Nowa Medycyna最新文献_第3页

Laser hemorrhoidoplasty (LHP) using a 1470 nm radial fibre laser – early efficacy assessment based on own data 1470nm径向光纤激光痔疮成形术——基于自身数据的早期疗效评估

Nowa Medycyna Pub Date : 2020-10-29 DOI: 10.25121/nm.2020.27.4.129

S. Glinkowski, D. Marcinkowska

{"title":"Laser hemorrhoidoplasty (LHP) using a 1470 nm radial fibre laser – early efficacy assessment based on own data","authors":"S. Glinkowski, D. Marcinkowska","doi":"10.25121/nm.2020.27.4.129","DOIUrl":"https://doi.org/10.25121/nm.2020.27.4.129","url":null,"abstract":"Introduction. Haemorrhoidal disease is one of the most common colorectal conditions. Although many treatment methods have been developed, Milligan-Morgan hemorrhoidectomy remains the most widely practised surgical technique. Aim. The aim of this study was to compare the effectiveness of Milligan-Morgan hemorrhoidectomy and laser hemorrhoidoplasty using a 1470 nm radial fibre laser. The following variables were analysed: procedure duration, length of procedure-related hospital stay, postoperative pain, and time to return to normal daily activities. Material and methods. The study group included 178 patients (women 45%, men 55%), including 82 patients undergoing laser hemorrhoidoplasty and 96 patients undergoing Milligan-Morgan hemorrhoidectomy. The mean age of the patients was 50 years, with the youngest patient aged 19 years and the oldest patient aged 65 years. The mean age of patients was lower in the laser hemorrhoidoplasty group (54.23 vs 45.15 years). The mean follow-up was 14 months (3-35 years). Results. The mean duration of laser hemorrhoidoplasty was shorter than that of Milligan-Morgan hemorrhoidectomy (13.9 vs. 22.3 min). There was no need for a revision surgery after laser hemorrhoidoplasty, whereas reoperation was necessary in three cases after classical hemorrhoidectomy. The mean and the shortest time of return to work was 14 and 5 days for laser hemorrhoidoplasty compared to 21 and 15 days for classical hemorrhoidectomy, respectively. Opioid analgesics were needed in 51% of patients after Milligan-Morgan hemorrhoidectomy and none of the patients after laser hemorrhoidoplasty. Conclusions. Laser hemorrhoidoplasty is an effective treatment approach in grade II-IV haemorrhoidal disease. It is associated with less pain compared to conventional hemorrhoidectomy. The duration of both the procedure itself and hospital stay is shorter after laser hemorrhoidoplasty compared to Milligan-Morgan hemorrhoidectomy. The return to normal daily activities is also faster in the first case.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132970006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proctology – an overview of new reports 肛肠学-新报告的概述

Nowa Medycyna Pub Date : 2020-10-22 DOI: 10.25121/nm.2020.27.4.151

P. Ciesielski, M. Sala, M. Kołodziejczak

{"title":"Proctology – an overview of new reports","authors":"P. Ciesielski, M. Sala, M. Kołodziejczak","doi":"10.25121/nm.2020.27.4.151","DOIUrl":"https://doi.org/10.25121/nm.2020.27.4.151","url":null,"abstract":"Every year, reports are published in medical journals to present new developments in the treatment of proctological diseases or related problems. The authors of this paper have reviewed the literature in the field of proctology spanning the last few years. A few publications have been selected and presented together with the authors’ practice-oriented comments. Research papers published in highly indexed scientific journals are subject to rigorous evaluation and review criteria, which makes them very credible. Nevertheless, there are often conflicting reports on similar or even the same surgical or pharmaceutical therapies. Time and clinical practice verify the value of these studies. The authors discuss reports on the application of chemical seton in the treatment of anal fistulas, FiXcision method in fistulectomy, outline contraindications to performing the LIFT procedure, and present the latest developments in stem cell therapy for fistulas and Botox treatment of anal fissures, as well as the application of new tools in proctological surgery. It is concluded that incorporating novel solutions into one’s own professional practice must be done with a certain amount of reserve, as their value is ultimately verified by time and distant outcomes of treatment.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133078869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Colon perforation during colonoscopy – the role of an anaesthesiologist in patient management. A case report 结肠镜检查时结肠穿孔-麻醉师在患者管理中的作用。病例报告

