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Influence of the Classic and Laparoscopic Bariatric Operations For the Ventilation Lung Activity

100%
Świαtkowska M., Cywiński J., Hedayati M., Drozda R., Wieloch M., Kołomecki K.
Polish Journal of Surgery
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2008
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vol. 80
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issue 12
659-663
EN
The obese patient constitute the group with high perioperative risk due to more respiratory and cardiovascular disorders. The respiratory disorders deepen during postoperative period.The aim of the study was an assessment of changes in ventilation lung activity after classic and laparoscopic bariatric operations.Material and methods. For the lung activity assessment the measurement of pick expiratory flow was used before operation, in the first and third twenty-four hours after operation. Moreover, before and in the first twenty-four hours after operation a spirometry was performed. The forced vital capacity (FVC), 1 second forced expiratory volume (FEV1) and Tiffenau index (FEV1/FVC) were estimated in the study. 54 persons were included in batriatric operations. The first group was formed by the patients after vertical banded gastroplasty (VBG), the second after laparoscopic vertical banded gastroplasty (LVBG), the third one after laparoscopic adjustable gastric banding (LABG).Results. The following average results were gained: first group-PEF before operation 399 liter per minute, in the first twenty-four hours after operation 195 liter per minute and in the third twenty-four hours 282 liter per minute. FEV1 before operation 2.6 liter, in the first twenty-four hours 1.5 liter, FVC before 3.5 liter and after operation 2liter. Tiffenau index before 86%, after 85%. The second group PEF before operation 446 liter per minute, in the first twenty-four hours 326 liter per minute in the third twenty-four hours 409 liter per minute, FEV1 before 3.6 liter, after 2.6 liter, FVC before 3.9 liter, after 2.7 liter, Tiffenau index before 92%, after 96%. The third group PEF before 460 liter per minute, in the first twenty-four hours 340 liter per minute, in the third twenty-four hours 430 liter per minute, FEV1 before 3.2 liter, after 3.1 liter, FVC before 4.5 liter, after 3.6 liter, Tiffenau index before 90%, after 90%.Conclusions. The bariatric operations reduce ventilation lung activity. After classic bariatric surgery respiratory disorders are longer and become more intense. Independently of bariatric operation's method all respiratory disorders have a restrict type.
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Assesment of Inflammatory Response Intensity in Early Postoperative Period in Patients After Hernioplasty Operated on with Classic Stoppa Method and Videoscopic TEP Method

100%
Libiszewski M., Drozda R., Białecki J., Wieloch M., Hedayati M., Kuzdak K., Kołomecki K.
Polish Journal of Surgery
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2011
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vol. 83
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issue 9
497-501
EN
The aim of the study was comparison of inflammatory response intensity through estimation of CRP, IL-6 and WBC concentration in blood serum in patients before and after inguinal hernia operations with Stoppa and TEP method.Material and methods. The study involoved 117 patients operated on inguinal hernia between 2006-2008. The patients were divided into two groups. In the first group (group I - 56) Stopp'a method was used, in the second (group II - 61) TEP method. The patients selection was coincidental. All examined patients were men between 25-75 years old (mean age 54.3). Moreover, the operation's time, state of postoperative wound, the average hospitalization time and intensity of pain were estimated. The observations were directed over two weeks after operation.Results. The inflammatory response estimated with CRP, IL-6 concentration in blood serum was considerably higher in patients operated with Stoppa method. There wasn't observed a relevant difference in increase of white blood cells' concentration in both groups. Moreover, the patients operated on with TEP method experienced lower pain. In group, operated on with Stoppa method, 3 cases of wound healing complications were observed. The operation's time was considerably shorter in the first group. The hospitalization time, was considerably shorter in patients operated on with videoscopic method.Conclusions. The operation of inguinal hernia with TEP technique in comparison with Stopp'a method is connected with considerably lower inflammatory response of organism, what directly involve with postoperative pain abridgment and reduction of hospitalization time. Moreover it may have influence on frequency of postoperative complications related with wound healing.
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Videoscopic Extraperitoneal Operations of Suprarenal Glandules

84%
Kołomecki K., Hedayati M., Cywiñski J., Drozda R., Libiszewski M., Wieloch M., Kalupa J., Kuzdak K.
Polish Journal of Surgery
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2008
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vol. 80
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issue 7
371-376
EN
An adrenal tumors are a clinical problem encountered by all health care providers go into endocrinological surgery. Nowadays the videoscopic adrenalectomy gains mounting acceptance. In the adrenal operations two kinds of operative access are used: an itraperitoneal and an extraperitoneal.The aim of the study was to analyse its own material and literature in purpose to find the answer if extraperitoneal access may be acknowledged as widely used method in adrenal tumor operations.Material and methods. 68 videoscopic adrenalectomy with extraperitoneal access were made in the Surgery Department of MSWiA Hospital in Łódź, between 2005 to 2007. The time of the operation, the time of the hospitalization, intraoperative blod loose, probability of complications, number and reasons of the conversies were taken into account.Results. In all the patients was performed complete tumor resection with adrenal gland. The diameter of removed tumors was between 4-14 cm. In 23 cases (33.8%), intraoperatively, during tumor preparation, the continuity of the peritoneum was broken however it didn't have any influence for the operation's proceedings and postoperative condition of the patients. Three conversions were made (4.4%). The average time of hospitalization was about 3.1 days. There weren't observed, in the postoperative period any wound suppurations or postoperative hernias.Conclusions. The own observations in confrontation with literature let find an extraperitoneal videoscopy as method with wide application in various size and origination in adrenal tumor operations.
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