Rozhledy v Chirurgii最新文献_第10页

Risk factors predicting cervical spine fracture on CT in craniocervical trauma - retrospective study. 颅颈外伤CT预测颈椎骨折危险因素的回顾性研究。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.3.119-124

O Pánková, T Rohan, M Krtička, J Kovařík, T Andrašina

{"title":"Risk factors predicting cervical spine fracture on CT in craniocervical trauma - retrospective study.","authors":"O Pánková, T Rohan, M Krtička, J Kovařík, T Andrašina","doi":"10.33699/PIS.2023.102.3.119-124","DOIUrl":"https://doi.org/10.33699/PIS.2023.102.3.119-124","url":null,"abstract":"Introduction: The study identifies risk factors predicting cervical spine fracture on CT based on information in the referral form.Methods: All patients aged over 18 years with a CT scan of the head and cervical spine completed at the University Hospital Brno in the year 2019 to exclude any fresh trauma were included in the retrospective study. The analyzed potential risk factors included gender, age over 65 years, unconsciousness or impaired consciousness, mechanism of injury, paresthesia or plegia suspected to be associated with trauma, cervical spine pain, other neurological symptomatology, presence of cervical collar, presence of intracranial hemorrhage on head CT, and presence of skull fracture on head CT.Results: In total, a cervical or upper thoracic spine fracture was described in 51 of 1177 patients (4.3%). Statistically significant risk factors for cervical spine fracture on CT scan were identified as mechanism of injury similar to car accident or jumping into water (OR 2.52; p=0.004), pain of the cervical spine (OR 1.81; p.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 3","pages":"119-124"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050254","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

Our experience with solitary fibrous tumors in the chest area. 我们胸部孤立性纤维性肿瘤的经验。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.3.134-138

J Muri, B Durcová, M Ledecký, V Kamarád, M Makovická, A Vrbenská

引用次数: 0

Massive transfusion protocol. 大规模输血方案。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.5.189-193

J Berková, J Kočí

引用次数: 0

Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report. 肺内隔离合并破坏性肺炎和危及生命的咯血1例。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.1.23-27

J Muri, B Durcová, A Garchar, P Makovický, A Vrbenská, V Kamarád

{"title":"Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report.","authors":"J Muri, B Durcová, A Garchar, P Makovický, A Vrbenská, V Kamarád","doi":"10.33699/PIS.2023.102.1.23-27","DOIUrl":"https://doi.org/10.33699/PIS.2023.102.1.23-27","url":null,"abstract":"The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 1","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10764919","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

Blood loss during HPB procedures. HPB 程序中的失血量。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.9.356-362

J Zajak, K Vinklerová, J Páral, E V Valkyová, E Čermáková, F Čečka

{"title":"Blood loss during HPB procedures.","authors":"J Zajak, K Vinklerová, J Páral, E V Valkyová, E Čermáková, F Čečka","doi":"10.33699/PIS.2023.102.9.356-362","DOIUrl":"10.33699/PIS.2023.102.9.356-362","url":null,"abstract":"Introduction: During the last decades, simultaneously with the development of surgical technique, modern equipment and perioperative management, there has been a significant improvement in postoperative outcome. Despite this, infectious complications and perioperative bleeding remain the leading causes of postoperative morbidity and mortality in HPB surgery.Methods: We conducted a retrospective study over a three-year period in 256 patients who underwent surgery of the pancreas, liver, gallbladder, or bile ducts. We monitored perioperative blood loss, the number of administered transfusions, the type and severity of postoperative complications, the number of reoperations and the number of readmissions.Results: The average blood loss was 457 ml. We administered transfusions to 39 patients (17%). We confirmed the hypothesis that the presence of blood loss statistically significantly increases the development of deep intra-abdominal infections (p=0.0188). Morbidity increases with increasing blood loss (p=0.0168). We confirmed a statistically significant difference in the blood loss between the groups with and without complications (p=0.001). Postoperative 30-day mortality was less than 1% (n=2). There were 15 (6%) reoperated patients, seven for acute bleeding and eight for infectious complications. The length of hospital stay was statistically significantly longer in patients who received transfusions - erythrocytes (p=0.023), and plasma (p=0.011). We readmitted 12 patients, three patients died during rehospitalization (the 90-day mortality rate was 2%, n=5). A total of 59% patients in our group were classified as ASA III.Conclusion: With increasing blood loss, morbidity (development of intra-abdominal infections) increases significantly, but despite this, overall post- operative mortality remains low. Early postoperative bleeding is the cause of more than half of reoperations. The length of hospitalization increases significantly with the number of transfusions administered.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 9","pages":"356-362"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577011","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

Pancreaticoduodenectomy in patients with an unusual course of the hepatic artery. 肝动脉异常病程的胰十二指肠切除术。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.3.111-118

