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1
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The Use of Three Free Flaps in the Simultaneous Reconstruction of the Nose after Extensive Resection Due to Malignant Cancer

100%
Grajek M., Maciejewski A., Szumniak R., Krakowczyk Ł.
Polish Journal of Surgery
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2012
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vol. 84
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issue 2
99-101
EN
Reconstructive techniques for extended posttraumatic or post-resectional nose defects are well described. Small defects can usually be closed using local flaps with a good esthetic result. Extended resections in the mentioned area require more complex reconstruction methods, including microvascular techniques. The Authors' presented a case of whole nose and partial cheek simultaneous reconstruction using three free flaps. Two auricular free flaps and one radial forearm free flap were used to cover the defect. Meticulous preoperative planning and harvesting of flaps enabled to achieve good esthetic and functional results.
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Surgical Treatment of a Ruptured Giant Renal Artery Aneurysm - Case Report and Literature Review

100%
Paruzel K., Krakowczyk Ł., Oleś B.
Polish Journal of Surgery
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2011
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vol. 83
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issue 6
343-346
EN
Renal artery aneurysms are the second most common visceral artery aneurysms after splenic artery aneurysms, and before hepatic artery aneurysms. The study presented a case of a ruptured giant right renal artery aneurysm in a female patient. The presented case is worth mentioning, due to the giant size of the lesion. The diameter of the aneurysm exceeded 10 cm. Available literature data mentioned single reports of such large aneurysms located in the renal arteries. In spite of the fact that renal artery aneurysms are the second most common visceral artery aneurysms, their management is accompanied by some controversy. Literature data mentioned the dominance of endovascular techniques. However, surgical treatment remains to be the most effective and radical method.
3
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Expression profiles of MGMT, p16, and APC genes in tumor and matching surgical margin from patients with oral squamous cell carcinoma

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Strzelczyk J., Gołąbek K., Krakowczyk Ł., Owczarek A.
Acta Biochimica Polonica
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2016
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vol. 63
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issue 3
505-509
EN
The aim of the study was to assess the expression of MGMT, p16, and APC genes in tumors and matching surgical margin samples from 56 patients with primary OSCC. We also analyzed the association of the clinical variables with the expression of the studied genes. After RNA isolation and cDNA synthesis gene expression levels were assessed by quantitative reverse transcription (qRT)-PCR. Two-sided parametrical Student's t-test for independent groups with equal/unequal variances showed no statistically significant differences in genes' expression in tumor compared to margin samples. No association was found between the genes' expression and clinical parameters, except for MGMT, whose low expression was probably associated with smoking (0.87 vs 1.34, p=0.065). 'Field cancerization' is an area with genetically or epigenetically altered cells and at the same time a risk factor for cancer. Disturbances in gene expression could also be the source of damages leading to cancerization. In conclusion, it is important to mention that the field remaining after a surgery may pose an increased risk of cancer development. It may be suggested that the diagnosis and treatment of cancers should not be concentrated only on the tumor itself, but also on the cancer field effect. Therefore, further molecular analysis on surgical margins and additional research regarding their assessment are required.
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Transverse (Tram) rectus abdominis myocutaneous flaps for Rectovaginal and Rectovesical Fistulas Treatment after low Anterior rectal Resection due to Adenocarcinoma

