Search results

1

New Technologies in Surgery: Diagnosis and Treatment of Complications of Mivat (Minimally Invasive Video-Assisted Thyroidectomy)

100%

Miccoli P., Materazzi G., Berti P.

Polish Journal of Surgery

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2008

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vol. 80

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issue 9

435-440

EN

The aim of the study was to present evolution of the technique of minimally invasive video-assisted thyroidectomy, its advantages, limitations and possible complications related to the method.Material and methods. Minimally invasive video-assisted thyroidectomy (MIVAT) is characterized by a unique central incision of 1.5 cm, 2 cm above the sternal notch. The operative space is maintained by means of an external retraction: no gas insufflation is utilized. Potential complications of Minimally Invasive Video-assisted Thyroidectomy (MIVAT) are roughly the same as in open surgery.Results. Since June 1998 to March 2008 1524 patients underwent a minimally invasive video-assisted thyroidectomy. Complications were represented by transient monolateral recurrent nerve palsy in 38 cases (2.4%), definitive monolateral recurrent nerve palsy in 18 cases (1.1%), bilateral transient recurrent nerve palsy in 2 cases. Fifty five patients exhibited a hypoparathyroidism, which corresponds to 5.1% of the 1059 total thyroidectomies performed, but only 5 complained of a permanent hypocalcemia which necessitated a substitutive therapy, thus reducing the rate of permanent hypoparathyroidism to 0.4%. We registered in two cases of postoperative bleeding requiring re-operation; wound sepsis occurred in three cases.Conclusions. MIVAT unlike other minimally invasive endoscopic techniques proposed for thyroidectomy, reproduces the standard operation and does not introduce any modification of the traditional technique and in our series total complication rate resulted similar to that described in literature for standard thyroidectomy in large series. As long as these criteria are carefully respected one need not to be concerned that these techniques might increase the complication rate.

2

The Effect of Time-to-Surgery on Outcome in Elderly Patients with Proximal Femoral Fractures

100%

Smektala R., Dasch B., Endres H., Lungenhausen M., Mayer C., Bonnaire F., Trampisch H.-J., Pientka L.

Polish Journal of Surgery

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2007

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vol. 79

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issue 2

98-105

EN

There is a controversial debate about whether early surgical treatment of elderly patients with hip fractures yields health benefits.Material and methods. In a prospective observational study of the care provided to hip fracture patients in Germany, the association between time-to-surgery and the frequency of postoperative complications and mortality was examined. The study was conducted between January 2002 and September 2003. We analyzed the data of patients aged 65 and older who underwent surgical treatment for isolated proximal femoral fractures (femoral neck fractures or pertrochanteric femoral fractures). The incidences of postoperative pneumonia, thrombosis or embolism, urinary tract infections, decubitus ulcers, and mortality (in-hospital mortality, one-year mortality) were compared in patients receiving early (≤ 24 h) and late (> 24 h) surgery.Results. Clinical data on 2325 hip patients was available for analysis. The mean age of the study participants was 83.2±7.4; 80.3% of the patients were women. Comparison between patients with early (n=631) and late (n=1694) surgery did not show any statistically significant differences in the frequency of postoperative pneumonia, thrombosis/embolism or urinary tract infections (≤ 24 h vs > 24 h; 2.5% vs 3.9%, p=0.11; 0.79% vs 0.89%, p=0.83; 7.8% vs 9%, p=0.33). However, we did observe that fewer patients undergoing early surgery developed postoperative decubitus ulcers than those undergoing late surgery (1.9% vs 0.6%, p=0.02). A significant relationship between time-to-surgery and in-hospital mortality and/or one-year mortality could not be demonstrated statistically (≤ 24 h vs > 24 h; 3.3% vs 3.5%, p=0.80; 12.5% vs 13.8%, p=0.41).Conclusions. In the present study, a statistically significant association between time-to-surgery and mortality could not be proven. Early surgical treatment, i.e. within 24 hours, significantly reduces the decubitus ulcer rate. This study confirms that elderly patients with femoral fractures in the hip region require surgical treatment within 24 hours.

3

Orthodontic Treatment – Complications and Preventive Measures

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Zarzycka-Kogut K., Pucek M., Szymańska J.

