Polski przeglad chirurgiczny最新文献

{"title":"Clinical Nutrition in Patients with Chronic Intestinal Failure.","authors":"Karolina Goral, Przemysław Matras","doi":"10.5604/01.3001.0055.5864","DOIUrl":"10.5604/01.3001.0055.5864","url":null,"abstract":"<p><p>Patients with chronic intestinal failure (CIF) require long-term parenteral administration of nutrients, minerals, vitamins, and water. CIF is associated with a high risk of malnutrition and sarcopenia, resulting from factors such as malabsorption, chronic inflammation, and sometimes, some case, delayed initiation of parenteral nutrition. The main goal of nutritional therapy in patients with CIF is to maintain adequate nutritional and hydration status, prevent complications arising from nutrient deficiencies, optimize quality of life, minimize the risk of complications related to parenteral nutrition (especially in patients after intestinal resections, e.g., short bowel syndrome), and aim to achieve partial or complete independence from parenteral nutrition, if the intestine retains adaptive potential. This study aims to systematise the current scientific knowledge on nutritional management in CIF patients and to determine the impact of nutritional therapy on intestinal adaptation. One of the significant challenges for the therapeutic team treating CIF patients is the assessment of gastrointestinal function. There is a lack of high-quality data from randomised clinical trials and carefully conducted clinical observations on therapeutic decision-making regarding the introduction of enteral nutrition in CIF patients.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794310","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":"Visceral artery compression syndromes.","authors":"Arkadiusz Janion, Radosław Kowalewski","doi":"10.5604/01.3001.0055.5839","DOIUrl":"10.5604/01.3001.0055.5839","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Visceral artery compression syndromes are rare diseases with ambiguous symptoms, varying between patients.&lt;b&gt;Aim:&lt;/b&gt; The aim of the paper was to review the disease&apos;s pathology, diagnosis and treatment.&lt;b&gt;Methods:&lt;/b&gt; Review based on a MEDLINE database search.&lt;b&gt;Results:&lt;/b&gt; Medial arcuate ligament syndrome (MALS) is caused by celiac trunk compression by the diaphragm&apos;s medial arcuate ligament. MALS is a diagnosis of exclusion because its symptoms are not clear-cut. Diagnostic imaging is based on Doppler ultrasound and computed tomography. Invasive treatment is aimed to decompress the celiac trunk with open, laparoscopic, or robotic methods, whereas endovascular procedures do not eliminate the disease cause. Superior mesenteric artery syndrome (SMAS) is a rare disease with symptoms resulting from compression of the duodenum between the superior mesenteric artery and the abdominal aorta. Symptoms may result from other pathologies within the abdominal cavity, therefore the diagnosis is based on exclusion of other gastrointestinal causes and on tomographic criteria. Conservative treatment is usually ineffective, while the choice of surgical methods requires individual assessment. Nutcracker syndrome (NCS) is characterized by symptoms caused by compression of the left renal vein by the superior mesenteric artery. Diagnosis is made after excluding other causes, as there are no established NCS diagnostic criteria. Doppler ultrasound and computed tomography are used in syndrome diagnosis, and its treatment should be individualized.&lt;b&gt;Conclusions:&lt;/b&gt; The compression syndromes are rare diseases that occur significantly more frequently in women. Their diagnosis and treatment are a clinical challenge. A better pathophysiology understanding and the use of minimally invasive treatment techniques can improve the patient&apos;s quality of life.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794313","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":"Treatment for full-thickness rectal prolapse using the abdominal access: An evaluation of 94 cases.","authors":"Przemysław Ciesielski, Magdalena Zaniewska, Matthias Waliszewski, Natalia Dziewa, Małgorzata Kołodziejczak","doi":"10.5604/01.3001.0055.5841","DOIUrl":"10.5604/01.3001.0055.5841","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Full-thickness rectal prolapse (FTRP) is a multifactorial disease that can be treated with different surgicaltechniques. There is still no standard surgical procedure, and the selection of the surgical technique is based on the individualassessment and the experience of the surgeon. The benefits to patients should focus on repair of bowel prolapse, reduction ofconstipation, and an improvement in pelvic floor muscle insufficiency.&lt;b&gt;Aim:&lt;/b&gt; Aim of this study was to evaluate clinical and functional outcomes after abdominal surgery for FTRP in a prospective single- -center observational study.