Polski przeglad chirurgiczny最新文献

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The influence of supportive therapy with a six-component myophlebotropic preparation on the reduction of symptoms in patients with symptoms of hemorrhoidal disease. 使用六成分肌注制剂进行辅助治疗对减轻痔疮患者症状的影响。
Polski przeglad chirurgiczny Pub Date : 2024-06-24 DOI: 10.5604/01.3001.0054.6443
Anna Kwiatkowska, Maciej Borejsza-Wysocki, Michał Głyda, Anna Maria Pietrzak, Marek Szczepkowski, Andrzej Organ, Tomasz Banasiewicz
{"title":"The influence of supportive therapy with a six-component myophlebotropic preparation on the reduction of symptoms in patients with symptoms of hemorrhoidal disease.","authors":"Anna Kwiatkowska, Maciej Borejsza-Wysocki, Michał Głyda, Anna Maria Pietrzak, Marek Szczepkowski, Andrzej Organ, Tomasz Banasiewicz","doi":"10.5604/01.3001.0054.6443","DOIUrl":"https://doi.org/10.5604/01.3001.0054.6443","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Hemorrhoidal disease is the most common disease treated in proctology ambulatories. Conservative treatment is the basic form of treatment for this disease. One of the elements of treatment may be preparations with myoand phlebotropic effects.&lt;b&gt;Aim:&lt;/b&gt; To assess the effect of a multi-ingredient myophlebotropic dietary supplement used as an adjunct on the rate and effectiveness of symptom relief in patients with stage II and III hemorrhoidal disease.&lt;b&gt;Material and method:&lt;/b&gt; Patients with stage II and III hemorrhoidal disease with clinical symptoms such as pain, burning, itching and bleeding were qualified for the study. The patients were divided into two groups. The control group (Group I) of 29 patients receiving standard local treatment plus placebo and the study group (Group II) of 32 patients receiving the same local treatment and a six-component myophlebotropic product. Symptoms were analyzed at the time of inclusion in the study (day 0), after 4 and 10 days of therapy. The severity of hemorrhoidal disease and the feeling of relief were assessed on the day of inclusion (W0) and after 30 days of therapy.&lt;b&gt;Results:&lt;/b&gt; There were no statistical differences between the groups in terms of disease advancement, age, gender, and duration of symptoms. Compared to the moment of inclusion in the study (W0), after 4 days (W1), after 10 days (W2) of taking the multi- -component product, there was a statistically significant improvement in the VAS scale: spontaneous pain and pain during defecation. In the qualitative assessment (yes/no), there were statistically significantly fewer cases of burning in the anus and itching. The treatment did not affect the rate of spontaneous bleeding, which was low at the beginning of the study, but significantly reduced the rate of bleeding during defecation. After 30 days of observation, it was found that the improvement in the severity of hemorrhoidal disease symptoms was significantly higher in the group using the tested preparation. Relief after a month of the study (one-question method) was noted in the group of patients receiving the tested product.&lt;b&gt;Conclusions:&lt;/b&gt; The tested six-component myophlebotropic product proved to be effective in reducing the severity of symptoms such as spontaneous pain, pain during defecation, burning/burning in the anus and bleeding during defecation. Statistical significance was demonstrated in the symptom's relief and reduction in the severity of hemorrhoidal disease.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474344","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
Mental Health, and Eating Disorders in Patients After Roux-en-Y Gastric Bypass Surgery (RYGB). 胃旁路手术 (RYGB) 术后患者的心理健康和饮食失调。
Polski przeglad chirurgiczny Pub Date : 2024-05-09 DOI: 10.5604/01.3001.0054.5209
Aleksandra Iljin, Michał Wlaźlak, Aneta Sitek, Bogusław Antoszewski, Tomasz Zieliński, Agnieszka Gmitrowicz, Paweł Kropiwnicki, Janusz Strzelczyk
{"title":"Mental Health, and Eating Disorders in Patients After Roux-en-Y Gastric Bypass Surgery (RYGB).","authors":"Aleksandra Iljin, Michał Wlaźlak, Aneta Sitek, Bogusław Antoszewski, Tomasz Zieliński, Agnieszka Gmitrowicz, Paweł Kropiwnicki, Janusz Strzelczyk","doi":"10.5604/01.3001.0054.5209","DOIUrl":"https://doi.org/10.5604/01.3001.0054.5209","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Obesity, as one of the main health problems worldwide, is associated with an increased risk of developing mental and eating disorders and negative eating habits. Bariatric surgery allows for rapid weight loss and alleviates the symptoms of concomitant diseases in obese patients.