Polish Journal of Public Health

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2015

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vol. 124

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issue 2

103-106

EN

Orthodontic treatment aims at restoring correct occlusion and chewing function and improving the aesthetics of the dentition and facial esthetics of the patient. During treatment complications may occur. Most frequently observed complications have been described in the paper. There role of the orthodontist in the therapeutic process and the principles on which doctor- patient cooperation should be based in order to achieve a therapeutic success have been presented. Particular emphasis has been put to the importance of prevention of dental caries and periodontal diseases in orthodontic patients.

4

Interstitial pneumonia during treatment with rituximab

80%

Leś D., Polakiewicz-Gilowska A., Kaleta B., Starzyczny-Słota D., Nowara E.

OncoReview

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2015

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vol. 5

|

issue 1

A16-A20

EN

Rituximab (RTX) is a chimeric anti-CD20 antibody. It plays an important role in the treatment of B-cell lymphomas and diseases of autoaggression. RTX-induced lung disease is a rare entity, which should be considered in those patients treated with RTX who present with pulmonary disorders with no clear evidence of infection. A 37-year-old woman suffering from CD20-positive DLBCL (diffuse large B-cell lymphoma) received two cycles of the R-CHOP (RTX, cyclophosphamide, doxorubicin, vincristine and prednisone) regimen. After the second cycle of immunochemotherapy, symptoms of interstitial pneumonia occurred. Having excluded all the other causes, it was diagnosed as a complication associated with the administration of RTX.

5

Hypocalcemia After Thyroid Surgery Single-Center Experience Based on 987 Patients Operated on for Various Thyroid Diseases Within One Year

80%

Cichoń W., Konturek A., Anielski R., Barczyński M., Gierada A., Orlicki P., Cichoń S.

Polish Journal of Surgery

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2007

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vol. 79

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issue 7

475-481

EN

The aim of the study was to compare the extent of surgery in removal of thyroid tissue and serum calcium values postoperatively.Material and methods. Between January 1 and December 31, 2005, 987 patients were operated on at our department due to various thyroid disorders. Patients with anaplastic, medullary and high-stage highly-differentiated (TNM>T3, N0, M0) thyroid carcinomas, as well as reoperated individuals, were excluded from the investigation. The patients were divided into three groups, depending on their serum calcium values; thus, the authors distinguished groups with mild (2.0-2.19 mmol/l), moderate (1.8-1.99 mmol/l) and severe hypocalcemia (<1.8 mmol/l). Differences between the groups were assessed by statistical methods (the t-Student's test and the X2 test - the STATISTICA software). The value of p<0.05 was accepted as statistically significant.Results. Of 987 surgical patients, 63 (6.4%) were found to have symptomatic or asymptomatic hypocalcemia. The group included 61 females and two males, their mean age being 50.1±12 years. The intensity of clinical symptoms of hypoparathyroidism was positively correlated with serum calcium values and the said symptoms were most clearly seen in patients classified as belonging to group 3 (Ca<1.8 mmol/l). The most common surgically treated thyroid disease was non-toxic nodular goiter. Hypocalcemia was the most frequent finding in patients operated on due to thyroid carcinoma. In all patients with a mild form of hypocalcemia, the onset of clinical symptoms occurred on postoperative day 2. As it follows from the analysis, there were no statistically significant differences in hypocalcemia prevalence between patients subjected to bilateral exposure of the thyroid lobes and subtotal vs. total thyroidectomy (6 (6.1%) vs 24 (7.1%) patients). On the other hand, a statistically significant difference between the lower prevalence rate of hypocalcemia in unilateral procedures (p<0.001) as compared to bilateral neck explorations (4 (1.4%) vs 59 (8.4%) patients) seems to be logical and physiologically justified. In addition, an element that was found to affect the level of calcium deficit was the number of parathyroid glands identified "in situ". Hence, the prevalence of hypocalcemia increased with a decrease in the number of identified parathyroids (p<0.05). In hypocalcemic patients, hospitalization time ranged from 3 to 11 days, with a mean time of 5.3 days as compared to 3 days in patients without complications. Six months after the surgery and pharmacotherapy, no clinical and biochemical signs of hypocalcemia were noted in the above described group.Conclusions. The risk of hypocalcemia following thyroid surgery is higher in bilateral neck explorations. There are no statistically significant differences in postoperative hypocalcemia between patients subjected to bilateral subtotal vs. total thyroidectomies.