&lt;b&gt;Materials and methods:&lt;/b&gt; Between 2016 and 2022, a total of 94 consecutive patients (46.2 18.2 years) underwent abdominal surgery due to FTRP using an abdominal approach. They were operated on with ventral mesh rectopexy (VMR) (55 pts.) or resection and suture rectopexy - Frykman-Goldberg procedure (FG) (39 pts.). Before and after the surgery, clinical and functional outcomes were measured. The follow-up period ranged from 1 to 6 years (mean: 26 months).&lt;b&gt;Results:&lt;/b&gt; At last follow-up, constipation occurred in 27.6% of VMR and 31.3% of FG patients (p = 0.754; calculated among patients with available postoperative constipation status). The Wexner incontinence score was significantly better in the VMR group (1.0 2.1 &lt;i&gt;vs.&lt;/i&gt; 3.6 5.0, p = 0.009). There were no differences in the EQ5D indices between the groups (1.7 2.0 &lt;i&gt;vs.&lt;/i&gt; 2.4 2.8, p = 0.257).&lt;b&gt;Conclusions:&lt;/b&gt; Both surgical procedures revealed comparable rates of recurrence and complications. While QoL was similarbetween groups, VMR yielded a significantly greater improvement in the Wexner incontinence score.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"8-12"},"PeriodicalIF":0.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019778","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":"Conservative treatment of abdominal organ trauma in children - a 8 year single center retrospective observation.","authors":"Milosz Saryusz-Romiszewski, Karolina Tokarska, Mateusz Zajączkowski, Emma Mróz, Bartosz Bogusz, Wojciech Górecki","doi":"10.5604/01.3001.0055.5840","DOIUrl":"10.5604/01.3001.0055.5840","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Trauma remains the leading cause of death in the pediatric population under 18 years of age. Non-operative management (NOM) has become the standard of care for hemodynamically stable pediatric patients with nonpenetrating abdominal injuries. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; This study evaluates the application of the American Pediatric Surgery Association (APSA) guidelines in a pediatric trauma center in Krakow, Poland, between 2017 and 2024. &lt;br&gt;&lt;br&gt;&lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis was conducted on 295 pediatric patients hospitalized with multi-organ injuries, including the intra-abdominal ones. The data were analyzed with respect to injury severity, hospitalization duration, and outcomes. Statistical methods included Shapiro-Wilk tests, Mann-Whitney U tests, Spearman&apos;s rho correlation, and chi-square tests. P-value of less than 0.5 was considered significant. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Conservative treatment was effective in all implemented cases, with no complications or rehospitalizations. Hospitalization duration correlated with age and presence of central nervous system (CNS) or thoracic injuries in multi-organ injuries, but not with sex or radiological American Association for the Surgery of Trauma (AAST) organ injury scales. Within abdominal organs, liver injury had the greatest impact on hospital stay length. Surgical intervention was required only in hemodynamically unstable patients or selected high-grade pancreatic injuries. Conservative management following APSA guidelines proved to be safe and effective, though concurrent injuries often prolonged hospitalization. Hospital stay length appeared to better reflect overall trauma severity than organ-specific injury grading. Imaging included eFAST (Extended Focused Assessment with Sonography in Trauma) and contrast-enhanced computed tomography (CEST); follow-up was typically conducted with standard ultrasound. No long-term complications were reported on. &lt;br&gt;&lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The application of APSA guidelines in diagnostic and therapeutic management in pediatric patients with blunt abdominal trauma is safe and effective. Nonoperative management remains the gold standard for stable pediatric abdominal trauma patients. &lt;br&gt;&lt;br&gt;&lt;b&gt;Significance for the field:&lt;/b&gt; Conservative treatment of blunt abdominal injuries in children is a safe way of patient management and needs a raised awareness, especially among non-pediatric surgeons.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 1","pages":"33-36"},"PeriodicalIF":0.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438990","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":"Prognostic value of novel serological markers in predicting postoperative complications of ileocecal resection in Crohn&apos;s disease patients.","authors":"Jakub Włodarczyk, Grzegorz Stępień, Mateusz Prusisz, Kasper Maryńczak, Inez Bilińska, Marcin Włodarczyk, Łukasz Dziki","doi":"10.5604/01.3001.0055.5120","DOIUrl":"10.5604/01.3001.0055.5120","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Crohn's disease (CD) is a chronic inflammatory bowel disease frequently necessitating surgical intervention, particularly ileocecal resection (ICR), due to complications unresponsive to medical therapy. Postoperative complications remain a significant concern, highlighting the need for reliable preoperative biomarkers to improve risk stratification.