&lt;b&gt;Aim:&lt;/b&gt; Pre- and postoperative estimation of mental disorders and eating behaviors in patients after Roux-en-Y Gastric Bypass (RYGB).&lt;b&gt;Material and methods:&lt;/b&gt; Analysis of data from up to 5 years of follow-up including clinical examination and questionnaires.&lt;b&gt;Results:&lt;/b&gt; Following parameters decreased after RYGB: anxiety and hyperactivity from 32.81% to 21.88%, mood disorders - 31.25% to 20.31%, substance abuse - 40.63% to 28.13%, emotional eating - 76.56% to 29.69%, binge eating - 50% to 6.25%, night eating - 87.5% to 20.31%. Postoperative rates of: negative eating habits, daily intake of calories and sweetened beverages, flatulence, constipation, and abdominal pain decreased, while the rate of food intolerance and emesis increased.&lt;b&gt;Conclusions:&lt;/b&gt; In our patients, the occurrence of: mental and eating disorders, negative eating habits, daily calories, sweetened beverages, coffee intake decreased after weight loss (as a result of RYGB), but water, vegetables and fruit consumption increased. Lower rate of flatulence, constipation, and abdominal pain, but higher of food intolerance and emesis were also confirmed after RYGB.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560681","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
Current approach to the management of preoperative iron deficiency anemia in colorectal cancer patients: a review of literature. 当前处理结直肠癌患者术前缺铁性贫血的方法:文献综述。
Polski przeglad chirurgiczny Pub Date : 2024-05-09 DOI: 10.5604/01.3001.0054.5124
Jakub Rudzki, Mikołaj Polewka, Paulina Agopsowicz, Anna Nowak, Michał Porada, Piotr F Czempik
{"title":"Current approach to the management of preoperative iron deficiency anemia in colorectal cancer patients: a review of literature.","authors":"Jakub Rudzki, Mikołaj Polewka, Paulina Agopsowicz, Anna Nowak, Michał Porada, Piotr F Czempik","doi":"10.5604/01.3001.0054.5124","DOIUrl":"https://doi.org/10.5604/01.3001.0054.5124","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; The prevalence of preoperative anemia is the highest in the group of colorectal cancer (CRC) patients and may reach over 75%. The prevalence of anemia in CRC patients increases even further following surgery. Approximately 75-80% of anemic CRC patients present with absolute or functional iron deficiency (ID). Preoperative anemia constitutes an independent risk factor for allogeneic blood transfusion (ABT), postoperative complications, prolonged length of hospital stay, and increased mortality. ABT is itself associated with increased morbidity and mortality.&lt;b&gt;Aim:&lt;/b&gt; The aim of this review article was to present the pathophysiology and the current approach to the diagnostics and treatment of preoperative iron deficiency anemia (IDA) in CRC patients.&lt;b&gt;Material and methods:&lt;/b&gt; Extensive search of medical literature databases was performed (Pubmed, Embase). The key words that were used were as follows: CRC, colorectal surgery, ID, IDA, intravenous iron, Patient Blood Management (PBM).&lt;b&gt;Results:&lt;/b&gt; There are several laboratory parameters that can be used for IDA diagnosis, however, the simplest and most cost- -effective is reticulocyte hemoglobin equivalent (RET-He). Pathophysiologic features of IDA in CRC patients favor treatment with intravenous, as opposed to oral, iron formulations. Applying PBM strategies minimizes the exposure to ABT.&lt;b&gt;Conclusions:&lt;/b&gt; Preoperative IDA is highly prevalent among CRC patients. Preoperative anemia is an independent risk factor for ABT, increased morbidity and mortality, as well as prolonged hospital length of stay. The same negative consequences are associated with ABT. Therefore, preoperative IDA in CRC patients needs to be screened for, diagnosed, and treated before surgery. Effective treatment of preoperative IDA in CRC patients is with intravenous iron formulations. ABT should be the treatment of last resort due to the risk of negative clinical consequences, including an increased rate of cancer recurrence.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977619","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
Applicability of sodium butyrate preparations from a surgeon's and gastroenterologist's perspective. 从外科医生和胃肠病学家的角度看丁酸钠制剂的适用性。
Polski przeglad chirurgiczny Pub Date : 2024-04-30 DOI: 10.5604/01.3001.0054.4152
Anna Pietrzak, Tomasz Banasiewicz
