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1
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Colonic Reservoirs in Patients After Rectal Resection

100%
Kruszewski W.
Polish Journal of Surgery
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2007
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vol. 79
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issue 12
790-796
2
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Laparoscopic Surgery For Colon Cancer - A Favorite Method? A Review of Literature

63%
Ciesielski M., Kruszewski W.
Polish Journal of Surgery
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2008
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vol. 80
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issue 11
633-638
3
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A One-Year Follow-Up of the Quality of Life After Stapled Hemorrhoidopexy

51%
Czarzasty W., Kruszewski W., Zieliński J., Niżnik M.
Polish Journal of Surgery
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2011
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vol. 83
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issue 4
204-211
EN
Articles presenting treatment outcomes of stapled hemorrhoidopexy are rarely based on detailed analyses of the quality of life.The aim of the study was the assessment of changes within one year of treatment in the quality of life of patients who underwent stapled hemorrhoidopexy using QLQ-C30 form (version 3).Material and methods. 120 patients with grade III and IV internal hemorrhoidal disease treated with stapled hemorrhoidopexy were enrolled in the study. They answered questions from QLQ-C30 form and were subjected to examination a day before surgery and 1 day, 7 days, 4 weeks, 6 and 12 months after surgery. Assessment included operation site inspection, pain intensity measurement in VAS scale and parameters incorporated in QLQ-C30 form evaluation.Results. The overall quality of life decreased immediately after surgery (a day after 50% vs. 60% before surgery), but rapidly improved in one week and in one month periods (60% and 80% consecutively) reaching a plateau one month after surgery. Early complications occurred in 6 patients (5%). Recurrence of the disease was not observed. Bleeding from anastomosis site and severe pain in anal area immediately post surgery as a result of improper purse-string suture placement were the main complications.Conclusions. In patients with grade III or IV hemorrhoidal disease, stapled hemorrhoidopexy ensures a rapid improvement in the quality of life after surgery to the level experienced prior to the operation. 7-day convalescence period is sufficient. After one month, the overall quality of life improves significantly and reaches a plateau.
4
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Sentinel lymph node in colorectal cancer - 5 years follow up

39%
Zielinski J., Jaworski R., Kabata P., Rzepko R., Kruszewski W., Jaskiewicz J.
Open Medicine
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2011
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vol. 6
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issue 3
271-278
EN
To assess the impact of micrometastases in sentinel and non-sentinel lymph nodes on long-term survival rates of patients treated for colorectal cancer (CRC). Data of 57 patients diagnosed with CRC and treated in the Department of Surgical Oncology in Gdansk in the years 2002–2006 were retrospectively analyzed. Clinico-histopathological data were analyzed using chi-square tests. The effect on long-time survival rates was analyzed using Kaplan-Meier survival probability estimates. Identification of the SLN was performed using the blue dye staining method. All regional lymph nodes were subject to standard histopathological examination. Additionally in 32(56.14%) patients whose nodes were found negative for metastases on standard staining further immunohistochemical analyses were performed. In the analyzed group SLNB was performed in 42(73.7%) patients with colon cancer and in 15(26.3%) with rectal cancer. Identification of the SLN was possible in 45(78.9%) patients. The sensitivity of SLNB was 33%. False negatives were found in 66%. SLNB is a feasible method in CRC patients. We presume that lack of micrometastases in the SLN and non-SLN cannot be regarded as a prognostic factor.
5
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Is Age a Risk Factor of Postoperative Complications in Colorectal Cancer?

39%
Wydra J., Kruszewski W., Jasiński W., Szajewski M., Ciesielski M., Szefel J., Walczak J.
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vol. 85
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issue 9
491-495
EN
Colorectal cancer is the most common malignant neoplasm in elderly with peak of incidence in 7. and 8. decade of life. Elderly patients with colorectal cancer more often require surgery. Advanced age of patients seems to increase the risk of postoperative complications. The aim of the study was to compare the frequency of early complications in two groups of patients: under 75 and over 75, undergoing elective colorectal cancer surgery. Material and methods. 440 consecutive adult patients subjected to colorectal cancer surgery between 08.2006 to 10.2011 in Oncological Surgery Department, Gdynia Centre of Oncology. Group A (over 75 year-of-life): 109 patients, median 79 and group B (up to 75 year-of-life): 331 patients, median 65. Patients requiring emergency surgery were excluded from the study. Postoperative 30-day mortality, anastomotic leakage, wound infection, bowel obstruction, postoperative respiratory and circulatory insufficiency were among analyzed complications. Results. Symptomatic disease was observed in 81.6% of group A and in 83% of group B. Groups A and B were comparable concerning: BMI, gender, tumor staging, rate of curative and palliative resections, and duration of hospital stay. Accompanying diseases were more common in group A (83% vs 65%; p<0.0002). Early complications occurred in 21.1% of patients from group A and in 19.9% from group B. The rate of reoperation in early perioperative period didn’t differ (6.4% vs 5.7%). Features like: age, gender, additional illnesses, tumor location and staging did not influence the occurrence of perioperative complications. Conclusions. Age itself is not a risk factor for postoperative complications in spite of higher rate of accompanying diseases in elderly.
6
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Protective Stomy as a Complement to Anterior Rectal Resection. Analysis of Authors' Material and Literature Review

33%
Kruszewski W., Jasiński W., Szajewski M., Szefel J., Kawecki K., Ciesielski M., Pikiel P., Dilling P., Warężak C.
Polish Journal of Surgery
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2011
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vol. 83
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issue 3
150-154
EN
Anastomotic leak after anterior rectal resection for cancer is one of the most dangerous complications of the procedure. Protective stomy is a way to avoid life-threatening consequences of this complication. The procedure is still under evaluation.The aim of the study was to evaluate the usefulness of forming a protective stomy as part of anterior rectal cancer resection on the basis of an analysis of the authors' material.Material and methods. In 2008 - 2009, we treated 111 patients with rectal cancer. Thirty-two of those patients received preoperative radio(chemo)therapy. Eighty-four patients (76%) underwent resection of the primary tumour. In 20 patients (24%), we performed abdominoperineal or abdominosacral resection; in 6 (7%) cases the Hartmann procedure was used and in 58 (69%) cases anterior rectal resection was performed. In 53 of 58 cases, the resections were assessed as curative and in 5 as palliative. In 18 of 58 (31%) patients, anterior resections were defined as low anterior resections. Twelve (67%) of these patients were subjected to preoperative radio(chemo)therapy. Two of 58 patients, who underwent anterior resection, had been treated by stomy creation before the radical procedure. One of them required neoadjuvant radiotherapy. In the second patient with the stomy, we restored the intestinal continuity during the primary tumour resection. Among the remaining 40 patients, only one underwent protective stomy creation during the resective procedure. This patient did not require preoperative radiotherapy.Results. We have not found any clinical indications of anastomotic leak in the analysed group of 58 patients subjected to anterior rectal resection for cancer.Conclusions. Our modest experience reaffirms our conviction that anterior rectal cancer resection does not require routine protective stomy creation, also when low anterior resection follows preoperative radiotherapy.
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