Search results

1

Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

100%

Matyja M., Strzałka M., Rembiasz K.

Polish Journal of Surgery

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2015

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vol. 87(12)

634-637

EN

It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

2

Does bile protect or damage interstitial cajal-like cells in the human gallbladder?

88%

Pasternak A., Szura M., Matyja M., Tomaszewski K. A., Matyja A.

Folia Medica Cracoviensia

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2013

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issue 4

3

Parastomal hernia – contemporary methods of treatment

88%

Skibiński R., Pasternak A., Szura M., Solecki R., Matyja M.

Polish Journal of Surgery

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2015

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vol. 87(10)

531-537

EN

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4

Number and distribution of interstitial cells of cajal in human gallbladder

76%

Pasternak A., Szura M., Mróz I., Mazur M., Matyja M., Matyja A.

Folia Medica Cracoviensia

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2014

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issue 1

5

Colonoscopy for colorectal cancer screening - is it effective in the hands of a general surgery resident?

76%

Matyja M., Pasternak A., Wysocki M., Pędziwiatr M., Szura M., Rembiasz K.

Polish Journal of Surgery

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2018

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vol. 90(5)

6-12

EN

INTRODUCTION: Colonoscopy is considered to be a gold standard for colorectal cancer (CRC) screening. Endoscopy training is an essential component of general surgery training program. Patients should receive care at the highest level possible, nevertheless residents need to gain experience. The aim of our study was to evaluate the effectiveness of colonoscopy performed by general surgery residents by comparing quality indicators between surgical trainees and consultants. MATERIALS AND METHODS: The analysis included 6384 patients aged 40–65 who underwent screening colonoscopy between October 2014 and February 2018. The patients were divided into two groups: group I – patients examined by residents, group II - patients examined by board-certified general surgeons. Quality indicators such as cecal intubation rate, adenoma detection rate and patient tolerance scale were compared between the two groups. RESULTS: Group I comprised 2268 (35.53%) and group II 4116 (64.47%) patients. The overall cecal intubation rate (CIR) was 95.99%, equal for both groups (p = 0.994). There was no statistically significant difference in adenoma detection rate: 29.30% among residents and 27.66% among consultants (p = 0.203). Patient tolerance of the examination was very good (4-point scale) in consultants group in 78.98% of cases and in 75.18% cases among residents (p < 0.001). CONCLUSION: In a proper learning environment general surgery residents are able to perform high-quality and effective screening colonoscopy. However, residents need to continue the progress in their technique to improve patient tolerance in order to reach the proficiency of a consultant.

6

Kolonoskopia w ramach Programu Badań Przesiewowych raka jelita grubego – czy może być właściwie przeprowadzona przez rezydenta chirurgii ogólnej?

76%

Matyja M., Pasternak A., Wysocki M., Pędziwiatr M., Szura M., Rembiasz K.

Polish Journal of Surgery

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2018

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vol. 90(5)

6-12

PL

WPROWADZENIE: Kolonoskopię uznaje się za złoty standard badań przesiewowych w kierunku raka jelita grubego (RJG). Trening endoskopowy jest podstawowym elementem programu specjalizacji w zakresie chirurgii ogólnej. Pacjenci powinni otrzymywać świadczenia medyczne najwyższej jakości, co nie zmienia faktu, że rezydenci muszą również nabierać doświadczenia. Celem naszego badania była ocena skuteczności kolonoskopii wykonywanych przez rezydentów chirurgii ogólnej z porównaniem wskaźników jakości pomiędzy lekarzami specjalistami i lekarzami w trakcie specjalizacji. MATERIAŁY I METODY: Analiza objęła 6384 pacjentów w wieku od 40 do 65 lat, którzy zostali poddani przesiewowemu badaniu kolonoskopowemu w okresie od października 2014 r. do lutego 2018 r. Pacjentów podzielono na dwie grupy: w grupie pierwszej pacjenci byli badani przez rezydentów, w grupie drugiej – przez specjalistów chirurgii ogólnej. Pomiędzy grupami porównano wskaźniki jakości badania, takie jak osiągalność kątnicy (cecal intubation rate, CIR), współczynnik wykrywalności gruczolaków (adenoma detection rate, ADR) i poziom tolerancji pacjenta. WYNIKI: Grupa pierwsza obejmowała 2268 (35,53%) pacjentów, a grupa druga – 4116 (64,47%). Całkowita osiągalność kątnicy (CIR) wynosiła 95,99% i była równa w obu grupach (p = 0,994). Nie stwierdzono istotnej statystycznie różnicy w wykrywalności gruczolaków (ADR), która to wynosiła 29,3% w grupie rezydentów i 27,66% w grupie specjalistów (p = 0,203). Tolerancję badania oceniono jako bardzo dobrą (w skali 4-stopniowej) w 78,98% przypadków w grupie specjalistów i 75,18% w grupie rezydentów (p < 0,001). WNIOSKI: Przy założeniu właściwego środowiska do nauki rezydenci są w stanie wykonywać wysokiej jakości przesiewowe badania kolonoskopowe, muszą jednakże stale doskonalić swoją technikę, aby zwiększyć tolerancję badania przez pacjenta i osiągnąć biegłość specjalisty.