{"title":"Applicability of sodium butyrate preparations from a surgeon's and gastroenterologist's perspective.","authors":"Anna Pietrzak, Tomasz Banasiewicz","doi":"10.5604/01.3001.0054.4152","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4152","url":null,"abstract":"<p><p>In recent years, much has been written about the possibilities of using exogenous sodium butyrate in the prevention and treatment of gastrointestinal diseases, in prehabilitation, in peri- and postoperative treatment, as well as its local application. It became possible thanks to the development of a special formulation (microencapsulation technique) enabling the delivery of unstable butyrate compounds to the large intestine, where it is used primarily as a source of energy. It also plays a key role in maintaining body homeostasis by maintaining the integrity of the intestinal epithelium and stimulating the intestinal immune system. There is growing evidence of the effectiveness of sodium butyrate in various areas of health. The following article discusses the possibilities of using microencapsulated sodium butyrate in the prevention and treatment of gastrointestinal diseases from the perspective of a gastroenterologist and gastrointestinal surgeon.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871012","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
Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) - Current literature review of diagnostics and therapy. What has changed in the management? 胃肠胰神经内分泌肿瘤(GEP-NENs)--诊断和治疗的最新文献综述。管理有何变化?
Polski przeglad chirurgiczny Pub Date : 2024-03-08 DOI: 10.5604/01.3001.0054.4169
Krzysztof Jurkiewicz, Michał Miciak, Krzysztof Kaliszewski
{"title":"Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) - Current literature review of diagnostics and therapy. What has changed in the management?","authors":"Krzysztof Jurkiewicz, Michał Miciak, Krzysztof Kaliszewski","doi":"10.5604/01.3001.0054.4169","DOIUrl":"https://doi.org/10.5604/01.3001.0054.4169","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) are malignancies originating from cells of the diffuse endocrine system. They are rare and localize in the upper and lower parts of the gastrointestinal tract and in the pancreas. Despite such a varied location, GEP-NENs are considered a common group of neoplasms due to the fact of their similar morphology and ability to secrete peptide hormones and biologically active amines. They are associated with clinical manifestations specific to the substances produced by a particular neoplasm. The classification of GEP-NENs is constantly systematized and updated based on their differentiation and grading. The development of available diagnostic and treatment methods for these tumors has made significant progress over the past 10 years and is still ongoing.&lt;b&gt;Aim:&lt;/b&gt; In the following paper, we review the diagnostics and treatment of GEP-NENs, taking into account the latest molecular, immunological, or gene-based methods. Imaging methods using markers for receptors allow for high diagnostic sensitivity&lt;b&gt;Methods:&lt;/b&gt; Medical databases were searched for the latest information. The authors also sought confirmation of the content of a particular publication in another publications, so as to present the most reliable information possible.&lt;b&gt;Results:&lt;/b&gt; Research results revealed that the diagnostics and treatment of GEP-NENs have significantly advanced in recent years. Surgical interventions, especially minimally invasive techniques, have shown efficacy in treating GEP-NENs, with specific therapies such as somatostatin analogs, chemotherapy, and peptide receptor radionuclide therapy demonstrating promising outcomes. The evolution of diagnostic methods, including imaging techniques and biomarker testing, has contributed to improved patient care and prognosis.&lt;b&gt;Conclusions:&lt;/b&gt; The increasing incidence of GEP-NENs is attributed to enhanced diagnostic capabilities rather than a rise in population prevalence. The study emphasizes the importance of ongoing research to identify specific markers for early detection and targeted therapies to further enhance the effectiveness of treating these rare and heterogeneous malignancies. The findings suggest a positive trajectory in the management of GEP-NENs, with future prospects focused on personalized and targeted treatment approaches.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977620","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
Malnutrition as an unfavorable prognostic factor after surgical treatment for metastatic colorectal cancer. 营养不良是转移性结直肠癌手术治疗后的不利预后因素。
Polski przeglad chirurgiczny Pub Date : 2024-03-05 DOI: 10.5604/01.3001.0054.2672
Michał Skroński, Natalia Olszewska, Paweł Nyckowski, Anna Ukleja, Joanna Lisowska, Maciej Słodkowski, Bruno Szczygieł