&lt;b&gt;Aim:&lt;/b&gt; This study aimed to evaluate the utility of selected serologic inflammatory markers in predicting postoperative complications and their severity in CD patients undergoing ICR.&lt;b&gt;Materials and methods:&lt;/b&gt; A retrospective analysis was conducted on 110 patients who underwent ICR for CD-related complications between 2015 and 2024. Preoperative blood parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and C-reactive protein (CRP), were analyzed in relation to postoperative complications classified by Clavien-Dindo grading and the Comprehensive Complication Index (CCI).&lt;b&gt;Results:&lt;/b&gt; Postoperative complications occurred in 46 patients (41.8%), with surgical site infection being the most common. Severe complications (Clavien-Dindo grade IV) were observed in 5 patients, with no mortality recorded. While no statistically significant associations were found between Clavien-Dindo grade and white blood cells (WBC), platelets (PLT), NLR, MPV, or CRP levels, CRP demonstrated a significant positive correlation with CCI score (p &lt; 0.05), suggesting its potential as a predictive marker for overall complication burden.&lt;b&gt;Conclusions:&lt;/b&gt; Elevated preoperative CRP levels may serve as a useful predictor of postoperative complication severity in CD patients undergoing ICR. Although other markers, such as NLR and MPV, showed trends toward association, statistical significance was not reached. Comprehensive preoperative assessment incorporating inflammatory biomarkers could enhance surgical planning and improve outcomes in this high-risk population.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"1-7"},"PeriodicalIF":0.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019796","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":"Impact of Vitamin D Levels on Clinical Outcomes in Hospitalized Burn Patients: A Systematic Review and Meta-Analysis.","authors":"Grzegorz Gryszko, Julia Nosko, Sylwia Kołpaczyńska, Joanna Zalewska-Gryszko, Artur Szewczyk, Jacek Skoczylas, Szymon Miśkiewicz, Piotr Jasek, Agnieszka Bielarska, Wojciech Jasek","doi":"10.5604/01.3001.0055.5118","DOIUrl":"10.5604/01.3001.0055.5118","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Vitamin D plays a key role in immune regulation, inflammation control, and musculoskeletal health. Patients with burn injuries are particularly vulnerable to its deficiency. Despite its importance, current clinical guidelines do not provide a clear consensus on how vitamin D should be managed in this population. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; This meta-analysis aimed to assess the clinical impact of adequate vitamin D levels or supplementation compared to vitamin D deficiency or no supplementation in patients with burns. &lt;br&gt;&lt;br&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases for studies reporting clinical outcomes in these 2 patient groups. The primary outcomes included duration of hospitalization, length of stay in burn intensive care units, mortality, and the incidence of sepsis and intubation. Subgroup analyses were performed for randomized and non-randomized studies. Statistical analysis was conducted using Cochrane's Review Manager. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Patients with sufficient vitamin D levels or those who received supplementation had significantly shorter overall hospitalization and burn intensive care unit stays. Although the difference in mortality was not statistically significant, intubation and sepsis occurred more frequently in patients with vitamin D deficiency or no supplementation. Subgroup analyses confirmed that both randomized and non-randomized studies showed a significantly reduced hospital stay in patients with adequate vitamin D status. &lt;br&gt;&lt;br&gt;&lt;b&gt;Discussion:&lt;/b&gt; The findings suggest that vitamin D management may improve clinical outcomes in burn patients and should be considered in future guidelines. &lt;br&gt;&lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Further prospective studies with larger patient populations are necessary to establish standardized treatment protocols.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"26-36"},"PeriodicalIF":0.