6

Splenic abscess with bleeding in a female patient following coronary artery bypass grafting and cholecystectomy – a case report and literature review

80%

Juszczak M., Szopińsk J., Szambelan M.

Polish Journal of Surgery

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2016

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vol. 88(6)

346-349

EN

Splenic abscess is a potential complication of many disease entities which involve infections. Diagnostics are based on imaging studies. Treatment involves splenectomy and antibiotic therapy. In the case the abscess is limited, and particularly in young patients, percutaneous abscess drainage may be performed. This paper presents a case of a 66-year old female patient following coronary artery bypass grafting (CABG) complicated with sternum infection and cholecystectomy due to gallbladder abscess complicated with surgical site infection, who underwent long-term treatment in the ICU due to respiratory failure and persistent septic condition. Splenic abscess is a rare complication of abdominal cavity diseases and systemic infections.

7

Severe vascular complications of acute pancreatiti

80%

Głuszek S., Nawacki Ł., Matykiewicz J., Kot M., Kuchinka J.

Polish Journal of Surgery

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2015

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vol. 87(10)

485-490

EN

Acute pancreatitis (AP) develops as a result of the imbalance of the mechanisms inhibiting the activity of enzymes in the pancreatic cells, which causes their autoactivation in the pancreas. The incidence of AP ranges from 10 up to 100 cases per 100,000 population per year in different parts of the world. The overall mortality rate for acute pancreatitis is 10- 15%. The mortality rate in patients diagnosed with the severe form of acute pancreatitis is up to 30- 40%. Material and methods. The study included 10 patients treated due to acute pancreatitis in two surgical departments run by one of the authors (S.G.) in the years 2004-2014, who developed a serious complication in the form of haemorrhage into the inflammatory tumour/pancreatic cyst or an adjacent organ. Haemorrhage was diagnosed based on the clinical picture, most often a sudden drop in blood pressure, peritonitis symptoms and imaging findings – abdominal ultrasound and abdominal computed tomography. Therapeutic methods included conservative treatment, endovascular embolisation and, in the absence of efficacy of the above mentioned methods, surgical treatment. Patients age and gender, the etiological factor, comorbidities, Atlanta Classification, treatment outcomes and mortality rate were assessed. Results. Alcohol was the most common etiological factor in the investigated AP cases. The patients received conservative treatment, interventional radiology treatment (endovascular embolisation) or surgical treatment. In the study group, 6 patients required surgical treatment, 3 patients received invasive radiology treatment, and conservative treatment was used in one patient. The mortality rate in the study group was 30%. Conclusions. Haemorrhages into the inflammatory cisterns or adjacent organs (stomach, transverse colon mesentery) secondary to AP are the most severe complications, which are difficult to manage. The successful use of interventional radiology methods to inhibit and prevent the recurrence of bleeding in some of the patients is a significant milestone.

8

Post-laryngectomy pharyngocutaneous fistula a still topical clinical problem

80%

Betlejewski S., Szymańska-Skrzypek A.

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vol. 61(3)

271-279

EN

Background. Pharyngocutaneous fistula following laryngectomy is a serious complication, and its incidence varies from 4% to 65%. The study’s objective was to determine the incidence of post laryngectomy fistulas in patients operated in our department to establish whether specific factors predispose to fistula formation. Methods. A retrospective study was performed in 573 patients who underwent laryngectomy. Results. Between 1989 and 1999, 835 cases of laryngeal carcinoma were diagnosed, 690 were treated surgically, 573 of them underwent laryngectomy in our department. Of these patients, 545 (95,1%) had total laryngectomy, while 28 (4,9%) partial laryngectomy. In 538 cases the laryngectomy was combined with radical or functional neck dissection. The presence of early postoperative fistula was established in 65 of the 573 patients (11,3%). Our study could not verify reports that any specific factors were significantly related to fistula formation, the only factors that did show statistical significance were the preoperative patient’s general health status and the kind of postoperative antibiotic therapy. Conclusions. On the base of literature review, the authors compare results obtained in the last decade of the 20 century with results obtained earlier. Although the incidence of post-laryngectomy pharyngocutaneous fistulas decreased in comparison with the fistula rate observed earlier, the problem is still unresolved, and the fistulae remain a serious complication of larynx oncology surgery.