{"title":"Malnutrition as an unfavorable prognostic factor after surgical treatment for metastatic colorectal cancer.","authors":"Michał Skroński, Natalia Olszewska, Paweł Nyckowski, Anna Ukleja, Joanna Lisowska, Maciej Słodkowski, Bruno Szczygieł","doi":"10.5604/01.3001.0054.2672","DOIUrl":"https://doi.org/10.5604/01.3001.0054.2672","url":null,"abstract":"<p><p>&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Colorectal cancer (CRC) is the second-leading cause of cancer-related deaths worldwide. Distant metastases are usually located in the liver and are present in 50% of patients.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study is to evaluate changes in body composition and phase angle before and after surgical treatment of CRC liver metastases, as well as survival time and treatment costs.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; The study included 134 patients who received 174 surgeries for CRC liver metastases. Bioelectrical impedance analysis (BIA) was performed using an AKERN BIA 101 analyzer.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; BIA was performed before and after surgery. The results of tests (total body water content [TBW], body cell mass [BCM], and phase angle) showed a reduction in BCM by 2.21 kg and a statistically significant decrease in phase angle values after surgery (from 5.06 to 4.25 in women and from 5.34 to 4.76 in men). These values are below the reference range for both sexes. There was a correlation between phase angle values and muscle mass, both before (R = 0.528, p&lt;0001) and after surgery (R = 0.634, p&lt;000.1). Preoperative levels of the tumor marker CEA were elevated in more than half of the patients. The median survival time after resection of liver metastases was 37.6 months.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Discussion:&lt;/b&gt; A significant factor that increases complications, mortality, and treatment costs of cancer patients is malnutrition, which could be the earliest symptom of malignant disease.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Successful treatment of CRC requires the patients to participate in follow-up examinations and to be aware of early signs associated with recurrence (e.g., blood in the stool or weight loss). The patients' nutritional status should be monitored and recorded in a DILO card.&lt;/br&gt.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892417","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
Incidence versus treatment outcomes and survival in patients before age 40 with colorectal cancer. 40 岁以前结直肠癌患者的发病率与治疗效果和生存率。
Polski przeglad chirurgiczny Pub Date : 2024-02-28 DOI: 10.5604/01.3001.0054.2671
Edyta Laska, Piotr Richter
{"title":"Incidence versus treatment outcomes and survival in patients before age 40 with colorectal cancer.","authors":"Edyta Laska, Piotr Richter","doi":"10.5604/01.3001.0054.2671","DOIUrl":"https://doi.org/10.5604/01.3001.0054.2671","url":null,"abstract":"<p><p>&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Colorectal cancer (CRC) was the third most common cancer and the second cause of cancer deaths worldwide in 2020. Its incidence has increased dramatically in people under 50 years of age (early-onset colorectal cancer; EOCRC).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to compare two age groups of patients with colorectal cancer in terms of stage, prognostic factors, survival and incidence of recurrence.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Materials and methods:&lt;/b&gt; The study group consisted of 588 patients operated on between 1995 and 2005 at the University Hospital in Krakow in the Clinical Department of General, Oncological and Gastroenterological Surgery. A method of retrospective documentation analysis was used. Patients were divided into two age groups: up to forty years of age and between 45 and 65 years of age.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; Up to 40 years of age, stage IV colorectal cancer was diagnosed in 33.3% of patients, while between 45 and 65 years of age, it was diagnosed in 26.1%. Five-year survival differed according to tumour stage. In the two groups analysed, there was a significant difference between the survival curves (P = 0.00000). Also, comparing recurrence times in the paired group excluding cancer-independent deaths revealed a statistically significant difference between the groups (P = 0.006).