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EN
Wide propagation of new generation of electrosurgical devices such as bipolar vessel sealing systems (eg. Thermostapler® by EMED) enabled seamless closing of blood vessels with a diameter up to 7 mm while maintaining the necessary safety margin, as well as reducing the duration of the operation. We decided to verify these reports in our material. Aim of the study was comparison of thyroid surgery performed with the electrocautery tool – Thermostapler® by EMED with surgery using classic hemostasis technique to evaluate the operative time and complications in the form of bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. Material and methods. We retrospectively analyzed 256 patients operated in the Department of General and Proctological Surgery Solec Hospital in Warsaw due to inert thyroid goitre. All patients underwent total thyroidectomy. Patients were divided into two groups. The first group consisted of 126 patients operated in 2000, using classic techniques of hemostasis. While the second group consisted of 130 patients operated in 2007-2008 with Thermostapler®. We compared duration of surgery and the incidence of postoperative complications. Results. The operative time was significantly shorter (average 18 minutes) in the second group of patients. We also recorded a statistically significant decrease in the incidence of complications in the group operated with Thermostapler. conclusions. Use of bipolar vessel sealing system in a decisive manner shortens the duration of operation. Use of bipolar vessel sealing system also enables a radical reduction in the incidence of complications rate such as bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. In the future, similar studies should be performed to assess the real costs resulting from the use Thermostapler®
EN
The “Polish Research on Gastric Cancer” project has been continued since 1986. The main aim of this project, which is a multicenter and interdisciplinary research, is enhancing the treatment results of gastric cancer patients by developing and promoting the use of optimal methods for diagnosis and treatment, both surgical as well as combined. One of the more important achievements of the project is the development and publication of a document named “Polish Consensus on Treatment of Patients with Gastric Cancer”, whose first version was published in 1998. Following versions were updated adequately to changing trends in the proceedings in patients with gastric cancer. A scientific symposium on “Polish Consensus on Treatment of Gastric Cancer – update 2016” was held in 3-4 June 2016 in Cracow. During the symposium a panel session was held during which all authors publicly presented the Consensus assumptions to be discussed further. Moreover, the already mentioned session was preceded by a correspondence as well as a working meeting in order to consolidate the position. It has to be underlined that the directions and guidelines included in the Consensus are not the arbitrarily assumed rules of conduct in a legal aspect and as such every doctor/team of doctors is entitled to make different decisions as long as they are beneficial to a patient with gastric cancer. The Consensus discusses as follows: a) recommended qualifications (stage of advancement, pathological, lymph node topography and the extent of lymphadenectomy, division of cancer of the gastroesophageal junction), b) rules for diagnostics including recommendations regarding endoscopic examination and clinical evaluation of the advancement stage, c) recommendations regarding surgical treatment (extent of resection, extent of lymphadenectomy, tactics of proceedings in cancer of the gastroesophageal junction), d) recommendations regarding combined treatment with chemotherapy or radiotherapy, e) place of endoscopic and less invasive surgery in the treatment of gastric cancer. This publication is a summary of the arrangements made in the panel session during the abovementioned scientific symposium in Cracow in 2016.
PL
Od roku 1986 kontynuowany jest projekt naukowy pt. „Polskie Badania nad Rakiem Żołądka”. Głównym celem tego projektu czyli wieloośrodkowych i interdyscyplinarnych badań jest poprawa wyników leczenia chorych na raka żołądka poprzez opracowanie i propagowanie optymalnych metod rozpoznawania i leczenia zarówno chirurgicznego, jak i skojarzonego. Jednym z ważniejszych osiągnięć projektu jest opracowanie i publikacja dokumentu pt. „Polski Konsensus w Sprawie Leczenia Chorych na Raka Żołądka”, którego pierwsza wersja została opublikowana w roku 1998. Kolejne wersje były aktualizowane adekwatnie do zmieniających się trendów w postępowaniu u chorych na raka żołądka. W Krakowie w dniach 3-4 czerwca 2016r. odbyło się sympozjum naukowe „Polski konsensus w sprawie leczenia raka żołądka – aktualizacja 2016”. W czasie sympozjum odbyła się sesja panelowa w trakcie wszyscy autorzy przedstawili publicznie założenia Konsensusu do dalszej dyskusji. Ponadto wspomniana sesja była poprzedzona zarówno dyskusją w formie korespondencji i jak i spotkaniem roboczym w celu ujednolicenia stanowiska. Należy podkreślić, że zawarte w Konsensusie wskazówki i zalecenia nie są arbitralnie przyjętymi zasadami postępowania w aspekcie prawnym a tym samym każdy lekarz/zespół lekarzy ma prawo podjęcia innych decyzji o ile będzie to korzystne dla chorego na raka żołądka. Konsensus omawia kolejno: a) zalecane kwalifikacje (stopnia zaawansowania, patologiczna, topografii węzłów chłonnych oraz zakresu wycięcia węzłów chłonnych, podziału raka połączenia przełykowo-żołądkowa) b) zasady rozpoznawania w tym zalecenia dotyczące badania endoskopowego i klinicznej oceny stopnia zaawansowania c) zalecenia dotyczące leczenia chirurgicznego (zakres resekcji, zakres limfadenektomii, taktyka postępowania w raku połączenia przełykowo-jelitowego) d) zalecenia dotyczące leczenia skojarzonego z chemioterapią lub radioterapią. e) miejsce chirurgii endoskopowej i małoinwazyjnej w leczeniu raka żołądka. Niniejsza publikacja jest podsumowaniem ustaleń sesji panelowej w trakcie wspomnianego sympozjum naukowego w Krakowie w 2016 roku.
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