Polski przeglad chirurgiczny最新文献

{"title":"Volume of surgical interventions for benign colorectal tumors - an analysis of 3510 surgical and endoscopic resections in the single colorectal center in Poland.","authors":"Michał Spychalski,&nbsp;Marcin Włodarczyk,&nbsp;Katarzyna Winter,&nbsp;Jakub Włodarczyk,&nbsp;Igor Dąbrowski,&nbsp;Adam Dziki","doi":"10.5604/01.3001.0015.2617","DOIUrl":"https://doi.org/10.5604/01.3001.0015.2617","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer is the most frequent neoplasm of the whole gastrointestinal track. Due to screening colonoscopy program, colorectal lesions are often diagnosed at early stage. The vast majority of them are possible to remove endoscopically. However, a substantial percentage of benign lesion in Western centers are still operated. The aim of this article was to determine the percentage of surgical resections due to benign adenomas in the reference center of endoscopic submucosal dissection (ESD) and colorectal surgery in Poland.</p><p><strong>Materials and methods: </strong>Retrospective analysis of 3 510 patients operated from 2015 to 2019 in Center of Bowel Treatment in Brzeziny.</p><p><strong>Results: </strong>We have analyzed 3 510 endoscopic and surgical procedures performed in the colon: 601 ESDs; 1 002 endoscopic mucosal resections (EMRs); and 1,907 surgical resections. Out of 601 ESDs, 57 invaded the submucosa, of which 29 (4.8%) were non-therapeutic ESDs. In 5 patients, due to occurrence of post-ESD perforation, an additional surgical intervention was necessary. Out of the 1,002 EMRs, 22 cases (2.2%) were diagnosed with deeply infiltrating cancers, which required a surgery. The overall percentage of the need for surgery in the endoscopically treated patients (ESD + mucosectomy) was 3.5% (56/1 603). Among resection surgeries, 15 of them (0.8%) ended with the diagnosis of a benign lesion in the postoperative histopathological examination.</p><p><strong>Conclusions: </strong>Inclusion advanced endoscopic techniques such as ESD to routine clinical practice in colorectal centers gives clear benefits for the patients. Well defined and standardized process of qualifying for appropriate treatment allows to significantly reduce the percentage of abdominal approach surgery due to benign colorectal lesions.  .</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"11-19"},"PeriodicalIF":0.6,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40379751","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":"A new criterion to predict recurrence after laparoscopic ventral hernia repair: mesh/defect area ratio.","authors":"Ramazan Kozan,&nbsp;Ahmet Ziya Anadol,&nbsp;Mustafa Sare","doi":"10.5604/01.3001.0015.0237","DOIUrl":"https://doi.org/10.5604/01.3001.0015.0237","url":null,"abstract":"<p><p>&lt;b&gt;Introduction:&lt;/b&gt;Minimizing recurrence in hernia surgery is one of the major aims. Defining surgeon-dependent risk factors for recurrence is therefore of great importance in laparoscopic ventral hernia repair (LVHR). This study aims to analyze the predictive value of the mesh area/defect area ratio (M/D ratio) in terms of recurrence as a new criterion in LVHR.&lt;/br&gt; &lt;/br&gt; &lt;b&gt;Methods:&lt;/b&gt; A total of 124 patients were enrolled in the study. Age, gender, hernia type, body mass index, defect size, size of the mesh, mesh overlapping, area of the defect, area of the mesh, M/D ratio, postoperative complications, follow-up time, recurrences and timing of recurrence were also recorded. The potential variables that may affect recurrence were examined by univariate and multivariate analysis.&lt;/br&gt; &lt;/br&gt; &lt;b&gt;Results:&lt;/b&gt; There were 12 (9.7%) recurrences in our series. A statistically significant difference was found if either the mesh/defect ratio was ≤6 or &gt;6 (p = 0.012). Multivariate analysis confirmed that M/D ratio was the only independent parameter for recurrence. &lt;/br&gt;&lt;/br&gt;&lt;b&gt;Conclusion:&lt;/b&gt; Understanding M/D ratio concept and using it in surgical clinical practice may help reduce recurrence rates after LVHR.&lt;/br&gt.