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Discussion:&lt;/b&gt; The incidence of colorectal cancer has increased worldwide in young people under 50 years of age, and it is therefore recommended that the research presented here be studied, and that prognostic factors be analysed and multicentre prophylactic studies combined with health education of those at risk be encouraged. Cancer occurring in younger patients is characterized by advanced stage at diagnosis and five-year survival is lower and has a poorer prognosis. The availability is very important of early diagnosis to detect pre-cancerous and considered pre-cancerous conditions is important. This involves detecting lesions at a lower stage of the disease.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; The availability of early diagnosis to detect precancerous and considered pre-cancerous conditions is very important. This involves detecting lesions at a lower stage of the disease. Diagnosing colorectal cancer at an early stage and treating the pre-cancerous lesions will improve treatment outcomes, resulting in fewer metastases and longer survival and recurrence times.&lt;/br&gt.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474341","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
Short- and long-term predictive power of the preoperative Geriatric Assessment components in older patients undergoing cholecystectomy. 对接受胆囊切除术的老年患者进行术前老年评估的短期和长期预测能力。
Polski przeglad chirurgiczny Pub Date : 2024-02-16 DOI: 10.5604/01.3001.0054.3479
Kinga Szabat, Urszula Skorus, Kuba Kupniewski, Jakub Kenig
{"title":"Short- and long-term predictive power of the preoperative Geriatric Assessment components in older patients undergoing cholecystectomy.","authors":"Kinga Szabat, Urszula Skorus, Kuba Kupniewski, Jakub Kenig","doi":"10.5604/01.3001.0054.3479","DOIUrl":"https://doi.org/10.5604/01.3001.0054.3479","url":null,"abstract":"<p><p>&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Increasing numbers of older patients will require laparoscopic cholecystectomies. Physicians may have doubts when qualifying these patients for elective surgeries since older age is considered a risk factor for complications. Determining biological age, using a Geriatric Assessment (GA), should be the key factor in the preoperative assessment.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to determine which GA components and frailty alone are most useful for predicting postoperative outcomes in both short- and long-term follow-up.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Materials and methods:&lt;/b&gt; 219 consecutive patients aged ≥70 years underwent surgery and were followed up prospectively for 12 months. The preoperative GA consisted of functionality, physical activity, comorbidity, polypharmacotherapy, nutrition, cognition, mood, and social support domains. Logistic regression analyses were used to analyze the predictive ability of GA.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; GA, frailty, and chronological age were not predictive of major 30-day morbidity. There were significantly more overall postoperative complications in the frail group than in the fit group (21% vs 4%), with mainly minor (Clavien-Dindo I, II) and medical (16 patients; 72.7%) complications. There were no significant differences in the rate of major and surgical complications (8 patients; 36.4%) between frail and fit patients. Only frailty was a predictor of 1-year mortality odd ratio 12.17 (2.47-59.94) P = 0.002.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Performing GA before elective laparoscopic cholecystectomies seems unnecessary for the evaluation of short-term outcomes but helpful for the assessment of long-term outcomes. Laparoscopic cholecystectomy can be safely performed also in older frail patients.&lt;/br&gt.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560682","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
Substance P concentration is associated with the inflammatory response and pain perception in patients with chronic pain in peripheral artery disease. P 物质浓度与外周动脉疾病慢性疼痛患者的炎症反应和痛觉相关。
Polski przeglad chirurgiczny Pub Date : 2024-02-08 DOI: 10.5604/01.3001.0054.2682
Małgorzata Paplaczyk-Serednicka, Beata Markowska, Tomasz Gach, Paweł Bogacki, Mirosław Szura, Joanna Bonior