7

Gender as a predictive factor in cholecystectomy — is it true or false?

72%

Osuch C., Dolecki M., Rogula W. P., Łapiak A., Matyja M., Czerwińska A., Rubinkiewicz M., Matyja A., Osuch C., Dolecki M., Rogula W. P., Łapiak A., Matyja M., Czerwińska A., Rubinkiewicz M., Matyja A.

Folia Medica Cracoviensia

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2020

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vol. 60

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issue 2

8

The use of the enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic surgery for colorectal cancer – a comparative analysis of patients aged above 80 and below 55

64%

Pędziwiatr M., Pisarska M., Wierdak M., Major P., Rubinkiewicz M., Kisielewski M., Matyja M., Lasek A., Budzyński A.

Polish Journal of Surgery

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2015

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vol. 87(11)

565-572

EN

Age is one of the principal risk factors for colorectal adenocarcinoma. To date, older patients were believed to achieve worse treatment results in comparison with younger patients due to reduced vital capacity. However, papers have emerged in recent years which confirm that the combination of laparoscopy and postoperative care based on the ERAS protocol improves treatment results and may be particularly beneficial also for elderly patients. The aim of the study was to compare the outcomes of laparoscopic surgery for colorectal cancer in combination with the ERAS protocol in patients aged above 80 and below 55. Material and methods. The analysis included patients aged above 80 and below 55 undergoing elective laparoscopic colorectal resection for cancer at the 2nd Department of General Surgery of the Jagiellonian University. They were divided into two groups according to their age: ≥80 years of age (group 1) and ≤55 years of age (group 2). Both groups were compared with regard to the outcome of surgery: length hospital stay, complications, hospital readmissions, degree of compliance with the ERAS protocol, and recovery parameters (tolerance of oral nutrition, mobilisation, need for opioids, restored gastrointestinal function). Results. Group 1 comprised 34 patients and group 2, 43 patients. No differences were found between both groups in terms of gender, BMI, tumour progression or surgical parameters. Older patients typically had higher ASA scores. No statistically significant differences were found with regard to the length hospital stay following surgery (5.4 vs 7 days, p=0.446481), the occurrence of complications (23.5% vs 37.2%, p=0.14579) or hospital readmissions (2.9% vs 2.4%). The degree of compliance with the ERAS protocol in group 1 and 2 was 85.2% and 83.0%, respectively (p=0.482558). Additionally, recovery parameters such as tolerance of oral nutrition (82.4% vs 72.1%, p=0.28628) and mobilisation (94.1% vs 83.7%, p=0.14510) within 24 hours of surgery did not differ among the groups. However, a smaller proportion of older patients required opioids in comparison with younger patients (26.5% vs 55.8%, p=0.00891). Conclusions. Similar levels of compliance with the ERAS protocol may be achieved among patients aged ≥80 and younger patients. When laparoscopy is combined with the ERAS protocol, age does not seem to be a significant factor that could account for worse utcomes. Therefore, older patients should not be excluded from perioperative care based on ERAS principles.

Refine search results

Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump

Does bile protect or damage interstitial cajal-like cells in the human gallbladder?

Parastomal hernia – contemporary methods of treatment

Number and distribution of interstitial cells of cajal in human gallbladder

Colonoscopy for colorectal cancer screening - is it effective in the hands of a general surgery resident?

Kolonoskopia w ramach Programu Badań Przesiewowych raka jelita grubego – czy może być właściwie przeprowadzona przez rezydenta chirurgii ogólnej?

Gender as a predictive factor in cholecystectomy — is it true or false?

The use of the enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic surgery for colorectal cancer – a comparative analysis of patients aged above 80 and below 55