9

Acute cholecystitis in patients with diabetes mellitus - systematic review

80%

Łącka M., Spychalski P., Dobrzycka M., Rostkowska O., Kobiela J.

European Journal of Translational and Clinical Medicine

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2019

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vol. 2

|

issue 2

71-79

EN

Introduction According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes Results Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

10

Comparison of Early Results of Surgical Treatment in Patients with Pancreatic Cancer

80%

Śmigielski J., Piskorz Ł., Kutwin L., Brocki M.

Polish Journal of Surgery

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2012

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vol. 84

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issue 1

1-5

EN

Pancreatic tumours are a serious medical and social issue. Patients come to the doctor too late, when the disease is well advanced. The most frequently applied method of surgical treatment is pancreatoduodenectomy (Whipple procedure). The most frequently used technique of pancreatoduodenectomy is the Child-Waugh method. The procedure can be performed in a classic way or as modified by Traverso (with preservation of the pylorus).Material and methods. Between August 2008 and June 2011, in the Department of Thoracic, General and Oncologic Surgery of Medical University in Łódź, a total of 79 patients with pancreatic tumours were hospitalized. In 61, pancreatoduodenectomy was performed. The patients were divided into two groups, depending on the diagnosis and the procedures performed: group 1 comprised patients in whom the pylorus was resected (n = 43); group 2 comprised patients in whom the pylorus was preserved (Traverso-Longmire procedure; n = 18).Results. Mean duration of surgery was about 3 hours and 50 minutes in both groups. Mean duration of hospitalization after the procedure was 15.6 days in group 1 and 12.2 days in group 2 (p < 0.05). Early complications (within 30 days of the procedure) were observed in 33.2% of patients in both groups. Blood transfusion was necessary in 21% of patients in group 1 and 28% of patients in group 2 (p>0.05).Conclusions. There are specific indications for each method of surgical treatment, however, it seems that both techniques of pancreatic resection can be recommended as standard surgical treatment, and the number of complications after both procedures is similar.

11

A Midgut Malrotation with Entire Small Bowel Necrosis

80%

Łukasiewicz A., Nawrocka E., Molski S.

Polish Journal of Surgery

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2009

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vol. 81

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issue 9

405-409

EN

A case of previously undiagnosed midgut malrotation with bowel torsion and subsequent total small bowel necrosis in adult is described. Curative resection saved patient's life. In short discussion, diagnostic and management pitfalls of late clinical presentation of midgut malrotation are described.

12

Pulmonary Sequestration - Analysis of Diagnostic and Therapeutic Difficulties

80%

Hauer J., Alchimowicz J., Harazda M., Pankowski J., Kużdżał J., Zieliński M., Grodzki T.

