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1

Intraoperative Parathyroid Hormone Level as a Predictor of Post-Thyroidectomy Hyproparathyrodism

100%

Lewandowicz M., Kuzdak K., Pasieka Z.

Polish Journal of Surgery

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2009

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vol. 81

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issue 8

340-347

EN

Hypoparathyroidism is the most common complication of thyroid surgery. Accurate treatment of this condition requires early diagnosis of patients at risk of hypocalcemia.The aim of the study was to evaluate the predictive value of intraoperative parathyroid hormone assessment in identification of affected subjects.Material and methods. Sixty five subjects participated in the prospective study. They underwent bilateral neck exploration with subtotal or total thyroidectomy. Parathormone (PTH) and calcium levels were assessed prior to surgery, intraoperatively and at different time-points following the operation.Results. In respect of the results, patients were allocated into 3 groups: (A) subjects with asymptomatic course; (B) subjects with perioperative symptomatic hypocalcemia; (C) subjects with prolonged symptomatic hypocalcemia. No differences between these groups were observed in the intraoperative calcium levels. Intraoperative parathormone (ioPTH) level was significantly lower in group C and at value minor of the reference range identified group C subjects with sensitivity and specificity of 100 and 91.5%, respectively. Mean intraoperative PTH level decrease (ΔioPTH) of 22.5% was observed. ΔioPTH rate was significantly higher (81.4%) in group C. This parameter presented sensitivity of 66.7% and specificity of 93.2% in identification of group C patients.Conclusions. Single intraoperative PTH level assessment identifies subjects at risk of postoperative hypoparathyroidism. Intraoperative drop of PTH (ΔioPTH) proves less sensitive. Intraoperative calcium levels cannot be regarded as a predictor of this complication.

2

Surgical Gloves – Do they Really Protect Us?

100%

Walczak D. A., Pawełczak D., Grobelski B., Pasieka Z.

Polish Journal of Surgery

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2015

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vol. 86

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issue 5

238-243

3

Papillary Thyroid Microcarcinoma - Own Experience

100%

Pomorski L., Pasieka Z., Kuzdak K.

Polish Journal of Surgery

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2008

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vol. 80

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issue 11

604-608

EN

Papillary thyroid microcarcinoma is a particular form of cancer of the thyroid gland. This term, according to the WHO classification, is applied to papillary tumors no larger than 1.0 cm in diameter, which are incidentally detected during the postoperative histopathological examination. In clinical practice, the term pertains to all papillary tumors of the size smaller than or equal to 1 cm.The aim of the study was to determine the prevalence of papillary thyroid microcarcinoma and its selected histopathological characteristics among patients with malignant cancer of the thyroid gland identified in our own material in the years 2000-2007.Material and methods. The study included 523 patients treated for thyroid carcinoma: 401 (76.7%) women and 122 (23.3%) men aged 12-83 years (mean 49.8 years). Surgeries were carried out according to the Polish Group for Endocrine Carcinomas recommendations, in compliance with the European consensus.Results. Papillary thyroid carcinoma was identified in the postoperative histopathological examination in 391 (74.8%) patients; 285 (72.9%) women and 106 (27.1%) men. Their age ranged from 14 to 75 years (mean 49.3 years).Among 391 cases, tumor progression classified according to the WHO criteria (3) was as follows: T1 in 260 (66.5%), T2 in 59 (15.1%), T3 in 53 (13.5%) and T4 in 19 (4.8%) patients.In 150 cases (38.4% of papillary tumors), the tumor fulfilled the morphological criteria for microcarcinoma (4) and was detected in 118 (78.7%) women and 32 (21.3%) men. Carcinoma was identified in the neutral goiter in 138 cases, and in 12 patients in hyperactive, including 9 in nodular and 3 in Graves' goiters. The disease was suspected or diagnosed preoperatively or at surgery in 112 patients. Postoperative diagnosis was performed in 38 (25.3%) individuals with micrcarcinoma. Twenty-four (38%) of 63 patients with multifocal tumors were subjected to adjunctive surgery as their cancer diagnosis was made only postoperatively in the histopathological examination. The subcapsular location of microcarcinoma was found in 78 (49.4%) cases including capsular infiltration and extracapsular invasion in 14 patients. The exact histopathological examination showed multifocality in 63 (42%) cases and involvement of the local lymph nodes in 29 (19.3%) patients. In 21 cases, the central compartment lymph nodes were involved. The presence of metastases in the central and lateral lymph node compartment was observed in 5 cases; in 3 patients skip metastases were detected in the lateral compartment on the tumor side omitting the central compartment. No patient with microcarcinoma diagnosed between the years 2000 and 2007 revealed distant metastases.Conclusions. Due to contemporary diagnostics, papillary thyroid microcarcinomas - tumors up to 1 cm - are most commonly identified cancers of the thyroid gland. High accuracy of US-guided fine-needle aspiration biopsy of high resolution permits to diagnose the majority of these tumors prior to surgery.

4

Properties Comparison of Intraperitoneal Hernia Meshes in Reconstruction of the Abdominal Wall - Animal Model Study

100%

Ławniczak P., Grobelski B., Pasieka Z.

Polish Journal of Surgery

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2011

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vol. 83

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issue 1

19-26

EN

Modern methods of hernia tension free treatment use very wide range of modern biomaterials. Most of them are used transabdominal. For the best and most convenient treatment of large hernias would be a mesh suitable for intraperitoneal use with low adhesion ability to internal organs.The aim of the study was to compare three types of intraperitoneal meshes.Material and methods. The study compared three types of intraperitoneal meshes. Sub-chronic (14 days) and chronic (90 days) macro-and microscopic examination were performed on rats (n = 69). Properties of the polypropylene mesh (PLP), Dynamesh®-iPOM and polypropylene covered with chitosan (PLP+chitosan) were evaluated and compared.Results. It has been shown that the test meshes differ slightly during the healing process.Conclusion. The PLP+chitosan mesh had the best biocompatible features of them all.