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019785","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":"Superior mesenteric artery syndrome - case series with review of literature - \"the truth in between and the two extremes\".","authors":"Ali Humood, Manar Hassan, Ahmed Ghazi Selais, Prabu Shankar Sivagnanam, Raja Nadeem, Sameer Almobarak, Abdulmenem Abualsel, Ajaz Wani","doi":"10.5604/01.3001.0055.6728","DOIUrl":"10.5604/01.3001.0055.6728","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Superior Mesenteric Artery Syndrome (SMAS) is a rare cause of upper intestinal obstruction characterizedby varying degrees of luminal obstruction of the third duodenal part. It can present suddenly or gradually with progressivesymptoms. Diagnosis is often delayed in view of nonspecific symptoms and extensive differential diagnosis. Considerablediscrepancy exists between radiological, endoscopic, and clinical features of SMAS. Cross-sectional imaging modalitieslike contrast-enhanced computed tomography (CECT) and MRI can identify the anatomical aberrations pathognomonic ofthe syndrome, besides helping to rule out other differential diagnoses. Upper gastro-intestinal (UGI) endoscopy can aid indecision-making and can help triage patients who need an upfront surgical approach. Patients with mild symptoms and nofeatures of luminal compromise on UGI endoscopy can be offered non-surgical treatment and monitored for their response.Surgery is indicated in patients with either significant upfront luminal compromise on UGI endoscopy or in cases that fail torespond to conservative management. Multiple surgical options have been described.&lt;b&gt;Case report:&lt;/b&gt; In our case series, we present our experience with multiple cases diagnosed with SMAS. The two operated patients had quite different clinical presentations. One of the patients presented through the emergency department with features of upper gastrointestinal obstruction, whereas the other patient had chronic refractory symptoms not responding to maximal medical therapy. Both patients underwent a laparoscopic duodenojejunostomy with uneventful recovery. Three patients were chosen for conservative management and they responded well with significant improvement of their symptoms.&lt;b&gt;Conclusions:&lt;/b&gt; SMAS is a rare diagnosis. The clinical presentation is very variable, and the list of differential diagnoses is large,explaining in part the delay in appropriate treatment. A thorough evaluation is needed to rule out other conditions that canmimic SMAS. Whenever indicated, laparoscopic duodenojejunostomy offers substantial sustained relief of symptoms.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794326","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":"Enhancing Surgical Proficiency: The Role of Virtual Reality Simulators in Laparoscopic Skill Transfer.","authors":"Antoni Sierant, Karolina Wawiernia, Julia Bijok, Michal Pirozynski","doi":"10.5604/01.3001.0055.5119","DOIUrl":"https://doi.org/10.5604/01.3001.0055.5119","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Virtual reality (VR) simulators have gained recognition in medical education as an innovative tool for training laparoscopic skills. With the advancement of minimally invasive surgery (MIS), it is critical to evaluate the effectiveness of VR simulators in transferring motor and psychomotor skills to the operating room (OR).&lt;b&gt;Aim:&lt;/b&gt; This review aims to assess the evidence on the transferability of laparoscopic skills acquired through VR simulators to the OR setting, focusing on technical proficiency and patient outcomes.&lt;b&gt;Materials:&lt;/b&gt; A literature review was conducted, evaluating studies from peer-reviewed medical databases, including controlled trials and meta-analyses, to examine the impact of VR training on surgical performance.&lt;b&gt;Results:&lt;/b&gt; Numerous studies have demonstrated that VR training significantly improves technical skills such as precision, time management, and error reduction. Furthermore, randomized controlled trials confirm that surgeons trained in VR perform faster and with fewer complications than those trained with traditional methods.&lt;b&gt;Discussion:&lt;/b&gt; Despite the advantages of VR training, challenges remain, including the fidelity of haptic feedback and emotional stress replication. However, the continuous development of VR technology, incorporating artificial intelligence and augmented reality, promises to enhance the realism and educational value of simulators.&lt;b&gt;Conclusions:&lt;/b&gt; VR simulators play an essential role in modern laparoscopic training, offering a safe, effective platform for skill acquisition. The transfer of VR-trained skills to real-life surgical procedures is well supported by current evidence, suggesting that integrating VR into standard surgical curricula will improve clinical outcomes.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 2","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794197","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":"Optimizing the Nuss Technique: Modified Approaches to Pediatric Pectus Excavatum.","authors":"Michał Szostawicki, Małgorzata Kowalska, Michał Puliński, Tomasz Janowicz, Łukasz Matus, Adam Hermanowicz","doi":"10.5604/01.3001.0055.4700","DOIUrl":"10.5604/01.3001.0055.4700","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt; Pectus excavatum is the most common congenital chest wall deformity, characterized by posterior displacement of the sternum and adjacent costal cartilages. In severe cases, it can impair cardiopulmonary function and negatively affect the quality of life due to physical limitations and psychosocial distress.