung separation difficult. Introduction of double lumen tube with an integrated video camera into clinical practice is aimed to provide easy and reliable separation and isolation of the lungs in case of pathological changes in the trachea and main bronchi without control bronchoscopy. The article analyses 17 cases when double lumen tubes with video monitoring were used for oncological thoracic surgeries, assesses the results and opportunities for their use in the patients with the changed anatomy of the tracheobronchial tree. Video monitoring provides safe and fast intubation of the left main bronchus reaching the required depth, reduces the time of preparation for surgery and its duration providing good working conditions for surgeons