76%
Krakowczyk Ł., Maciejewski A., Wierzgoń J., Szumniak R., Grajek M., Dobrut M., Półtorak S.
Polish Journal of Surgery
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2010
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vol. 82
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issue 5
279-282
EN
The rectovaginal or rectovesical fistula is a rare complication after low anterior resection for rectal cancer. Treatment is difficult and the result is often unsatisfactory.The aim of this paper was to present results of treatment with transverse rectus abdominis myocutaneous flaps of rectovaginal and rectovesical fistulas as complication of low anterior rectal resection due to adenocarcinoma.Material and methods. We report six patients with rectovaginal or rectovesical fistulas as a postoperative complication after low anterior resection of rectal cancer in Department of Oncological and Reconstructive Surgery in 2006-2008. Transverse rectus abdominis myocutaneous flaps are used for rectovaginal and rectovesical fistulas treatment.Results. In the follow-up period from 4 to 30 months no rectovaginal or rectovesical fistula recurrences and any postoperative complications were noted in all cases.Conclusions. Transverse (TRAM) rectus abdominis myocutaneous flaps are an effective, surgical method for rectovaginal or rectovesical fistulas treatement, especially in patients who recived pre or postoperative radiotherapy.
5
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Czerniaki złośliwe regionu głowy i szyi w materiale Kliniki Chirurgii Onkologicznej i Rekonstrukcyjnej Centrum Onkologii IMSC w Gliwicach

76%
Krakowczyk Ł., Maciejewski A., Grajek M., Szymczyk C., Wierzgoń J., Jędrzejewski P., Półtorak S.
Polish Journal of Otolaryngology
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2010
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vol. 64
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issue 7
55-59
EN
Introduction: About 25% of melanomas are localized in head and neck skin, and this particular localization is most difficult to treat, and the prognosis is less favorable. The depth of melanoma infiltration (Clark and Breslau grade) into the skin is the main factor of local advancement of the disease. Surgical treatment is an essential therapeutic modality in patients with melanoma. Aim: The aim of this study was to evaluate results of our surgical treatment of melanomas in head and neck localisation, treated from 1997 to 2007 in Department of Oncological and Reconstructive Surgery in Center of Oncology IMSC in Gliwice. Material: We analysed group of 47 patients (aged 26 to 75 years, mean 49), treated by surgical excision of malignant melanoma in the head and neck region. Most of the patiens required to use free fl aps or skin graft technique to close posexcisional defect, on basis of clinical considerations. Results: The 5-year total survival for all patients was 62% and were dependent on depht of melanoma infiltration and regional lymph node metastasis. The significant prognostic factors were: localization of primary focus, local progression of disease, free microscopical excision margins sex and age. Conclusions: Prognosis in the patients with melanoma of the head and neck is unreliable and dependent on local advancement of disease and localization of primary focus. Surgical treatment is an essential therapeutic modality in patients with melanoma. Adiuvant radiotherapy after surgical treatment of melanoma of the head and neck is intended for the patiens with high risk of local or regional recurence of disease.
6
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Virtual surgical planning and cone beam computed tomography in reconstruction of head and neck tumors – pilot study

64%
Krakowczyk Ł., Piotrowska-Seweryn A., Szymczyk C., Wierzgoń J., Oleś K., Ulczok R., Donocik K., Dowgierd K., Maciejewski A.
Polish Journal of Otolaryngology
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2021
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vol. 75
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issue 2
28-33
EN
Introduction: The aim of the study was to prove that a combination of visual surgical planning (VSP) and cone beam computed tomography (CBCT) is an optimal technique in fibular free flap reconstructions after complex tumor resections in the head and neck region and that it leads to better functional and aesthetic outcomes. Material and method: Six patients (3 females, 3 males) with head and neck tumors were included in the study. The region concerned midface in 2 cases and mandible in 4 patients. On the basis of computed tomography of the head, fibular free flap (FFF) reconstruction was planned with the VSP technique. The 3D-printed models were prepared. At the beginning of the operation and a few minutes after the reconstruction, an xCAT CBCT by XORAN was performed. Minor corrections of the angles of the reconstructed bony parts were made where needed. The time of the operation was assessed for each case. Functional and cosmetic results were evaluated in a 1-year follow-up. Results: The mean time of operation was 6 hours and 48 minutes, which was approximately 1hour and 40 minutes less than standard reconstructive surgery. Functional recovery was achieved in all patients. Aesthetic result was unsatisfactory for 2 patients due to insufficient soft tissue masses of FFF. Conclusions: The authors claim that intraoperative CBCT imaging, regardless of the cost, improves the accuracy of aesthetic outcome of reconstructive surgeries based on VSP, especially in the region of the midface and the mandible. Further studies on a higher number of subjects are required.
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The activity of antioxidant enzymes in colorectal adenocarcinoma and corresponding normal mucosa