Nowa Medycyna Pub Date : 2020-09-01 DOI: 10.25121/nm.2020.27.3.107

Jacek Wadełek

引用次数: 0

Anaesthetic considerations for emergency laparotomy 急诊剖腹手术麻醉注意事项

Nowa Medycyna Pub Date : 2020-09-01 DOI: 10.25121/nm.2020.27.3.86

Jacek Wadełek

引用次数: 0

Fast-track cancer pathway (DiLO Card) in the diagnosis and treatment of colorectal cancer: ”Early detection saves lives” 快速癌症通路(DiLO卡)在大肠癌诊疗中的应用:“早发现，救生命”

Nowa Medycyna Pub Date : 2020-09-01 DOI: 10.25121/nm.2020.27.3.81

J. Snarska, D. Zadrożny, Jarosław Parfianowicz, R. Grabysa, M. Michalak, G. Kade

{"title":"Fast-track cancer pathway (DiLO Card) in the diagnosis and treatment of colorectal cancer: ”Early detection saves lives”","authors":"J. Snarska, D. Zadrożny, Jarosław Parfianowicz, R. Grabysa, M. Michalak, G. Kade","doi":"10.25121/nm.2020.27.3.81","DOIUrl":"https://doi.org/10.25121/nm.2020.27.3.81","url":null,"abstract":"Gastrointestinal malignancies, colorectal cancer in particular, come second in terms of incidence and mortality among all male and female neoplasms. Early detection guarantees good treatment outcomes. Endoscopy (colonoscopy) with biopsy and imaging (abdominal ultrasound and computed tomography), as well as biochemical markers should be included in the diagnostic process. Depending on the stage of colorectal cancer, combined treatment including surgery, chemotherapy and radiation therapy, is used. Therefore, not only coordinated multidisciplinary treatment, but also prompt diagnosis is important. For this reason, a fast track to diagnose and treat cancer patients, known as the DILO card, was introduced in 2015. Both, medical case conferences, whose aim is to determine further diagnostic and, in particular, therapeutic steps, and coordinators, whose role in this case cannot be overestimated, play an important role in DILO implementation. The DILO card serves as a referral to outpatient cancer clinics and departments, as well as diagnostic laboratories. Properly functioning multidisciplinary medical case conferences and combined treatment approach are the basis for establishing Centres of Competence for the Treatment of Colorectal Cancer.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129529898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Antoni Tuchendler i Leon Plocker – twórcy polskiej powojennej szkoły gastrologicznej

Nowa Medycyna Pub Date : 2020-09-01 DOI: 10.25121/nm.2020.27.3.118

M. Ciesielska, Przemysław Ciesielski

{"title":"Antoni Tuchendler i Leon Plocker – twórcy polskiej powojennej szkoły gastrologicznej","authors":"M. Ciesielska, Przemysław Ciesielski","doi":"10.25121/nm.2020.27.3.118","DOIUrl":"https://doi.org/10.25121/nm.2020.27.3.118","url":null,"abstract":"The origin of gastrology as an independent field of internal medicine began in the second half of the 19th century. The so-called “Polish gastrological school” of the first half of the 20th century was composed of, among others: Edward Korczyński, Walery Jaworski, Antoni Gluziński, Józef Wacław Grott, Ludwik Justman, Wilhelm Rubin, Anastazy Landau, Antoni Tuchendler and Leon Plockier (vel Plockier, Płocker, Płockier). Dr. Antoni Tuchendler, after graduating from the University of Dorpat, trained at the Charitè Clinic in Berlin. He worked in Warsaw and was a member of the prestigious Warsaw Medical Society. Before the outbreak of the war, Dr. Leon Plocker worked at the Czyste Jewish Hospital in Warsaw. In 1939 he took part in the defensive war and was taken prisoner by the Germans. In 1940 both doctors were forcibly relocated to the Warsaw ghetto. From 1942, Dr. Plocker hid after the so-called on the Aryan side under the false name of Konstanty Szustowski. He took part in the Warsaw Uprising as the commander of one of the field hospitals. The article is devoted to the fate of two of the above-mentioned doctors: Antoni Tuchendler and Leon Plocker. The first one dealt with the etiology and diagnosis of habitual constipation, the second focused his scientific work on issues related to the stomach cancer.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"336 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115881363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fistulotomy followed by anal sphincter reconstruction – indications, benefits and pitfalls of the method 瘘管切开术后肛门括约肌重建-适应症，优点和缺点的方法