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"40-46"},"PeriodicalIF":0.6,"publicationDate":"2021-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40379753","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 COVID-19 pandemic on bariatric patients in Podlaskie Voivodeship in Poland.","authors":"Agnieszka Popławska,&nbsp;Joanna Jamiołkowska,&nbsp;Paulina Woźniewska,&nbsp;Krzysztof Drygalski,&nbsp;Urszula Kościuczuk,&nbsp;Marzena Wojewódzka-Żelezniakowicz,&nbsp;Hady Razak Hady","doi":"10.5604/01.3001.0014.9622","DOIUrl":"https://doi.org/10.5604/01.3001.0014.9622","url":null,"abstract":"<p><p>The research shows that despite the pandemic and higher risk of mortality and complications after SARS-CoV-2 infection, bariatric patients declare a high level of willingness to undergo the bariatric procedure, and the impact of COVID-19 pandemic does not play an important role in their decision-making process concerning the bariatric procedure. &lt;/br&gt; &lt;/br&gt; Due to the noticeable lifestyle changes during the pandemic such as greater food intake and decrease in physical activity among the bariatric patients, the process of qualification to the bariatric procedure should be conducted very meticulously and the recommended values for weight loss should be implemented to increase patients' motivation before and after the procedure. As the research shows, bariatric patients tend to neglect their strive for healthy lifestyle, even in the presence of the pandemic. Therefore, weight gain prior to the bariatric procedure can lead to more frequent complications during surgery and deterioration of the expected results of bariatric surgery. In conclusion, the group of bariatric patients is a high-risk group not only because of greater mortality due to COVID-19 infection, but also because they do not attach much importance to the external factors such as global pandemic.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"25-32"},"PeriodicalIF":0.6,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40378896","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":"Preoperative and intraoperative risk factors of postoperative pancreatic fistula after pancreaticoduodenectomy - systematic review and meta-analysis.","authors":"Kajetan Kiełbowski,&nbsp;Estera Bakinowska,&nbsp;Rafał Uciński","doi":"10.5604/01.3001.0014.9659","DOIUrl":"https://doi.org/10.5604/01.3001.0014.9659","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative pancreatic fistula (POPF) is a potentially life-threatening complication after pancreaticoduodenectomy (PD). It is observed when the amylase activity in the drain fluid exceeds three times the normal upper value. Grades B and C of POPF are considered as clinically relevant. Fistula might originate due to failure of healing of a pancreatic anastomosis or from raw pancreatic surface.</p><p><strong>Materials and methods: </strong>18 retrospective and prospective studies published between 2015 and 2020 were included in this meta-analysis. Total number of patients was 5836. To investigate potential risk factors associated with the occurrence of POPF, odds ratios (OR) with 95% confidence intervals (CI) were calculated. To compare discontinuous data, mean differences (MD) were calculated.</p><p><strong>Results: </strong>13 factors were divided into preoperative and intraoperative groups. Male sex, higher BMI, soft pancreatic texture and small pancreatic duct were considered as significant risk factors while vascular resection lowered the risk of development pancreatic fistula.</p><p><strong>Discussion: </strong>It is considered that the development of POPF is associated with intrapancreatic fat. More severe infiltration with fat tissue is responsible for soft texture of the gland, while higher BMI is one of the risk factors of increased pancreatic fat. On the contrary, diabetes is associated with fibrotic pancreas which could lower the risk of developing POPF.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"1-10"},"PeriodicalIF":0.6,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40379749","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":"Predictors of Surgical Difficulty in Laparoscopic Total Mesorectal Excision.","authors":"Joseph C Kong,&nbsp;Swetha Prabhakaran,&nbsp;Alison Fraser,&nbsp;Satish Warrier,&nbsp;Alexander G Heriot","doi":"10.5604/01.3001.0014.9721","DOIUrl":"https://doi.org/10.5604/01.3001.0014.9721","url":null,"abstract":"Concerns have been raised regarding the oncological safety of laparoscopic total mesorectal excision (TME) as compared to an open approach. This study aimed to identify risk factors for