Polish Journal of Surgery

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2007

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vol. 79

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issue 1

24-28

EN

The aim of the study was to review the clinical characteristics of operated patients with respect to pulmonary sequestration and analyze diagnostic and therapeutic problems connected with this anomaly.Material and methods. We performed a retrospective analysis of 23 patients operated on because of pulmonary sequestration between 1963 and 2004 in the Departments of Thoracic Surgery in Zakopane (10 patients) and Szczecin-Zdunowo (13 patients).Results. The study group comprised 8 men and 15 women and the mean age was 28 years. 15 patients (65.2%) presented with clinical symptoms such as coughing, fever and chest pain. Preoperatively, pulmonary sequestration was suspected in 5 patients. Amongst the remaining patients, the preoperative diagnosis was lung cancer (9 patients), metastasis from testicular neoplasms (n=1), emphysematous bullae (n=2), pulmonary cyst (n=4), bronchiectasis (n=1) and lung abscess (n=1). None of the patients were subjected to arteriography and 6 patients underwent contrast-enhanced computer tomography examination, although it did not lead to a proper diagnosis. We found 20 intralobar sequestrations and 3 extralobar sequestrations, which were situated above the diaphragm. There were 11 sequestrations on the right side and 12 on the left side. The operations performed included: lobectomy (14 patients), segmentectomy 1+2 (n=1), wedge resection (n=3), sequestrectomy (n=3), lower bilobectomy (n=1), and middle lobectomy (n=1). Blood supply from the thoracic aorta was found in 17 patients and the abdominal aorta in the remaining 6 patients. In 5 patients, the pulmonary sequestration was supplied by more than one artery. Complications included hemorrhage from supplying arteries in 8 patients and phrenic nerve palsy in one patient. One patient required mechanical ventilation after the operation. There was no further morbidity and mortality. Distant surgical results were good.Conclusions. 1. Pulmonary sequestration in adults is difficult to diagnose before the operation, even with a detailed computer tomography examination. 2. Intralobar sequestration is much more common (87%) than extralobar and is often situated in the basal segments with comparable incidence on the right and left sides. 3. The greatest danger during the operation is major bleeding from the supplying artery. 4. Prognosis after the operation is favorable.

13

Intraoperative neuromonitoring of hypogastric plexus branches during surgery for rectal cancer – preliminary report

80%

Wałęga P., Romaniszyn M., Wałęga M., Szymon Świrta J., Nowak W.

Polish Journal of Surgery

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2017

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vol. 89(2)

69-72

EN

Aim: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. Materials and methods: We qualified 4 patients (2 women, 2 men; age 42 – 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery. Moreover, we inserted a standard, 18FR Foley’s urinary catheter to which a T-tube was connected to allow urine outflow and measurement of pressure changes in the bladder induced by detrusor contractions during stimulation. Results: Setting up neuromonitoring prolonged surgery time by 30 to 40 minutes, or even by 60 to 80 minutes in the case of the first two patients. Neuromonitoring itself took additional 20 to 30 minutes during surgery. In all patients, we stimulated branches of the inferior hypogastric plexus in their anatomical position during dissection. In three patients, we evoked responses both from the bladder and the sphincter in all planes of stimulation. In one patient, there was no response from the left side of the bladder, and in the same patient, we observed symptoms of neurogenic bladder. Conclusions: Based on the available literature and our own experience, we state that monitoring of bladder pressure and electromyographic signals from rectal sphincters enables visualization and preservation of autonomic nervous system structures, both sympathetic and parasympathetic. Intraoperative signals seem to be correlated with clinical presentation and functional examinations after surgery. In order to objectify our results, it is necessary to perform functional examinations before and after surgery in a larger group of patients.

14

Surgical complications of intra-articular calcaneal fracture treatment

80%

Golec P., Tomaszewski K., Nowak S., Dudkiewicz Z.

Medical Rehabilitation

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2016

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vol. 20(2)

25-30

PL

Wstęp: Autorzy pracy prezentują zarejestrowane w materiale własnym powikłania leczenia operacyjnego złamań stawowych kości piętowej z wykorzystaniem różnego rodzaju materiałów zespalających. Materiały i metody: Analizowanymi technikami operacyjnymi były zespolenie Westhuesa oraz jego modyfikacja z dodatkową stabilizacją odłamów kostnych drutami Kirschnera, a także przezskórna stabilizacja sposobem Rąpały. Materiał badań obejmuje lata od 1990 do 2012 roku, a stanowi go 82 operowanych, w tym 68 mężczyzn (83%) i 14 kobiet (17%). Analizowane złamania kości piętowej klasyfi kowano w oparciu o podział Essex-Lopresti. Wyniki: Autorzy pracy zwracają uwagę, że najczęściej rejestrowanymi powikłaniami leczenia operacyjnego złamań stawowych kości piętowej w obserwacji wczesnej są powikłania zakrzepowo-zatorowe oraz miejscowy odczyn zapalny skóry w miejscu wprowadzenia do kości materiału zespalającego, a w obserwacji odległej zespół pozakrzepowy i zaburzenia algodystrofi czne. Wnioski: Czynnikami sprzyjającymi występowaniu tych powikłań jest morfologia samego złamania, zespolenie odłamów kostnych nadmierną liczbą elementów materiału zespalającego oraz długotrwałe unieruchomienie kończyny operowanej.