64%
Strzelczyk J. K., Wielkoszyński T., Krakowczyk Ł., Adamek B., Zalewska-Ziob M., Gawron K., Kasperczyk J., Wiczkowski A.
Acta Biochimica Polonica
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2012
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vol. 59
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issue 4
549-556
EN
Oxidative stress is one of several factors which contribute to the development of colorectal carcinogenesis. The aim of the study was an assessment of the activity of antioxidant enzymes in tumour and corresponding normal distal mucosa in a group of patients with colorectal adenocarcinoma. Samples of tumour and corresponding normal mucosa were obtained during a resection of colorectal cancer from 47 patients aged between 26 and 82 years. The average distance of corresponding normal distal mucosa from the tumour was 4.49 cm. Activities of antioxidant enzymes: superoxide dismutase (SOD), glutathione reductase (GR), glutathione peroxidase (GPx), glutathione S-transferase (GST), and catalase (CAT) were measured in tissue homogenates. The patients were grouped according to the tumour stage (Duke's staging), grading, localization, and size of tumour, as well as age and sex. Statistical analysis was performed. The activity of SOD and GPx was considerably increased, while the activity of GST decreased significantly in tumour as compared with normal mucosa. GR activity in colorectal cancer was evidently higher in tumours of proximal location compared with the distal ones. The distance of corresponding normal distal mucosa from the tumour was analyzed and related to all assayed parameters. A decreased GST activity was observed in corresponding normal mucosa more than 5 cm distant from the tumour in patients with CD Duke's stage. The higher activity of superoxide dismutase and glutathione peroxidase in tumour compared to corresponding normal mucosa could indicate higher oxidative stress in colorectal adenocarcinoma cells.
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Wirtualne planowanie przestrzenne i tomografia komputerowa wiązki stożkowej w chirurgii rekonstrukcyjnej guzów głowy i szyi – badanie pilotażowe

64%
Krakowczyk Ł., Piotrowska-Seweryn A., Szymczyk C., Wierzgoń J., Oleś K., Ulczok R., Donocik K., Dowgierd K., Maciejewski A.
Polish Journal of Otolaryngology
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2021
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vol. 75
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issue 2
28-33
PL
Wprowadzenie: Celem badania było wykazanie, że połączenie wirtualnego planowania zabiegu chirurgicznego (VSP) i tomografii komputerowej wiązki stożkowej (CBCT) stanowi optymalną, umożliwiającą uzyskiwanie lepszych wyników czynnościowych i estetycznych, technikę rekonstrukcji wykonywanych z wykorzystaniem wolnego płata strzałkowego po złożonych resekcjach guzów w rejonie głowy i szyi. Materiał i metody: Do badania włączono 6 pacjentów (3 kobiety i 3 mężczyzn) z nowotworami głowy i szyi. Zmienionymi chorobowo obszarami były: środkowa część twarzy (2 przypadki) i żuchwa (4 przypadki). W oparciu o obrazy uzyskane w tomografii komputerowej głowy, techniką VSP opracowano plany rekonstrukcji z wykorzystaniem wolnego płata strzałkowego (FFF). Przy użyciu drukarki 3D sporządzono odpowiednie modele. Przy rozpoczęciu operacji i kilka minut po zakończeniu rekonstrukcji wykonywano skan CBCT, używając tomografu xCAT XORAN. W sytuacjach, gdy było to wymagane, wprowadzano drobne poprawki w zakresie kątów rekonstruowanych części kostnych. W każdym przypadku mierzono czas trwania operacji. Wyniki czynnościowe i kosmetyczne oceniano w badaniu kontrolnym po upływie 1 roku. Wyniki: Średni czas operacji wynosił 6 godzin 48 minut, tj. około 1 godzinę 40 minut krócej niż w przypadku standardowej operacji rekonstrukcyjnej. U wszystkich pacjentów uzyskano powrót do pełnej sprawności czynnościowej. U dwóch stwierdzono niezadowalający wynik estetyczny, będący wynikiem niewystarczającej ilości tkanki miękkiej w FFF. Wnioski: Według autorów, śródoperacyjne obrazowanie CBCT, niezależnie od kosztów, poprawia dokładność estetycznych rezultatów zabiegów rekonstrukcyjnych prowadzonych w oparciu o VSP, szczególnie w obszarach środkowej części twarzy i żuchwy. Wymagane jest przeprowadzenie dalszych badań na większej liczbie pacjentów.
9
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The role of MGMT polymorphisms rs12917 and rs11016879 in head and neck cancer risk and prognosis