Nowa Medycyna Pub Date : 2020-09-01 DOI: 10.25121/nm.2020.27.3.99

M. Kołodziejczak, P. Ciesielski, Maja Gorajska-Sieńko, M. Szczotko

{"title":"Fistulotomy followed by anal sphincter reconstruction – indications, benefits and pitfalls of the method","authors":"M. Kołodziejczak, P. Ciesielski, Maja Gorajska-Sieńko, M. Szczotko","doi":"10.25121/nm.2020.27.3.99","DOIUrl":"https://doi.org/10.25121/nm.2020.27.3.99","url":null,"abstract":"Fistula-in-ano is a disease which has challenged surgeons for centuries because of high postoperative complication rates including recurrences, and symptoms of postoperative gas and stool incontinence. The paper addresses the surgical method of fistula excision followed by sphincter reconstruction. The procedure is not new, but it has gained popularity in recent years. The primary indications for its use include complex high anal fistulas, posterior transsphincteric fistulas in patients with good baseline continence, and fistulas of “borderline” height, involving approximately 50% of the external sphincter mass. In cases of high and/or complex fistulas, the first stage of management is typically loose seton drainage to reduce the risk of infection. Prior to surgical intervention, it is important to assess the patient’s preoperative continence status. The paper presents the surgical technique of the intervention, outlines possible complications, and reviews the literature reporting the experiences of other authors who use the method. Fistulotomy followed by sphincter reconstruction is a bold surgical approach. It requires extensive experience in performing colorectal surgical procedures, and it is suitable for a selected group of patients. On account of possible complications including impaired postoperative gas and stool continence, the patient should receive appropriate information before surgery, and sign the surgical consent form. Fistulotomy followed by sphincter reconstruction is a good therapeutic option in patients with recurrent high anal fistulas unsuccessfully treated by other methods.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130950573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Colorectal cancer after kidney transplantation – risk factors and the need for prevention 肾移植后结直肠癌的危险因素及预防的必要性

Nowa Medycyna Pub Date : 2020-04-03 DOI: 10.25121/nm.2020.27.2.57

Łukasz Kozak, J. Janiszewski, Joanna Wozniak, Martyna Kamrowska, B. Januszko-Giergielewicz

{"title":"Colorectal cancer after kidney transplantation – risk factors and the need for prevention","authors":"Łukasz Kozak, J. Janiszewski, Joanna Wozniak, Martyna Kamrowska, B. Januszko-Giergielewicz","doi":"10.25121/nm.2020.27.2.57","DOIUrl":"https://doi.org/10.25121/nm.2020.27.2.57","url":null,"abstract":"Kidney transplantation (KT) in patients with chronic kidney disease is considered a method of renal replacement therapy offering the longest and most comfortable survival possible. Kidney transplantation reduces the risk of multiple complications associated with chronic dialysis, as well as allows patients after transplantation of this organ for full participation in family and social life. However, like any other treatment modality, kidney transplantation has its limitations. These are primarily associated with the need for chronic immunosuppressive therapy. It was shown that chronic immunosuppression increases the risk of cancer. Skin cancers are the most common immunosuppression-related neoplasms. Also, the risk of solid organ cancers is several times higher after kidney transplantation compared to the general population. Cancer is one of the leading causes of mortality in kidney graft recipients. This is due to its insidious and aggressive course in this patient population and the frequent need to modify anticancer therapy. In this paper, we discuss the increased incidence of colorectal cancer (CRC) in patients after kidney transplantation, differences in the course of the disease, as well as its potential prevention, based on the available literature and our own experience. Based on our analysis, we postulate the need for strict recommendations unified for all transplantation centres, regarding oncological surveillance for early detection of colorectal cancer in patients after kidney transplantation.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125140435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of treatment methods and outcomes for perianal abscess (PA) and fistula in ano (FIA) in infants 婴儿肛周脓肿(PA)和肛门瘘(FIA)的治疗方法及疗效分析