{"title":"Substance P concentration is associated with the inflammatory response and pain perception in patients with chronic pain in peripheral artery disease.","authors":"Małgorzata Paplaczyk-Serednicka, Beata Markowska, Tomasz Gach, Paweł Bogacki, Mirosław Szura, Joanna Bonior","doi":"10.5604/01.3001.0054.2682","DOIUrl":"10.5604/01.3001.0054.2682","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Previous studies indicate a significant role of the inflammatory response in the etiopathogenesis of peripheral artery disease (PAD) and chronic pain (CP).&lt;b&gt;Aim:&lt;/b&gt; The aim of the study was to determine the relationship between the concentration of SP and the level/concentration of inflammatory mediators (pro-inflammatory cytokines, positive and negative acute phase protein, anti-inflammatory cytokines) and pain intensity in people suffering from chronic pain (CP) in the course of PAD.&lt;b&gt;Material and methods:&lt;/b&gt; We examined 187 patients of the Department of Vascular Surgery. As many as 92 patients with PAD and CP (study group) were compared to 95 patients with PAD without CP (control group). The relationship between SP and the level/concentration of fibrinogen, C-reactive protein (CRP), antithrombin III (AT), serum albumin, interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α) and pain intensity (Numeric Rating Scale; NRS) was analyzed. Statistical analysis was performed using the R program, assuming the level of statistical significance of α = 0.05.&lt;b&gt;Results:&lt;/b&gt; Patients with CP had significantly higher levels of fibrinogen (P &lt; 0.001), CRP (P &lt; 0.001), SP (P &lt; 0.001), IL-10 (P &lt; 0.001), and lower serum albumin levels (P &lt; 0.023). Higher SP concentration was associated with higher levels of IL-10, CRP, and pain intensity. In both groups, SP concentration correlated negatively with the level of fibrinogen (P &lt; 0.001) as well as with albumin in the control group (P &lt; 0.001).&lt;b&gt;Conclusions:&lt;/b&gt; Thus, there is a relationship between the concentration of SP and fibrinogen, along with CRP, IL-10, and the intensity of pain in people suffering from CP in the course of PAD, and the level of albumin in the group without CP.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977621","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
The impact of oncological package implementation on the treatment of rectal cancer in years 2013-2019 in Poland - multicenter study. 波兰 2013-2019 年实施肿瘤治疗套餐对直肠癌治疗的影响 - 多中心研究。
Polski przeglad chirurgiczny Pub Date : 2024-02-08 DOI: 10.5604/01.3001.0054.2680
Jerzy Krzeszowiak, Radosław Pach, Piotr Richter, Zbigniew Lorenc, Andrzej Rutkowski, Kajetan Ochwat, Wojciech Zegarski, Mariusz Frączek, Antoni Szczepanik
{"title":"The impact of oncological package implementation on the treatment of rectal cancer in years 2013-2019 in Poland - multicenter study.","authors":"Jerzy Krzeszowiak, Radosław Pach, Piotr Richter, Zbigniew Lorenc, Andrzej Rutkowski, Kajetan Ochwat, Wojciech Zegarski, Mariusz Frączek, Antoni Szczepanik","doi":"10.5604/01.3001.0054.2680","DOIUrl":"10.5604/01.3001.0054.2680","url":null,"abstract":"<p><p>&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; In 2015, in Poland, the oncological package (OP) was established. This law constituted a fast track of oncological diagnosis and treatment and obligatory multidisciplinary team meetings (MDT).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to analyze the impact of OP on rectal cancer treatment.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Methods:&lt;/b&gt; The study was a multicenter, retrospective analysis of data collected from five centers. It included clinical data of patients operated on due to rectal cancer between 2013 and 2019. For most analyses, patients were categorized into three groups: 2013-2014 - before OP (A), 2015-2016 - early development of OP (B), 2017-2019 - further OP functioning (C).&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; A total of 1418 patients were included. In all time intervals, the majority of operations performed were anterior resections. There was a significantly lower local tumor stage (T) observed in subsequent time intervals, while there were no significant differences for N and M. In period C, the median of resected nodes was significantly higher than in previous periods. Four of the centers showed an increasing tendency in the use of preoperative radiotherapy. The study indicated a significant increase in the use of short-course radiotherapy (SCRT) and a decrease in the number of patients who did not receive any form of preoperative therapy in subsequent periods. In the group that should receive radiotherapy (T3/4 or N+ and M0), the use of SCRT was also significantly increasing.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; In the whole cohort, there was a significant increase in the use of preoperative radiotherapy and a decrease in the T stage, changing with the development of OP. Nevertheless, this relation is indirect and more data should be gathered for further conclusions.&lt;/br&gt.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474343","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
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