surgically difficult laparoscopic TME. All consecutive laparoscopic rectal cancer cases were included from a prospectively maintained colorectal cancer database. The primary outcome was to identify risk factors for surgically difficult TME. A Surgical Difficulty Risk Score (SDRS) between 0 and 6 was calculated for each case with cases achieving an SDRS of 2 or greater being deemed as surgically difficult. A total of 2795 consecutive cases of laparoscopic TME were identified, with 464 (16.6%) surgically difficult cases. Univariate analysis found that operating in the male pelvis, performing abdomino-perineal resections, Hartmann's procedures, and proctocolectomies were all significantly associated with higher operative difficulty (P < 0.001). A higher nodal stage of cancer (P = 0.046), and the resection of another organ (P = 0.003) were significantly associated with higher surgical difficulty. On multivariate analysis, a female pelvis was associated with a favorable laparoscopic resection (Odds ratio [OR] 0.54, 95% CI 0.43-0.67, P < 0.001), whereas patients who had another organ resection (OR 2.6, 95% CI 1.53-4.42, P < 0.001), nodal positivity (OR 1.37, 95% CI 1.11-1.69, P = 0.003), and high ASA scores had more difficult surgeries. Predictive factors for surgically difficult laparoscopic TME include male gender, high ASA scores, mid and low rectal cancer, positive nodal stage, and resection of another organ at time of surgery.","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"33-39"},"PeriodicalIF":0.6,"publicationDate":"2021-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40379750","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":"Diagnosis and management of epiploic appendagitis: a single-institution 10-year experience.","authors":"Riley Tan,&nbsp;Simon Parys,&nbsp;Yuki Watanabe","doi":"10.5604/01.3001.0014.8912","DOIUrl":"https://doi.org/10.5604/01.3001.0014.8912","url":null,"abstract":"<p><p>&lt;b&gt;Introduction&lt;/b&gt;: Epiploic appendagitis is known to be a benign and self-limiting process, yet optimal management is not well understood. Research focused on the efficacy of treatment in this rare condition may allow future patients diagnosed with epiploic appendagitis to be treated accordingly with the best evidence-based medical practice.&lt;br/&gt;&lt;b&gt;Aim&lt;/b&gt;: The aim of this study was to investigate the diagnosis, compare management options and follow up epiploic appendagitis. &lt;br&gt;&lt;b&gt;Materials and methods&lt;/b&gt;: This retrospective study included all patients over 18 years of age who were treated in a large tertiary hospital in the years 2009-2019 with a confirmed diagnosis of epiploic appendagitis and no coexisting acute intra-abdominal pathologies. Patients' health information was recorded and analysed.&lt;br/&gt;&lt;b&gt;Results&lt;/b&gt;: As many as 78 patients were diagnosed with epiploic appendagitis over a 10-year observation period. A minor male predominance (55%) and a broad range of ages at the moment of diagnosis (18-75) were found, with diabetes (n = 10) being the most common comorbidity in this condition . In the majority of cases, the disease was located in the sigmoid (41%) and descending colon (35%). Diagnosis was primarily based on imaging (computerised tomography 91%, ultrasonography 2.6%). Six percent of patients were diagnosed during surgery and these patients recovered with smaller rates of readmissions and recurrences (P &lt; 0.05). Patients given opioids on discharge were less likely to be readmitted to hospital (P &lt; 0.05), while those given antibiotics had a longer inpatient stay (P &lt; 0.05) with no change in readmission rates (P = 0.78) or recurrence rates (P = 0.48). &lt;br/&gt;&lt;b&gt;Discussion&lt;/b&gt;: Managing epiploic appendagitis with antibiotics is shown to have no effect on patient outcomes, while opioid use for pain control did not affect the length of hospital stay but it reduced the number of readmissions when compared to simple analgesics alone.