64%
Kiczmer P., Prawdzic Seńkowska A., Strzelczyk J., Szydło B., Biernacki K., Osadnik T., Krakowczyk Ł., Ostrowska Z.
Acta Biochimica Polonica
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2018
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vol. 65
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issue 1
87-92
EN
Head and neck squamous cell carcinoma (HNSCC) is one of the leading cancers by incidence worldwide. The risk of these cancers is strictly associated with alkylation factors present in tobacco smoke. The crucial role in preventing DNA alkylation is played by O6-methylguanine-DNA methyltransferase (MGMT). Dysfunction or lack of MGMT is associated with an increased risk of cancer. The aim of the study was to assess the influence of MGMT polymorphisms: rs12917 and rs11016879 on HNSCC risk and course. The study consisted of 69 HNSCC patients and 242 healthy individuals. Case samples were taken from resected tumour tissue. The control group comprised samples of epithelial cells collected from mucous membranes using swabs. DNA samples were genotyped by employing the 5' nuclease assay for allelic discrimination using TaqMan SNP Genotyping Assays. The significance between distributions of genotypes and alleles was tested using Pearson's χ2 test analysis. Our results indicated that the MGMT rs12917 TT genotype increases the risk of HNSCC. The MGMT rs11016879 AG genotype and A allele were associated with increased HNSCC risk. We noted higher risk of nodal metastasis in rs11016879 AA homozygotes. Mechanisms leading to MGMT enzymatic defect are unknown and hence further studies need to be carried out. Our data suggest that the examined polymorphisms may be considered as potential prognostic factors for HNSCC risk and outcome. Further studies are necessary to verify our results.
10
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The Use of Double Independent Free Flaps for Tissue Reconstruction After Extensive Head and Neck Tumors Resection

52%
Maciejewski A., Jędrzejewski P., Szymczyk C., Wierzgoń J., Dobrut M., Szumniak R., Grajek M., Krakowczyk Ł., Półtorak S., Ulczok R., Oleś K.
Polish Journal of Surgery
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2010
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vol. 82
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issue 12
666-676
EN
Malignant tumors of head and neck regions usually need wide radical resections and may cause significant functional and aesthetic deficits. When a surgeon has to deal with extensive 3-D defect in lower or middle face region, double or multiple free flaps can be used.The aim of the study was to present own methods modifications and results of double free flaps techniques in patients with extensive defects of head and neck region. The authors present quality of life evaluation related to different flaps reconstructions.Material and methods. Clinical material consists of 33 patients with locally advanced cancer of lower or middle face region, who underwent surgical treatment in Departmant of Surgical and Reconstructive Surgery, Cancer Center Maria Skłodowska-Curie Instytute, Gliwice, Poland. In all patients double free flaps were chosen.Results. Whole group good functional and aesthetic results have been achieved. The QOL analysis show that the use of double flap in middle of lower face reconstruction gives generally very good results.Conclusions. The use of double free flaps after extensive resections of head and neck tumors is an efficient solution. The above-mentioned technique enables to reconstruct several different anatomical structures, restore optimal functioning, and assure a satisfactory psychosocial effect.
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