The original techniques of soft-tissue purulent lesion treatment by means of a continuous-wave CO2 laser are elaborated. The following laser treatment advantages--minimal tissue damage, prophylaxis of local dissemination of infection, haemostatic and sterilizing effects--have been proved experimentally. Laser utilization in clinical trial (360 cases) made it possible to obtain significantly improved outcomes and marked shortening of treatment.

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In the U.S.S.R., investigation into the application of laser surgery began in the mid-1960s. Wider clinical applications with the COz laser began in 1975, when we performed the first total and partial gastrectomies, colon resections, and biliary tract interventions. Unique instruments were designed for these procedures, such as clamps and stapling devises, that provide complete sterile hemostasis. This, in turn, made it possible to use a one-layer seromuscular intestinal suture, which is stronger than twoor three-layer sutures, for anastomosis formation.Morphological studies in experimental surgery and endoscopic examinations with biopsy in clinical surgery demonstrated that the laser anastomosis, unlike conventional anastomoses, healed after first intervention with a slight aseptic inflammation reaction without leukocytic infiltration. This resulted in more reliable anastomosies and in early restoration of intestinal content passage. Laser anastomoses show normal physiological function and are not affected by stenosis.Currently manufactured in the Soviet Union are two serial multipurpose C02 surgical laser units: a 30-W "Scalpel-1" and a "Romashka" unit of up to 100 W. The total number of surgical procedures performed with C02 laser technique in various fields of surgery in the U.S.S.R. involves several tens of thousands of operations. In our hospital, 436 total and partial gastrectomies and 269 operations on colon, rectum, and anorectal organs were performed. Biliodigestive anastomoses and papillosphincterotomies performed with the laser beam (69 procedures) are not frequently accompanied by stenosis, and function well. In 28 procedures resecting the liver or pancreas, the applications of laser beam and specially designed instruments make it possible to achieve good hemostatic effect and complete sealing of the secretory system ducts.In addition, the Soviet surgeons have performed more than 300 pulmonary procedures including anatomical and atypical resections, abscessectomies, and pneumo-and pleurolysis. Great experience has been gained with laser applications with approximately 10, OOO operations in dermatological surgery.The use of the C02 laser is effective in plastic surgery, where bloodless, asceptic excision of tumors and scars at the recipient site becomes possible. Graft taking is also peformed with the aid of the laser, after the sterile, physiologically indifferent fluid (playing the role of a shield) has collected in the tissue. The skin graft is prepared in the required layer bloodlessly and asceptically-"a laser photohydraulic

The analysis of the results of photodynamic therapy (PDT) for treatiing malignant neoplasms of skin, breasts, tongue, oral mucose, lower lip, larynx, stomach, bladder, rectum and other locations has been made. During 1992 -1996 years 867 tumoural foci in 222 patients have been treated with PDT. All patients were previously treated with conventional techniques or they were not treated due to contraindications either because of severe accompanying diseases or because of old age. A part of the patients had PDT because of recurrences or intradermal metastases in 1 -2 years after surgical, radial or combined treatment.Up to now we have follow-up control data within 2 months and 4 years. Positive effect of PDT was seen in 93.7% of patients including complete regression of tumours in 64.9% and partial in 28.8%. Currently this new perspective technique of treating malignant neoplasms is successfully being used in Russia; new photosensitizers and light sourses for PDT and fluorecsent tumour diagnostics are being developed as well.