Polish Journal of Surgery最新文献

{"title":"Hemorrhoidal laser ablation procedure: a minimally invasive treatment for grades II, III, and IV using a 1470 nm diode laser","authors":"A. A. Seymen, Sehrazat Kavraal, Bilgin Ünsal Avcıoğlu, Mert Can Hoşafcı, Fatma Zehra Akkuyu, Gizem İnci, Bülend Ortaç","doi":"10.5604/01.3001.0054.4819","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4819","url":null,"abstract":"Indroduction: Hemorrhoids often cause pain, and achieving painless outcomes through surgery is challenging. Hemorrhoidal Laser Ablation, a method for treating severe hemorrhoids, has limited documentation in clinical trials. Aim: This retrospective study aimed to present our experience with Hemorrhoidal Laser Ablation in symptomatic grade II, III, and IV internal hemorrhoids and evaluate the efficacy and safety of this relatively recent technique. Material and methods: The cohort included 138 patients with symptomatic hemorrhoids who underwent Hemorrhoidal Laser Ablation at three different medical centers in 2017–2022. Patients were treated with a 1470 nm diode laser. Data were collected on clinical and perioperative characteristics and outcomes. Results: No evidence of intraoperative complications occurred. There was no rectal tenesmus or alteration of defecation habits. Early mild postoperative symptoms were observed for an average of one week after the operation. The plateau of symptom resolution and downgrading of hemorrhoid size reached approximately six months post-procedure. The shortterm recurrence rate was 0.8% within roughly a month after the laser surgery, while the long-term recurrence rate was 5% over up to five years of follow-up. The overall satisfaction rate was 95% with symptomatic relief. Conclusions: Hemorrhoidal Laser Ablation is a painless outpatient technique that does not require general anesthesia. It is an easy-to-perform, convenient, safe, and efficient modality in reducing symptoms and complications of grades II, III, and IV internal hemorrhoids. Hemorrhoidal Laser Ablation limits postoperative discomfort and allows the patient to return to daily routines quickly.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141232964","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}

{"title":"Assessment of the usefulness and effectiveness of interactive telemedicine classes in surgery – survey of polish medical students","authors":"M. Borejsza-Wysocki, Jacek Hermann, Grzegorz Wallner, Piotr Richter, Kamil Torres, Tomasz Skoczylas, Jakub Kenig, Piotr Pawałowski, Wojciech Jozefowicz, A. Bobkiewicz, Tomasz Banasiewicz","doi":"10.5604/01.3001.0054.4680","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4680","url":null,"abstract":"Assessment of the usefulness and effectiveness of interactive telemedicine classes in surgery – survey of polish medical students","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140724177","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}

{"title":"The impact of adipose fat tissue on pathogenesis of crypto-glandular anal fistula","authors":"Marcin Włodarczyk, J. Włodarczyk, Kasper Maryńczak, Anna Waśniewska-Włodarczyk, Łukasz Dziki, Jakub Fichna","doi":"10.5604/01.3001.0054.4682","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4682","url":null,"abstract":"Background: Cryptoglandular perianal fistula represents a prevalent benign anorectal condition, primarily addressed through surgical interventions, occasionally posing considerable therapeutic challenges. The associated decline in patient quality of life underscores the significance of effective management. However, the lack of a fully understood pathogenesis complicates the treatment approach. Recent research has proposed the involvement of adipose fat tissue in the inflammatory response and pathogenesis of cryptoglandular anal fistula.Methods: This study involved the characterization of serum levels of inflammatory cytokines and adipose tissue hormones. A total of 35 samples from both simple and complex cryptoglandular perianal fistula cases were collected during surgical procedures.Results: Serum levels of leptin, resistin, IL-1 and IL-8were significantly elevated in patients operated due to complex cryptoglandular perianal fistula when compared to patients with simple fistula. Adiponectin was significantly lowered in samples from complex perianal fistula in comparison to simple fistula. Conclusions: Complex perianal cryptoglandular fistula have a reduced level of antiinflammatory adipokines adiponectin and increase the level of proinflammatory resistin, leptin, IL-1 and IL-8.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140723145","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}