5

"There is no Smoke Without a Fire" - Surgical Smoke and The Risk Connected with It

100%

Walczak D., Grobelski B., Pasieka Z.

Polish Journal of Surgery

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2011

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vol. 83

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issue 11

634-639

6

Solid Pseudopapillary Tumor of the Pancreas in a Young Woman - Case Report

100%

Arkuszewski P., Pasieka Z., Srebrzyński A., Kuzdak K.

Polish Journal of Surgery

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2011

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vol. 83

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issue 7

389-391

EN

We report a case of pancreatic solid pseudopapillary tumor that was diagnosed in a 36-year-old female patient. This neoplasm usually occurs in young women. Solid and cystic areas form a characteristic appearance of this tumor. Surgical resection is the mainstay of treatment and is possible in the majority of cases. Neoplasm is associated with a low-grade malignancy and a very good outlook.

7

Adrenal Metastases

76%

Pomorski L., Kołomecki K., Brocki M., Pasieka Z., Kaczka K., Kuzdak K.

Polish Journal of Surgery

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2010

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vol. 82

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issue 2

95-100

EN

The aim of the study was an retrospective assessment of adrenal metastases based on the analysis of patients operated on in three surgical institutions between 2001 and 2005.Material and methods. Between 2001 and 2005 169 patients (106 females and 63 males) were treated due to adrenal tumors. The age of patients ranged between 25 and 82 years (mean 55.4± 11.8 years). All patients were routinely diagnosed by means of ultrasound, computed tomography or magnetic resonance imaging and hormonal tests such as cortisol, chromogranine A, aldosterone and natrium, potassium concentrations. Patients were surgically managed after preparation dependent on general status, tumor type and concomitant diseases. Operations were carried out using classic techniques via lumbar approach in 146 cases (86.4%) or videoscopic techniques via retroperitoneal or transperitoneal approaches (13.6%).Results. In 143 cases (84.6%) benign tumors and in 26 (15.4%)-malignant lesions were diagnosed. 16 (9.5% of all cases and 61.5% of malignant tumors) were secondary- metastases form various cancers treated previously. Adrenal metastases occurred most often in the 7th decade (43.7%), and primary site was clear cell carcinoma of the kidney (9 cases - 56.25%) and non-small cell lung cancer (4 - 25%), melanoma (2 cases - 12.5%) and rectal cancer (1 - 6.25%). During the follow-up of 1-5 years (mean 3.1 years) 12 patients died of metastatic tumors - 6 with multiple metastases and 6 with solitary adrenal metastasis. 4 patients are still alive with metastatic deposits in the adrenal glands (at the moment of adrenalectomy) - 3 with metastatic renal cancer (currently 2 without other metastases) and 1 with disseminated lung cancer.Conclusions. 1. Adrenal metastases are the most frequent malignant tumors of these glands. 2. Metastatic tumors occur most often during the 6th and 7th decades. 3. Results of treatment are not satisfactory and dependent on the extent of spread.

8

SYNTHESIS AND POTENTIAL CYTOTOXICITY EVALUATION OF CARBOXYMETHYL CHITOSAN HYDROGELS

76%

Kłosiński K. K., Girek M. K. G., Wach R. A., Czechowska-Biskup R., Arkuszewski P. T., Szymański P. B., Pasieka Z.

Progress on Chemistry and Application of Chitin and its Derivatives

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2017

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vol. 22

82-96

EN

The aim of the research was to employ radiation to produce flexible carboxymethyl chitosan (CMCS) based hydrogels of uniform structure to characterise their swelling properties and cytocompatibility for potential applications as hydrogel wound dressings. CMCS in aqueous solution was irradiated with an electron beam in the presence of a poly(ethylene glycol) diacrylate (PEGDA) macromonomer as a crosslinker, at 12 different compositions, i.e. 3–20% CMCS, 3 and 5% PEGDA. The obtained hydrogels were subjected to sol–gel analysis. The amount of insoluble fraction (up to 100%) rose with an increase in the PEGDA/polysaccharide ratio. Moreover, the equilibrium degree of swelling, ca. 15 to 200 g of water per g of gel, which was higher for lower content of crosslinker, decreased with the delivered dose, which was associated with an increase in crosslinking density. The in vitro XTT cell viability assay (murine fibroblasts, L929 cell line) showed no significant cytotoxicity of CMCS gels.

9

The Value of Scoring Systems for the Diagnosis of Acute Appendicitis

64%

Walczak D. A., Pawełczak D., Żółtaszek A., Jaguścik R., Fałek W., Czerwińska M., Ptasińska K., Trzeciak P. W., Pasieka Z.

Polish Journal of Surgery

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2015

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vol. 87

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issue 2

65-70

EN

Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis

Refine search results

Intraoperative Parathyroid Hormone Level as a Predictor of Post-Thyroidectomy Hyproparathyrodism

Surgical Gloves – Do they Really Protect Us?

Papillary Thyroid Microcarcinoma - Own Experience

Properties Comparison of Intraperitoneal Hernia Meshes in Reconstruction of the Abdominal Wall - Animal Model Study

"There is no Smoke Without a Fire" - Surgical Smoke and The Risk Connected with It

Solid Pseudopapillary Tumor of the Pancreas in a Young Woman - Case Report

Adrenal Metastases

SYNTHESIS AND POTENTIAL CYTOTOXICITY EVALUATION OF CARBOXYMETHYL CHITOSAN HYDROGELS

The Value of Scoring Systems for the Diagnosis of Acute Appendicitis