&lt;b&gt;Aim:&lt;/b&gt; To present current modifications of the Nuss procedure and assess their impact on the safety, postoperative outcomes, and patient comfort of surgical treatment for pectus excavatum.&lt;b&gt;Methods:&lt;/b&gt; A narrative review based on a comprehensive analysis of relevant literature was conducted, focusing on advancements and technical modifications of the original Nuss technique.&lt;b&gt;Results:&lt;/b&gt; Since its introduction in 1998, the Nuss procedure has become the standard minimally invasive approach for correcting pectus excavatum. Various modifications - such as changes in bar design, stabilization methods, use of thoracoscopy, and postoperative pain management protocols - have improved surgical outcomes and reduced complication rates. These advancements have increased the procedure's safety and patient comfort, while maintaining high correction efficacy.&lt;b&gt;Conclusions:&lt;/b&gt; The evolution of the Nuss procedure has significantly enhanced the surgical management of pectus excavatum. Ongoing refinements continue to optimize patient outcomes, making the technique safer, more comfortable, and more widely applicable across age groups.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 1","pages":"1-6"},"PeriodicalIF":0.7,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215295","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":"Characteristics of patients with abdominal and/or pelvic injuries presenting to Emergency Departments.","authors":"Andrzej Kopta, Małgorzata Sulej-Niemiec, Kacper Sumera, Carl Webster, Maciej Polak, Paweł Kukla, Miroslaw Szura","doi":"10.5604/01.3001.0055.4693","DOIUrl":"10.5604/01.3001.0055.4693","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Introduction:&lt;/b&gt; This study characterizes patients with abdominal and/or pelvic trauma admitted to Emergency Departments (EDs) in Poland, focusing on differentiating stable from unstable cases. The objective is to inform of evidence-based guidelines for managing these injuries in both critical and non-critical trauma patients. &lt;br&gt;&lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The study aims to characterize patients admitted to randomly selected Hospital Emergency Departments in Poland after abdominal and/or pelvic injury. It aims to provide evidence-based recommendations for managing abdominal and pelvic trauma. &lt;br&gt;&lt;br&gt;&lt;b&gt;Materials and methods:&lt;/b&gt; A retrospective analysis was conducted using anonymized medical records from three randomly selected EDs in Poland, representing Levels I, II, and III of the Polish Trauma Care System. Patients with abdominal and/ or pelvic trauma were identified and categorised by trauma type, injury mechanism, severity, and stability. Data were summarized using descriptive statistics, and relationships between variables were analyzed using the Chi-square or Fisher's exact test, with α = 0.05 for significance. &lt;br&gt;&lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Of 93,714 ED patients, 708 met the study criteria, with 215 confirmed cases of abdominal and/or pelvic trauma. Closed (blunt) injuries were predominant (96.3%), especially low-energy injuries among older adults. Mild trauma was most common (64.65%) according to the CRAMS scale, while severe injuries accounted for only 8.84%. A substantial proportion of patients were stable upon ED admission, with 69.3% of abdominal trauma and 100% of pelvic trauma patients exhibiting no signs of organ failure or peritoneal symptoms. The findings indicate a higher-than-expected prevalence of stable trauma cases, underscoring the need for guidelines to manage stable but potentially vulnerable patients. &lt;br&gt;&lt;br&gt;&lt;b&gt;Discussion:&lt;/b&gt; This study offers insights into the demographic and clinical characteristics of patients with abdominal and/or pelvic trauma in EDs, with a particular focus on differentiating stable from unstable trauma patients and addressing distinct clinical needs. By testing key hypotheses on trauma type, severity, and patient stability, the study brings attention to areas in trauma management that may benefit from revised protocols and resource allocation. Our findings underscore the importance of recognizing stable trauma patients as a significant but underrepresented group in trauma literature. Existing studies are often conducted in EDs located within trauma centres, which influences the patient populations represented in the literature. Additionally, a common inclusion criterion in such studies is trauma team activation or the explicit identification of unstable patients with systolic blood pressure below 90 mmHg. Research focusing on stable patients with abdominal and/ or pelvic trauma is rare and typ","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":"98 1","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215483","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}