Nowa Medycyna Pub Date : 2020-03-30 DOI: 10.25121/nm.2020.27.2.33

M. Puliński, N. Hawryluk, W. Choiński

{"title":"Analysis of treatment methods and outcomes for perianal abscess (PA) and fistula in ano (FIA) in infants","authors":"M. Puliński, N. Hawryluk, W. Choiński","doi":"10.25121/nm.2020.27.2.33","DOIUrl":"https://doi.org/10.25121/nm.2020.27.2.33","url":null,"abstract":"Introduction. Perianal abscess (PA) is a relatively common condition in children and occurs in 0.5 to 4.3% of the infant population. In the majority of cases, it is associated with fistula in ano (FIA). Surgical treatment of FIA includes fistulectomy, fistulotomy or, rarely, cryptotomy. Aim. The aim of the study is to perform a retrospective analysis of treatment methods and outcomes for PA and FIA in infants at the Department of Paediatric Surgery and Urology of the Regional Specialised Children’s Hospital in Olsztyn, Poland, in 2014-2019. Material and methods. From January 2014 to December 2019, 44 infants with diagnosed PA and FIA were treated. The majority of patients were boys: 41 (93%) and only 3 (7%) were girls. For PA, three different treatment methods were used: incision and drainage, fistulotomy or fistulectomy. Results. Out of 44 treated infants with diagnosed PA and FIA, 29 were treated only by incision and drainage. Among them, 19 were cured. FIA was identified in 9 patients and fistulectomy or fistulotomy was performed. In this group, there was 1 recurrence, which was retreated with fistulectomy and cured. In 6 patients, PA drained spontaneously; in 3 of them there was recurrence and FIA was diagnosed during another hospital stay. There were 7 fistulotomies and 14 fistulectomies performed and their efficacy was 100 vs 93%, respectively. Conclusions. Fistulotomy is the most effective and safest method of FIA treatment in infants. In every case of perianal abscess diagnosis, a fistula in ano should be looked for.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132376147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Wide opening of the tract of horseshoe fistulas and high intersphincteric fistulas 马蹄形瘘管和高括约肌间瘘管的大开口

Nowa Medycyna Pub Date : 2020-03-01 DOI: 10.25121/nm.2020.27.1.10

P. Ciesielski, M. Kołodziejczak

{"title":"Wide opening of the tract of horseshoe fistulas and high intersphincteric fistulas","authors":"P. Ciesielski, M. Kołodziejczak","doi":"10.25121/nm.2020.27.1.10","DOIUrl":"https://doi.org/10.25121/nm.2020.27.1.10","url":null,"abstract":"Wide surgical opening of the fistulous tract is a surgical modality that has been known for a long time. Nevertheless, the method is only used on a sporadic basis, by few surgeons, owing to the large extent of postoperative wound associated with this type of surgery, and a long healing period that may be burdensome for the patient. The surgical management of horseshoe fistulas by opening the fistulous tract and thereby exposing the deep postanal space from the posterior approach, with separation of the superficial external sphincter muscle fibers, was first described by Hanley in 1965, though other surgeons also highlighted the key role of wide surgical opening and drainage of the deep postanal space. The modality is most commonly used in the treatment of horseshoe and high intersphincteric fistulas. The authors of the paper describe the method of wide opening of the fistulous tract, and outline modifications of the method reported in the literature. Transrectal ultrasound examination is recommended prior to surgery, and where the presence of high cisterns and branching is suspected, the diagnostic work-up should be extended to include pelvic MRI. The procedure is usually preceded by drainage of the main fistulous tract and branches in order to reduce infection. Various types of setons have been proposed, hence multiple modifications of the method are reported. Wide opening of the horseshoe fistula tract is an example of a bold surgical intervention, resulting in an extensive wound and associated with prolonged postoperative healing. The method represents an effective therapeutic option in patients with recurrent horseshoe fistulas involving the deep postanal space.","PeriodicalId":311146,"journal":{"name":"Nowa Medycyna","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132713999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0