P Skalický, M Loveček, J Tesaříková, M Gregořík, K Knápková, R Kovář, D Klos

{"title":"Pancreaticoduodenectomy in patients with an unusual course of the hepatic artery.","authors":"P Skalický, M Loveček, J Tesaříková, M Gregořík, K Knápková, R Kovář, D Klos","doi":"10.33699/PIS.2023.102.3.111-118","DOIUrl":"https://doi.org/10.33699/PIS.2023.102.3.111-118","url":null,"abstract":"Introduction: Variations in hepatic artery anatomy are very common in the population. The aim of this study is to evaluate the rates of individual types of hepatic artery variants in the population of patients undergoing pancreaticoduodenectomy (PD), assess the accuracy of preoperative staging CT imaging to identify hepatic artery variants, and evaluate the impact of the hepatic artery variants on perioperative and postoperative morbidity of PD patients.Methods: A prospective observation study of 147 patients undergoing PD for a pancreatic head pathology at the 1st Department of Surgery, University Hospital Olomouc between 1/2015-12/2018. Preoperative diagnosis of the course of the hepatic artery was made based on staging CT imaging analysis of the abdomen. The result was classified according to the Michels' scale and correlated with the final perioperative finding. Demographic, histopathological and clinicopathological data were included in a prospectively maintained database.Results: A total of 147 patients were included in the study, 83 (56.5%) males and 64 (43.5%) females, median age 65.0 (37-83) years. A variant course of the hepatic artery was found in 37 (25.2%) patients. The accuracy of preoperative CT imaging in determining the variant was 100%. The presence of a hepatic artery variant was not statistically significant as a factor in terms of postoperative complications - CD I-II (50.0% vs 47.2%), CD III-IV (8.3% vs 13.8%). Similarly, the 30-day (4.2% vs 2.4%) and 90-day mortality rates (4.2% vs 3.3%) were comparable in both groups.Conclusion: Preoperative diagnosis of vascular variants based on multidetector CT imaging of the abdomen is routinely available and shows high detection accuracy. There was no difference in postoperative morbidity and mortality in patients with and without a variant hepatic artery undergoing PD.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 3","pages":"111-118"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050261","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

Open revascularization in a patient with chronic mesenteric ischemia and a history of aorto-bifemoral bypass - a case report. 慢性肠系膜缺血并有主动脉-双侧旁路病史患者的开放血运重建术1例报告。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.5.204-207

M Olexa, K Lipár, J Chlupac, L Janousek, J Froněk

引用次数: 0

Volvulus 8 years after bariatric surgery. 减肥手术后8年的扭转。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.3.139-141

B Jíšová, M Podhráský, P Hladík, M Vlková, R Lischke

{"title":"Volvulus 8 years after bariatric surgery.","authors":"B Jíšová, M Podhráský, P Hladík, M Vlková, R Lischke","doi":"10.33699/PIS.2023.102.3.139-141","DOIUrl":"https://doi.org/10.33699/PIS.2023.102.3.139-141","url":null,"abstract":"Introduction: Bariatric surgery is a widespread branch of surgery because of the increase in obesity in population. It is one way to achieve long-term weight loss effect in obese patients. Like other surgeries, bariatric surgery has many complications including ileus and volvulus in small intestine. It is an acute state in surgery and usually leads to a revision surgery.Case report: 58 years old woman who underwent mini-gastric bypass in 2014. She was admitted to our department because of manifestation of ileus on the second day after TEP of the hip joint. There was a typical sign of volvulus on the CT scan. She was operated on the same day. The reinsertion of enteroenteroanastomosis and denotation of the small intestine, desufflation of the large intestine, and reconstruction of new enteroenteroanastomosis was needed. After the surgery, the patient was without any complications. The bowel function recovery was slower postoperatively.Conclusion: Diagnosis of volvulus is not easy because of non-specific clinical symptoms. In this case report, the volvulus occurred 8 years after the primary surgery. Symptoms developed because of paralytic ileus after hip replacement.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 3","pages":"139-141"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032664","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

Prehabilitation bundle can reduce incidence of postoperative pulmonary complications. 术前康复捆绑可降低术后肺部并发症的发生率。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.7.277-282

O Ryska, A Dereham, S Mahmoud, N Helmy, E Janta

{"title":"Prehabilitation bundle can reduce incidence of postoperative pulmonary complications.","authors":"O Ryska, A Dereham, S Mahmoud, N Helmy, E Janta","doi":"10.33699/PIS.2023.102.7.277-282","DOIUrl":"10.33699/PIS.2023.102.7.277-282","url":null,"abstract":"Introduction: Elective major colorectal surgery is still associated with postoperative morbidity and mortality. Preoperative optimization can potentially reduce postoperative pulmonary complications, which significantly prolong recovery and increase the risk of mortality. The aim of this study was to evaluate the effect of the prehabilitation bundle on postoperative pulmonary complications.Methods: All patients undergoing elective colorectal procedure for benign or malignant diagnosis before and after the introduction of the prehabilitation bundle were enrolled in the study. Prehabilitation was focused on nutritional support, regular aerobic and muscle strength exercise, preoperative optimization of anaemia, improvement of oral hygiene including regular chlorhexidine mouth wash, psychological support, restriction of smoking and alcohol consumption. In addition to the general characteristics, compliance with individual measures, incidence of pulmonary complications and length of stay were monitored.Results: A total of 596 patients were included in the study (226 before and 370 after the implementation of the package). After the introduction of prehabilitation, the incidence of postoperative pulmonary complications decreased significantly - 29 (13%) vs. 17 (4.6%), RR: 0.21-0.67), p=0.001 and shorter length of stay was observed à 9.7 (±8.8) to 7.7 (±5.5) days (p=0.0005). Except for optimization of anaemia, compliance with the individual components of the established bundle was very good.Conclusion: Introduction of a prehabilitation bundle focused on improvement of cardiorespiratory capacity, optimization of diet and oral hygiene, can reduce the risk of postoperative pulmonary complications and shorten the length of stay.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"102 7","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577005","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

Innovative trends in surgery: a robotic approach to retrotracheal goitre. 外科手术的创新趋势：气管后甲状腺肿的机器人方法。

Rozhledy v Chirurgii Pub Date : 2023-01-01 DOI: 10.33699/PIS.2023.102.11.433-436

D Adamica, M Mitták, L Čierna, M Kepičová, L Tulinský

引用次数: 0