{"title":"The intraoperative application of indocyanine green (ICG), in breast reconstructive surgery using a latissimus dorsi flap, as a preventive factor for tissue ischemia and postoperative complications","authors":"Maja Molska, Jakub Migoń, Jerzy Kolasiński, S. Cieśla, Dawid Murawa","doi":"10.5604/01.3001.0054.4681","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4681","url":null,"abstract":"Introduction: Breast cancer is the most frequent cancer among women. Nowadays more and more women decide to undergo breast reconstruction, both using implants as well as autologous flaps. The most important factor in avoiding bad wound healing is the preservation of blood supply and good tissue perfusion. Latissimus dorsi flap is a commonly used method, mainly reserved for irradiated patients, delayed reconstruction, or salvage procedures. With damaged tissues, objectively assessing the conditions is much more difficult than in primary surgery.Aim: The aim of the study is to present the intraoperative application of ICG, in breast reconstructive surgery with a latissimus dorsi flap, as a preventive factor for tissue ischemia and postoperative complications. Materials and methods: A single-center retrospective review of the outcomes of 12 patients who underwent breast reconstruction using an LD flap, with an intraoperative assessment of flap blood supply using ICG. Patient characteristics, comorbidities, and smoking were taken into account. Results: In two cases, after an initial assessment of tissue perfusion, it was decided to resection the distal part of the flap with less blood supply. All reconstructions were successful and the wounds healed properly. None of the patients required reoperation, there were no postoperative complications or surgical site infections.Conclusion: The use of ICG in breast reconstruction with an LD flap is an important predictor of postoperative complications, especially flap necrosis and loss of reconstruction.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140725281","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}

{"title":"Analysis of risk factor for surgical site infection and other postoperative complications in patients following loop ileostomy reversal.","authors":"M. Borejsza-Wysocki, Krzysztof Szmyt, Pamela Jeske, A. Bobkiewicz, Witold Ledwosiński, Tomasz Banasiewicz, Ł. Krokowicz","doi":"10.5604/01.3001.0054.4604","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4604","url":null,"abstract":"Introduction:Loop ileostomy reversal (LIR) procedure is associated still with relatively high risk of complications. Surgical site infection (SSI) is the most common complication in this group of patients. As a result of SSI, it leads to prolonged hospital stay, delay the adjuvant therapy and increase the hospital costs. Aim of the study:The aim of the study was to analyze the risk factors for SSI in patients following loop ileostomy reversal procedure.Material and methodsA single-centre retrospective analysis was conducted in a tertiary reference center. Finally, sixty five patients following loop ileostomy reversal procedure performed between 2018 and 2022 were enrolled into the study. Data were collected retrospectively based on the available medical charts. The study group comprised of 23 women (35%) and 42 men (65%) with the mean age 48.914.5 years and the mean body mass index 24.34.9 kg/m2. The most common indication for index surgery was ulcerative colitis (33%) and colorectal cancer (29%). Preferably, handsewn anastomosis was performed (n=42; 64.6%).Results:The most important parameter evaluated in the above study was the diagnosis of surgical site infection, which was important, among others, in during hospitalization after surgery, the need for antibiotic therapy or CRP values. 9 patients (13.8%) were diagnosed with SSI during their hospital stay (more than 86% without SSI). In the group with SSI it was over 13 days compared to almost 6 days in the group without SSI (p=0.00009). The time of the procedure had a statistically significant correlation with antibiotic therapy introduction (p=0.01). The type of intestinal anastomosis had a significant impact on the operative time (p=0.0011) and the time of hospital stay after surgery (p=0.04).Conclusions:Most of the analyzed clinical factors were directly related to the impact on the duration of postoperative hospitalization. The duration of hospitalization is an independent and undeniable factor of increasing the risk of other postoperative complications and significantly increases the cost of hospitalization. Another factor that has a large clinical impact on postoperative treatment is the presence of comorbidities, which made patients more likely to develop SSI, CRP increase or the need for antibiotic therapy. An important factor was the level of CRP, the elevated value of which may be a predictor of many negative aspects in postoperative treatment.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140747644","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}