EN

Introduction: The authors present complications following surgical treatment of intra-articular calcaneus fractures, in regards to the surgical technique employed, based on their own clinical material. Materials and methods: The techniques analyzed included the Westhues’ technique and its modifi cation with additional bone stabilization by Kirschner wires and the percutaneous stabilization by Rapala. The research material covered the years from 1990 to 2012 and consists of 82 operated patients - 68 men (83%) and 14 women (17%). Analyzed calcaneus fractures were divided using the Essex-Lopresti classifi cation. Results: The authors of the article indicate that the most frequently registered complications of surgical treatment of intra-articular calcaneus fractures in early observation were thromboembolic complications and local infl ammatory reactions of the skin at the point of incision and placing the stabilizing material. During the long-term follow-up, the post-thrombotic syndrome and algodystrophic disorders were the most common. Conclusions: Factors contributing to the occurrence of the complications registered were fracture morphology, fixation of bone fragments by an excessive number of stabilizing materials and prolonged immobilization of the operated limb. Cite this article as: Golec P., Tomaszewski K.A., Nowak S., Dudkiewicz Z. Surgical complications of intra-articular calcaneal fracture treatment. Med Rehabil 2016; 20(2): 25-30.

15

Laparoscopic Treatment of Abdominal Hernia – 5 Years of Experience

80%

Litarski A., Pawełczyk J., Majcherek J., Janczak D., Pawłowski L., Rucińska Z., Janczak D.

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vol. 86

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issue 8

353-358

EN

Laparoscopic surgery has become a well approved method of abdominal hernias treatment in recent years. Due to the advancement of laparoscopy and the use of improved synthetic materials laparoscopic surgery is characterized not only by low complication but also by a short period of recovery after surgery. The aim of the study was a retrospective analysis of the results of laparoscopic abdominal hernia surgeries (IPOM). Material and methods. Between year 2007 and 2012, 65 patients aged between 29 to 76 underwent laproscopic abdominal hernia surgeries due to either primary or postoperative abdominal hernias. All patients were examined in perioperative period, after 12 and 24 months after surgery in search of complications, pain and reccurence. Recovery period was also estimated. Results. In most cases postoperative pain was estimated from 1 to 4 on VAS scale. The most frequent complications were seromas that occured in 3 patients. The other complications were pneumothorax, wound hematoma and wound infection that occured once each. One patient required reoperation due to wound hematoma. Chronic postoperative pain was diagnosed in 3 patients and 4 recurrences were stated. Conclusions. Laparoscopic therapy of abdominal hernias is a safe operative method characterized by low recurrence and complication rates as well as short hospital stay and quick recovery. This technique is restricted by high material costs and the lack of full refund for the procedure.

16

Multiple colon perforation as a fatal complication during treatment of metastatic melanoma with ipilimumab – case report

80%

Dilling P., Walczak J., Pikiel P., Kruszewski W. J.

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vol. 86

|

issue 2

94-96

EN

Ipilimumab, an anticancer drug, is an anti-CTLA4 monoclonal antibody. It is used in treatment of disseminated melanoma. Therapy is associated with high risk of complications. One of the most serious, although one of the rarest is perforation of gastrointestinal tract. In this case report we describe a 52-year old male, with disseminated melanoma with unknown starting point, treated with anti- CTLA4 monoclonal antibody. After 3rd dose of drug administration, bloody diarrhea and acute abdominal pain occurred as a symptom of gastrointestinal perforation. A single perforation was sutured during laparotomy. Symptoms of acute abdomen returned after 10 days. Pus-faecalperitonitis, symptoms of necro-hemorrhagic colitis and multilocal perforation of the colon were found during relaparotomy. Pancolectomy with end ileostomy was performed. Few hours since relaparotomy pacient died due to multiple organ failure. The purpose of this case report is to draw attention to a risk of multilocal colon perforation in patient treated with ipilumumab.

