Search results

1

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.

2

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.

3

Surgical Treatment of Meckel's Diverticulum

80%

Arkuszewski P., Kuzdak K.

Polish Journal of Surgery

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2010

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vol. 82

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issue 6

329-336

EN

The aim of the study. Assessment of own research material associated with surgical treatment of Meckel's diverticulum (MD).Material and methods. Retrospective analysis of medical records of 27 patients managed in the Department of Endocrine and General Surgery of Medical University in Łódź between 1st October 2002 and 31st December 2009 due to incidentally found during surgery and not producing symptoms MD and also operated on for its complications.Results. After excision of MD causing symptoms surgical complications possibly directly associated with the removal of MD were not observed. After prophylactic excision of MD such complications occurred in 2 patients (11.11%). Moreover, in this group we found one death after the operation, but it was not attributable to performed diverticulectomy and was caused by multiple coexisting diseases. In 3 of 14 prophylactically removed and macroscopically normal Meckel's diverticula the presence of reactive inflammation was diagnosed on histopathology.Conclusions. Excision of MD, both producing symptoms and incidentally found, is associated with the low risk of complications. After the recognition of acute appendicitis all identified Meckel's diverticula should be removed, even macroscopically normal, because they can present with the reactive inflammatory process. The method of MD excision depends on intraoperative diagnosis. The risk of MD-related complications may increase with age.

4

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.

5

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.

6

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.

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vol. 23(6)

411-416

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.

7

Laparoscopic Treatment of Abdominal Hernia – 5 Years of Experience

80%

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

Polish Journal of Surgery

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2015

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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.

8

Major vascular injury during laparoscopy

80%

Paśnik B., Modrzejewski A.

Polish Journal of Surgery

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2019

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vol. 91(4)

36-40

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.

9

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.

Polish Journal of Surgery

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2015

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vol. 86

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issue 2

94-96

EN

80%

Szewczak A.

Long-Term Care Nursing

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2019

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vol. 3

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issue 4

EN

Introduction Injured head injuries often leave long-term consequences in the form of permanent damage to the central nervous system and behavioral disorders. Aim The aim of this study is to present the assessment of patients treated for head injury in the context of chronic disorders. Material and method The study included 60 selectively selected patients of the hospital emergency department over 20 years after head injury. Results Among the respondents (60), 25 people, including 6 women and 19 men remained for further treatment in the hospital, 28 respondents, ie 8 women and 20 men applied for further treatment in a specialist clinic, and 7 respondents, including 1 woman and 6 men reported to see your GP for further treatment. Conclusions Patients after head injuries should be monitored for possible further post-traumatic complications by primary care physicians.

PL

Wstęp Przebyte urazy głowy często pozostawiają po sobie odległe następstwa w postaci trwałego uszkodzenia ośrodkowego układu nerwowego i zaburzeń behawioralnych. Cel Celem niniejszego opracowania jest przedstawienie oceny pacjentów opatrywanych z powodu urazu głowy w kontekście zaburzeń przewlekłych. Materiał i metody Badaniem objęto 60 wybiórczo wybranych pacjentów szpitalnego oddziału ratunkowego powyżej 20 roku życia po urazie głowy. Wyniki Wśród 60 ankietowanych 25 osób, w tym 6 kobiet i 19 mężczyzn pozostało do dalszego leczenia w szpitalu, 28 respondentów, tj. 8 kobiet i 20 mężczyzn zgłosiło się do dalszego leczenia w poradni specjalistycznej, a 7 ankietowanych, w tym 1 kobieta i 6 mężczyzn zgłosiło się do lekarza rodzinnego na dalsze leczenie. Wnioski Pacjenci po urazach głowy winni być objęci monitorowaniem ewentualnych dalszych powikłań pourazowych przez lekarzy podstawowej opieki zdrowotnej.

19

Hearing loss in patients with extracranial complications of chronic otitis media

80%

Przewoźny T., Kuczkowski J.

Polish Journal of Otolaryngology

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2017

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vol. 71

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issue 3

31-41

EN

Objective: A pure tone audiomety analysis of patients with extracranial complications of chronic suppurative otitis media (ECCSOM). Material and methods: We retrospectively analyzed audiometric data performed before treatment from 63 patients with ECCSOM (56 single, 7 multiple complications) including groups of frequencies. Results: The greatest levels of hearing loss were noted for 6 and 8 kHz (79.0 and 75.7 dBHL) and for the frequency groups high tone average (76.1 dBHL). As regards the severity of hearing impairment in pure tone average the prevalence of complications was as follows: labyrinthitis (77.8±33.6 dBHL), facial palsy (57.1±14.3 dBHL), perilymphatic fistula (53.9±19.9 dBHL) and mastoiditis (42.2±9.5 dBHL) (p=0.023). Conclusions: Hearing loss in ECCSOM is dominated by mixed, high-tone, moderate type of hearing loss, most profound in labyrinthitis. In 11% of patients the complication causes total deafness.

20

Hearing loss in patients with extracranial complications of chronic otitis media

80%

Przewoźny T., Kuczkowski J.

Otolaryngologia Polska

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2017

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vol. 71(3)

31-41

EN

Objective: A pure tone audiomety analysis of patients with extracranial complications of chronic suppurative otitis media (ECCSOM). Material and methods: We retrospectively analyzed audiometric data performed before treatment from 63 patients with ECCSOM (56 single, 7 multiple complications) including groups of frequencies. Results: The greatest levels of hearing loss were noted for 6 and 8 kHz (79.0 and 75.7 dBHL) and for the frequency groups high tone average (76.1 dBHL). As regards the severity of hearing impairment in pure tone average the prevalence of complications was as follows: labyrinthitis (77.8±33.6 dBHL), facial palsy (57.1±14.3 dBHL), perilymphatic fistula (53.9±19.9 dBHL) and mastoiditis (42.2±9.5 dBHL) (p=0.023). Conclusions: Hearing loss in ECCSOM is dominated by mixed, high-tone, moderate type of hearing loss, most profound in labyrinthitis. In 11% of patients the complication causes total deafness.

Refine search results

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

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

Surgical Treatment of Meckel's Diverticulum

Surgical complications of intra-articular calcaneal fracture treatment

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

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

Laparoscopic Treatment of Abdominal Hernia – 5 Years of Experience

Major vascular injury during laparoscopy

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

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

Acute cholecystitis in patients with diabetes mellitus - systematic review

Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Department's Own Material