{"title":"Characteristic of Adrenal Hemorrhage. One Clinical single experience","authors":"Siavash Świeczkowski-feiz, S. Toutounchi, Piotr Kaszczewski, Ewa Krajewska, Krzysztof Celejewski, Remigiusz Gelo, R. Pogorzelski, Zbigniew Gałązka","doi":"10.5604/01.3001.0054.4570","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4570","url":null,"abstract":"Adrenal hemorrhage (AH) is a very rare and potentially life threatening disease, which may be secondary to the trauma or of and non-traumatic etiology. Aim of the study covered in the article has been to characteristic and management of adren-al Hemorrhage and shows that adrenal hemorrhage is more common than we ex-pected and clinical symptoms are not specifics.(2) This retrospective study involved 199 patients with postoperative diagnosis of adrenal hemorrhage. The factors identified as potentially causes of adrenal hemorrhage are ACC, Pheochromocy-toma and adrenal adenoma.; (3) The study group included 199 patients with post-operative diagnosis of AH. It showed that in all patients with postoperative di-agnosis were Pheochromocytoma (n=54), adrenal adenoma (n=68), Adenocar-cionma (n=17). If we look more careful for the results we can find only 30% ( n=39) patients with preoperative diagnosis of AH. This group of 39 patients was prepared for expedited surgery. In this group of patients preoperative diagnosis of Ah were Pheochromocytoma 28% (N 11), Adenocarcinoma 10% (n=4), Adrenal adenoma 23% (n=9).(4)Bleeding into adrenal tumors is still an insufficiently under-stood topic due to its unpredictability and, as you can see in our material, of varying severity. Out of 199 patients, only 30% (n=39) were prepared for surgery with a preoperative diagnosis of AH, and most of them are pheo-chromocytoma. We suggest that is very important to prepare patients with preoperative diagnosis of AH to surgery using α-adrenoreceptor antagonists.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753011","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}

{"title":"The central venous port system removal. Is it an appropriate training procedure for resident doctors? A single-center retrospective study","authors":"Patrycja Sosnowska-Sienkiewicz, Julia Ciechanowicz, Cezary Miedziarek, E. Bućko, P. Mańkowski","doi":"10.5604/01.3001.0054.4526","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4526","url":null,"abstract":"INTRODUCTIONA venous port system consists of a port chamber attached to a central catheter, which is implanted into the central venous system. The removal of the vascular port includes all items of this system. This procedure is usually simple and quick. Complications with port removal are rare but possible.The study aimed to summarize venous port removal procedures performed by pediatric surgeons.MATERIAL AND METHODSThe single-center, retrospective study was conducted on 360 pediatric patients treated during the years 2010-2022 in the Department of Pediatric Surgery, Traumatology, and Urology in Poznan.RESULTSThe port usage time before the removal ranged from 3 days to 8 years and 3 months, with an average of 22 months. The leading cause of vascular port removal was the end of treatment (78.06%). Other less frequent reasons were the infection (13.89%) and mechanical damage of the port (3.33%). There were almost no complications connected with the procedure of vascular port removal (92.2%). If the complications occurred, they included bleeding during surgery (3%), covering the vascular catheter with bone tissue of the clavicle, causing difficulties with the catheter removal from the vein (1.4%), and connected with the previous complications- prolonged clavicle pain after surgery(1.4%) and hematoma after surgery (2%).CONCLUSIONSRemoving the venous port is a safe procedure with a low risk of complications. This procedure can be considered as an appropriate training procedure for young trainees. A more extended period of use of the vascular port before its removal may be associated with more difficulties during surgery.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375302","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}

