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Spontaneous, idiopathic urinary bladder perforation – case report

100%
Wieloch M., Bazylińska K., Ziemniak P.
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vol. 85
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issue 12
727-729
EN
Spontaneous, idiopathic urinary bladder rupture is a very rare disease entity, which may face the problem of proper preoperative diagnosis. In many cases the medical history, physical examination, and additional tests raise false suspicion of gastrointestinal perforation. The study presented a case of a female patient with spontaneous urinary bladder perforation, paying particular attention to the diagnostic difficulties associated with the above-mentioned pathology. The aim of the study was to analyse the presence of symptoms and imaging and laboratory results observed in case of spontaneous urinary bladder rupture, as well as differentiate the above-mentioned pathology with gastrointestinal perforation. Whenever diagnosing a patient with acute peritonitis symptoms, in whom the predominating symptoms include sudden abdominal pain, peritoneal cavity fluid presence, hematuria, oliguria, and coexisting increased urea, creatinine, and potassium levels, one should consider the possibility of urinary bladder rupture.
2
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One-Day Thyroid Surgery – Is it Safe?

88%
Wieloch M., Koza P., Kuzdak K., Ziemniak P., Kołomecki K.
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vol. 85
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issue 6
317-322
EN
was to evaluate the safety of one-day thyroid surgery based on the assessment of the incidence of early postoperative complications. Material and methods. The study comprised 726 patients who underwent total thyroidectomy during the period between January, 2012 and February, 2013. The study considered the three most common thyroidectomy complications. Results. In the group of 726 patients, recurrent laryngeal nerve paralysis was observed in 22 cases, accounting for 3.07% of all patients. Postoperative bleeding was observed in 12 cases (1.65%). In 8 cases, bleeding occurred during the first 8 hours after surgery, while in the remaining four cases- 9, 12, 18, and 26 hours after surgery. The study group was divided into three subgroups, in which the concentrations of calcium and parathyroid hormone, 6 hours and 20 hours after surgery, were determined. In the first group (223 patients), only the parathyroid hormone level was determined. The decreased PTH level was associated with the appearance of tetany symptoms in 15% of cases. Amongst patients in whom the parathyroid hormone level was normal, tetany symptoms were observed in 0.5% of cases. In the second group (256 patients), only the serum calcium level was determined. Amongst patients with normal serum calcium levels, 1% of cases presented with tetany symptoms. In patients where the serum calcium level was reduced, tetany symptoms appeared in 35% of cases. In the third group (247 patients), both serum calcium and parathyroid hormone levels were determined. In the group of patients with normal, both serum calcium and parathyroid hormone levels, tetany symptoms were not observed. Amongst patients with normal serum calcium levels and decreased PTH levels on the day of surgery, tetany symptoms were observed in 25% of cases, while during the first postoperative day-37% of cases. Conclusion. One-day thyroid surgery, due to the appearance of complications cannot be regarded as a completely safe procedure.
3
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Influence of the Classic and Laparoscopic Bariatric Operations For the Ventilation Lung Activity

76%
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.
4
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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

76%
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.
5
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Videoscopic Extraperitoneal Operations of Suprarenal Glandules

64%
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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