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Treatment of Patients with Giant Tumors in the Course of Recklinghausen Disease – Own Experience

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Fijałkowska M., Antoszewski B.
Polish Journal of Surgery
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2012
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vol. 84
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issue 12
632-637
EN
Neurofibromatosis type 1 (NF-1, von Recklinghausen disease) is included in the group of diseases known as phacomatosis. Clinical diagnosis of Recklinghausen disease is based on the presence of 2 from 7 criteria developed by a panel of expert. So far effective strategy of treatment of patients with NF-1 is not developed. One method of treatment are surgical excisions. The aim of the study was to present own experience of treatment of patients with giant tumors in the course of Recklinghausen disease. Material and methods. The Department of Plastic, Reconstructive and Aesthetic Surgery of Medical University in Łódź has under care 34 patients with NF-1. Fifteen patients (8 females and 7 males) with giant tumors were included in this analysis. The patients age was from 6 to 57 years. In analyzed group a retrospective review of surgical treatment was carried out on the basis of patients’ medical documentation. Results. Ten from 15 analyzed patients were operated on in our Department and performed surgeries were aimed to partially reduce the tumors mass. Only one patient had his tumor excised in one-stage procedure, in rest of the patients the lesions were too extensive. Most patients in histopathological examinations were diagnosed with neurofibroma (8 patients), 1 - neurofibromaplexiforme and 1 - neurofibrolipoma. Conclusions. Unpredictable course of Recklinghausen disease causes that follow-up examinations are necessary. Treatment of such patients is particularly indicated when the tumor mass causes difficulty in patients daily habits or is life-threatening. Also it is worth to remember that delayed decision of surgical treatment unable excision of the whole tumor in one-stage procedure. This in turn causes the risk of tumor re-growing and/or developing of malignancy
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The Prevalence of Cleft Lip and/or Palate in Children from Łódź in Years 2001-2010

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Antoszewski B., Fijałkowska M.
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vol. 85
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issue 6
329-332
EN
One of the most frequent congenital malformations is cleft lip and/or palate. The above-mentioned defect is a serious medical and social problem, and knowledge concerning its incidence pictures the scale of this phenomenon. The aim of the study was to determine the prevalence of cleft lip and/or palate in children in Łódź during the period between 2001 and 2010. Material and methods. We were able to obtain data from The Polish Registry of Congenital Malformations concerning the number of live born infants, and birth of children with cleft malformations in Łódź during the period between 2001 and 2010. Results. The mean incidence of cleft malformations amounted to 1.16/1000 live born infants in Łódź during the period between 2001 and 2010. Conclusions. During the period between 2001 and 2010, a significant decrease in the prevalence of cleft lip and/or palate was observed in Łódź. The most common type of defect was isolated cleft palate, while the most rare - cleft lip. Considering boys the most frequent defect was cleft lip and palate, while in girls - isolated cleft palate. Attention should be drawn to the fact of the decreased number of deliveries in Łódź, observed in the past decade
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Surgical Treatment of Patients with Poland's Syndrome - Own Experience

100%
Fijałkowska M., Antoszewski B.
Polish Journal of Surgery
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2011
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vol. 83
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issue 12
662-667
EN
Poland's syndrome is characterized by variable clinical picture. Classic deformity consists of unilateral hypoplasia or aplasia of the sternocostal head of the pectoralis major muscle and ipsilateral hand malformations. Additionally on the affected side hypoplasia or aplasia of the breast in women is observed. Variable malformations in Poland's syndrome cause that there is no uniform treatment schedule.The aim of the study was to analyze surgical treatment conducted in patients with Poland's syndrome in Plastic, Reconstructive and Aesthetic Surgery Clinic.Material and methods. A retrospective analysis of surgical treatment was carried out in the group of 66 patients with Poland's syndrome on the basis of their medical documentation.Results. The most common operation performed in women was breast reconstruction with silicone implant. Two men had their chest symmetrized by fat grafting. Syndactyly observed in patients with complete Poland's syndrome was surgically removed in early childhood.Conclusions. Treatment of patients with Poland's syndrome, mainly due to variable clinical picture, is individual and depends on age, sex and degree of deformity. In children with complete Poland's syndrome operations include surgical removing of syndactyly. Breast reconstruction in women with Poland's syndrome with silicone implants is known and safe method. Such procedures are performed after 18 years of age.
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Face Skin Neoplasms - Reasons for Delayed Treatment

81%
Antoszewski B., Kasielska A., Fijałkowska M.
Polish Journal of Surgery
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2011
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vol. 83
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issue 7
361-366
EN
The most common skin neoplasms are carcinoma: basocellulare, spinocellulare, planoepitheliale and melanoma malignum. Early surgical treatment is crucial for recovery as well as for good aesthetic result, especially on exposed body parts. All those lesions are visible for observers and the time from their appearance to surgical treatment seems to be too long.The aim of the study was to answer the following questions: 1. After what time from the skin lesion appearance the patients report to a surgeon? 2. What is the underlying cause of delayed reporting for treatment of patients with skin lesions?Material and methods. Questionnaire studies and analysis of medical histories were performed in the group of patients referred to Plastic Surgery Out-Patient Clinic in Łódź because of facial skin tumor in the last 5 years. Finally we collected data for 123 patients.Results. The analyzed group consisted mostly of men (n=72). The age of respondents ranged from 45 to 92 years, mean 69.9 years ± 10.8 years. Mean time from observing lesion to the first medical consultation was 7.3 months and to visiting our Out-Patient Clinic was 2.7 years (ranged from 3 months to 16 years). All patients were qualified to surgical excision of tumor. Histopathological verification confirmed diagnosis of malignant neoplasms in 116 patients. In question concerning causes of delay in medical consultation or treatment, all respondents answered that fear of surgical procedure was one of the reasons.Conclusions. Fear of surgical treatment is the most common cause of delay in patients' visiting doctor. In our society conviction of neoplasm spreading after surgical excision is common, especially among elderly.
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Giant epidermal cyst of the occipital area