{"title":"Esophageal cancer: current status and new insights from inflammatory markers – a brief review","authors":"B. Strzelec, Piotr Paweł Chmielewski, Wojciech Kielan","doi":"10.5604/01.3001.0054.4523","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4523","url":null,"abstract":"Esophageal cancer (EC) poses a significant challenge to the healthcare system due to its profound impact on cancer-related morbidity and mortality worldwide. This malignancy ranks among the most arduous conditions confronting the surgeon. EC arises from a complex interplay of genetic predispositions and environmental factors. While the incidence of esophageal adenocarcinoma (EAC) is on the rise in the West, esophageal squamous cell carcinoma (ESCC) remains prevalent in the East. Chronic inflammation plays a pivotal role in the initiation and progression of EC. Accordingly, serum inflammatory markers, growth factors, and cytokines have been shown to be clinically useful. Thus, evaluating serum cytokine levels for EC prediction is a safe and feasible screening method. Given the aggressive nature and poor prognosis of the disease, innovative approaches to diagnosis, prognosis, and management of EC are indispensable. This review discusses the major risk factors and the current landscape of EC, with a specific focus on the potential contributions of new inflammatory markers to enhance disease management and improve patient outcomes.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374146","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}

{"title":"Does large parathyroid adenomas increase risk of severe hypercalcemia?","authors":"Monika Kaszczewska, W. Chudziński, Joanna Kaszczewska, Michał Popow, Jakub Grzybowski, Magdalena Bogdańska, Anna Skowrońska-Szcześniak, Herbert Kozubek, Michał Elwertowski, Oskar Gąsiorowski, Zbigniew Gałązka","doi":"10.5604/01.3001.0054.4440","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4440","url":null,"abstract":"(1) Background: Primary hyperparathyroidism (PHPT) is mainly caused by parathyroid adenoma (PA). Rare variants of PA, weighing >2,0-3,5g are called “large” or “giant” adenomas and account for about 1,5% of all PA. The purpose of this study was to compare normal sized and large parathyroid lesions identifying risk factors for severe hypercalcemia; (2) Methods: 27 patients with PHPT and parathyroid lesion ≥2,0cm3 (study group) were compared with 73 patients with PHPT and lesion <2,0cm3 (control group). In both groups majority were women (81,5%-study group, 90,5%-control group, gender ratios 9,4:1 and 4,4:1 respectively). The patients were examined preoperatively and postoperatively: PTH, creatine, calcium and phosphate serum and urine concentrations and calcidiol serum levels were assessed. Preoperatively ultrasonography (US) was performed. (3) Results: Patients with larger parathyroid lesions had signifficantly higher PTH and calcium serum concentration and lower serum phosphate and calcidiol concentration. There were no statistically significant differences in the concentration of creatine in serum and urine, calciuria and tubular reabsorption of phosphorus (TRP). US relatively underestimated the parathyroid volume of about 0,3-0,4ml (10% in larger lesions and 43% in smaller ones); (4) Conclusions: Due to higher PTH and calcium levels, larger parathyroid adenomas may be the higher risk of severe hypercalcemia. US underestimated in general parathyroid volume.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226227","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}

{"title":"X-ray-guided self-expandable metal stent (SEMS) implantation in oesophageal malingnancy as a alternative possibility of treatment","authors":"M. Sznapka, Bartłomiej Stasiów, Krzysztof Ziaja, Jerzy Chudek","doi":"10.5604/01.3001.0054.0954","DOIUrl":"https://doi.org/10.5604/01.3001.0054.0954","url":null,"abstract":"Significant dysphagia, aspiration pneumonia, and impossible oral nutrition in patients with unresectable or recurrent gastroesophageal malignancy or bronchial cancer invading the oesophagus with a tracheoesophageal fistula lead to cachexia. Dehiscence of the esophago-jejunal or gastroesophageal anastomosis may cause severe oesophageal haemorrhage. We believe that X-ray guided oesophageal stent implantation (SEMS) is an alternative palliative method for microjejunostomy or full parenteral nutrition.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456505","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}