</p>","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"20-24"},"PeriodicalIF":0.6,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40378894","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":"Port site metastases a year after initial laparoscopic cholecystectomy. Should the use of retrieval bags during laparoscopic cholecystectomy be the new gold standard?","authors":"Natalia Petryshyn,&nbsp;Teodora Dražić,&nbsp;Piotr Hogendorf,&nbsp;Janusz Strzelczyk,&nbsp;Alicja Strzałka,&nbsp;Krzysztof Szwedziak,&nbsp;Adam Durczyński","doi":"10.5604/01.3001.0015.3280","DOIUrl":"https://doi.org/10.5604/01.3001.0015.3280","url":null,"abstract":"&lt;p&gt;&lt;p&gt;As a result of gallbladder cancer being rare, it is often an understudied disease. There is lack of information particularly about long-term outcomes after resection during either laparoscopic or open surgery techniques [4]. There is also little data on the ways in which surgical techniques can be improved to further aid patients diagnosed with gallstones or other indications for cholecystectomy, and resulting positive histopathology. Furthermore, there is a lack of general acknowledgement on the vitality of using plastic retrieval bags during cholecystectomy regardless of the histopathology. The case study at hand shows how critical a plastic bag can be during cholecystectomy in further preventing the risk of local or distant metastasis originating from the gallbladder. This is especially important as it is estimated that almost one third of patients who undergo curative intent surgery for gallbladder cancer develop a tumor recurrence. Specifically, our patient was found to have a distant recurrence occurring a year after the elective surgery, which is in range with the usual median recurrence of 9.5 months or within the first 12 months [5]. &lt;/br&gt; &lt;/br&gt; Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, there are some key factors that surgeons must take into consideration with one of them being whether to use a retrieval bag or not. According to the \"Guidelines for the Clinical Application of Laparoscopic Biliary Tract Surgery\" of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the use of a retrieval bag for gallbladder extractions is purely at the discretion of the surgeon [6]. Generally, plastic bags should be used when gallbladder cancer is suspected to minimize disseminating tumor cells, or in the case of acute cholecystitis, to avoid spillage of gallbladder contents including possible infected bile, stones or pus. While one study states that when a cholecystectomy is performed due to gallstones, generally, surgeons will only opt for a plastic bag if there are large gallstones, great inflammation or an edematous gallbladder [7, 8]. However, another article claims the adverse, with endoscopic bags being in fact used commonly in elective cholecystectomy, despite the increased cost and apparent benefit [7]. A major drawback, and possible reason why some surgeons may decide not to use retrieval bags could be due to the extra skills needed, or increased difficulty to the surgery. This could be due to the need for enlargement of port site incision, placement of the bag around the gallbladder, as well as the potential risk to abdominal organ damage during the insertion and retrieval of the bag [7]. Sometimes the decision not to use the bag is purely economic, especially in developing countries. Fortunately nowadays commercially available endobags be","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"61-65"},"PeriodicalIF":0.6,"publicationDate":"2021-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40378895","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":"[SURGICAL PROBLEMS IN THE TREATMENT OF CHRONIC APPENDICITIS].","authors":"W KRZYZANOWSKI","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"1339-45"},"PeriodicalIF":0.6,"publicationDate":"1964-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40792411","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":"[ELECTRIC BURNS].","authors":"M SZCZEPANSKI","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"1357-65"},"PeriodicalIF":0.6,"publicationDate":"1964-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40792415","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":"[APROPOS OF THE THORAC-ABDOMINAL EXTRAPLEURAL APPROACH TO THE SUBPHRENIC REGION].","authors":"Z JEZIORO,&nbsp;J BIELAWSKI,&nbsp;Z ZIMMER","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":501107,"journal":{"name":"Polski przeglad chirurgiczny","volume":" ","pages":"1347-52"},"PeriodicalIF":0.6,"publicationDate":"1964-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40792413","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}