17

Major vascular injury during laparoscopy

80%

Paśnik B., Modrzejewski A.

|

EN

Major Vascular injury during laparoscopy is most deadly complication of laparoscopy. This report is review major vascular injuries based on surgeon’s relation and literature. The incidence of MVI is 0,04–0,1%. Extremely important is to learn proper technique of insuflation. According to patient’s physique surgeon should consider best technique of insuflation, take caution against slim people, and induct implements with proper angle. We should avoid excesive force during trocar and Verres’s needle insertion, we also should avoid redundant movement after Verres needle is inserted in abdomen cavity. Elevation of the anterior abdominal wall at the time of Veress or primary trocar insertion is routinely recomended. Major vascular injury is seriously underestimated problem of laparoscopic operations.

18

Two-stage Reimplantation in Infected Total Knee Arthroplasty by Using Resterilized Femoral and Tibial Components with a New Polyethylene Insert: Report of 4 Cases with at Least 15 Years’ Follow-up

80%

Öztürk A., Çevik N., Akalın Y., Çetin O., Avci Ö., Kaya A. Ö.

|

EN

Background. This study evaluates 15 years’ results of the implantation of autoclaved femoral and tibial prosthesis components together with a new same brand polyethylene insert which were used as a temporary articulating spacer in patients with periprosthetic infection of total knee arthroplasty (TKA) in a two-stage reimplantation procedure in 6 patients. Material and methods. The femoral and tibial prostheses of 6 patients with deep chronic periprosthetic infection of TKA who underwent elective two-stage exchange arthroplasty were autoclaved and reinserted with a new polyethylene insert of the same brand and bone cement mixed with tecoplanin in 2004. Results. Four patients were followed for 15 years. They were all female and between 47-70 years old. The infectious agent was meticillin-resistant Staphylococcus aureus (MRSA) in 3 and coagulase negative Staphylococcus in one patient. Patients were invited for second stage reimplantation, but they refused to undergo the second stage. Three of them had their second stage reimplantation after 15, 13 and 10 years while one patient was reinfected after 5 years, in 2009, and arthrodesis was performed. They were all happy with the result and infection free at last follow-up. Conclusions. 1. Regarding the results of our patients, reinsertion of autoclaved femoral and tibial prostheses together with a new same brand polyethylene insert with teicoplanin loaded bone cement can be used cautiously in the management of periprosthetic deep infection of TKA. 2. That is because patients might not want the second stage reimplantation. 3. We believe that the refusal of patients to undergo the surgery shows that the single-stage treatment is effective.

19

Predictive factors of complications post intracranial meningioma surgery leading to early unplanned reoperations — a single center study

80%

Kwinta B. M., Krzyżewski R. M., Kliś K. M., Dragan M. M., Donicz P., Gackowska M., Stachura K., Moskała M.

Folia Medica Cracoviensia

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2018

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vol. 58

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issue 2

20

Acute cholecystitis in patients with diabetes mellitus - systematic review

80%

Łącka M., Spychalski P., Dobrzycka M., Rostkowska O., Kobiela J.

European Journal of Translational and Clinical Medicine

|

2020

|

vol. 2

|

issue 2

71-79

EN

Introduction: According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods: This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes. Results: Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions: Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.

Refine search results

New Technologies in Surgery: Diagnosis and Treatment of Complications of Mivat (Minimally Invasive Video-Assisted Thyroidectomy)

The Effect of Time-to-Surgery on Outcome in Elderly Patients with Proximal Femoral Fractures

Orthodontic Treatment – Complications and Preventive Measures

Interstitial pneumonia during treatment with rituximab

Hypocalcemia After Thyroid Surgery Single-Center Experience Based on 987 Patients Operated on for Various Thyroid Diseases Within One Year

Splenic abscess with bleeding in a female patient following coronary artery bypass grafting and cholecystectomy – a case report and literature review

Severe vascular complications of acute pancreatiti

Post-laryngectomy pharyngocutaneous fistula a still topical clinical problem

Acute cholecystitis in patients with diabetes mellitus - systematic review

Comparison of Early Results of Surgical Treatment in Patients with Pancreatic Cancer

A Midgut Malrotation with Entire Small Bowel Necrosis

Pulmonary Sequestration - Analysis of Diagnostic and Therapeutic Difficulties