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Antoszewski B., Pisera P., Fijałkowska M., Kasielska-Trojan A.
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vol. 85
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issue 11
666-668
EN
Epidermal cyst is the most commonly observed cutaneous tumor. It usually involves the scalp, neck, face, back, and trunk. A commonly seen epidermal cyst is usually a slow-growing tumor of a diameter of 1-2 cm. Cysts with a diameter of more than 5 cm have rarely been reported in the literature. Herein we report a case of a giant epidermal cyst localized in the scalp of the occipital area, diagnostic problems and therapeutic proceedings.
6
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Dermatoscopy as a Helpful Tool in Plastic Surgeon’s Practice – A Preliminary Study

81%
Antoszewski B., Fijałkowska M., Stabryła P., Kasielska-Trojan A.
Polish Journal of Surgery
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2015
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vol. 87
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issue 12
609-613
EN
The aim of the study was to examine the utility of dermatoscopy in plastic surgeons’ practice in pigmented and non-pigmented skin lesions management. Material and methods. The examined group consisted of 68 patients with 132 lesions (50 women and 18 men) aged from 12 to 75 years (the mean: 47.2 years ± 16.9 years), who underwent dermatoscopy. Dermatoscopic photographs were analysed according to the ABCD and 7-point scales and then, a further treatment (surgical excision, electro resection or regular follow-up and observations) was planned. Results. The mean score of all lesions according to ABCD scale was 2.34 while in 7-point scale it was 0.62. In male and female groups the number of lesions and their ABCD and 7-point scale scores were similar (p>0.05). Histopathological examination revealed that all excised lesions were benign (compound melanocytic nevi) which corresponded with dermatoscopic evaluation. Conclusions. Dermatoscopy seems to be helpful in surgeons’ dealing with skin lesions practise and in many cases it enables to choose less invasive technique of lesions’ removal (electro resection), which gives better aesthetic results.
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Long-term Results of Breast Reduction in Female-to-Male Transsexuals

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Antoszewski B., Bratoś R., Sitek A., Fijałkowska M.
Polish Journal of Surgery
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2012
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vol. 84
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issue 3
144-151
EN
Transsexualism is considered to be an extreme end in a large group of gender identity disorders. Two main types of transsexualism are identified: male-to-female (MtF) and female-to-male (FtM). Transsexual persons have a feeling of being incarcerated in a foreign body and therefore they wish to change their sex by hormone therapy and surgical treatment. Breast reduction usually is the first procedure in the process of surgical reassignment in FtM transsexual persons.The aim of this study was to evaluate the long-term results of breast reduction in FtM transsexual persons, taking into account breast size and surgical technique. The doctors' and patients' opinions about the results were also compared.Material and methods. The study was carried out in a group of 98 FtM transsexual persons treated at the Department of Plastic, Reconstructive and Aesthetic Surgery. Evaluation of the long-term results of breast reduction was performed based on clinical examination done by the doctors and a questionnaire filled in by the patients and the surgeons.Results. Good results of breast reduction were achieved in more than 60% of the examined patients operated on mainly by Webster technique.Conclusions. Clinical examination of the long-term results of breast reduction in FtM transsexual persons revealed good aesthetic effects. The doctors' and the patients' opinions were similar.
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Selected Methods of the Chest Wall Reconstruction for Sternal Dehiscence after Median Sternotomy

71%
Lewandowicz E., Iljin A., Kasielska-Trojan A., Fijałkowska M., Antoszewski B.
Polish Journal of Surgery
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2015
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vol. 86
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issue 5
230-234
EN
Dehiscence of a median sternotomy wound is a potentially devastating and life-threatening complication of cardiac procedures.Depending on the localization, extensiveness, and profoundness of the defect a variety of muscle flaps may be used to cover the frontal mediastinum, in particular: pectoralis major, rectus abdominisor latissimus dorsi. In spite of several options for restoration of sternal integrity we cannot avoid following serious local complications increasing patients morbidity. The aim of this paper is to report a method of sternal dehiscence management. Surgical technique and its results are presented on the example of two patients treated in Plastic, Reconstructive and Aesthetic Surgery Clinic, Medical University in Łódź because of sternal dehiscence after cardiovascular procedure with sternotomy. Our experience indicates that modified bilateral pectoralis major flap seems to be effective surgical method of sternal dehiscence treatment. Also it is worth to remember that surgical procedure in this complication should be performed as soon as possible to decrease patient’s disability and to avoid following complications
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