Rozhledy v Chirurgii最新文献

{"title":"Incarceration of Bochdalek hernia in an adult - case report.","authors":"V Přibáň, P Pták","doi":"10.33699/PIS.2024.103.3.100-103","DOIUrl":"10.33699/PIS.2024.103.3.100-103","url":null,"abstract":"<p><p>This paper presents the case of a 32-year-old female patient with acute colon incarceration in the thoracic cavity due to Bochdalek hernia. An asymptomatic right Bochdalek hernia was also discovered, which is a rare finding. The patient underwent laparotomy with reposition of the incarcerated organs and primary closure of the left-sided defect. The stenotic portion of the originally incarcerated colon was resected one year later due to the symptoms of chronic bowel problems. At present, 18 months from the first surgery, the patient's clinical condition remains good with a positive clinical response to the secondary surgery involving resection of the stenotic colon, and the right Bochdalek hernia remains asymptomatic.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 3","pages":"100-103"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421858","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":"Skin pigmented lesions in the hands of an ambulatory surgeon.","authors":"Ondřej Troup, A Růžičková, A Koy, Vlastimil Woznica, Inka Třešková","doi":"10.48095/ccrvch2024381","DOIUrl":"10.48095/ccrvch2024381","url":null,"abstract":"<p><p>The ambulatory surgeon deals daily with patients who come for various pigmented skin lesions. A number of patients come on the recommendation of a dermatologist, but for the majority of patients, the primary visit is directly to the surgical clinic. The reason for removing a pigmented lesion may be an unsatisfactory cosmetic appearance or frequent irritation due to inappropriate location of the lesion, but also the fear of the development of malignancy. Pigmented lesions of the skin are a very hetero-geneous group represented from benign nevi to malignant melanoma. They occur in all age groups. Congenital nevi and hemangiomas are most often treated at an early age, and the incidence of skin malignancies increases in older patients. The ambulatory surgeon is often faced with the decision whether and how radically the pigmented lesion needs to be removed. Skin lesions such as lentigo solaris do not need to be treated surgically. Other lesions, such as basal cell carcinoma, require radical excision and subsequent professional dispensary. However, the treatment of melanoma is complex, it is led by specialists in dermato-oncology centers and therefore interdisciplinary approach is neces-sary. Every ambulatory surgeon should be knowledgeable and experienced enough to be able to decide on the need for removal of pigmented lesions and, in case of uncertainty, refer the patient to a skin specialist. This article provides a brief overview and specifics of basic skin pigment manifestations and criteria for their surgical removal.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 10","pages":"381-386"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958635","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":"Endoscopic sleeve gastroplasty - where we are and where we are heading.","authors":"Jan Král, E Machytka","doi":"10.48095/ccrvch2024331","DOIUrl":"10.48095/ccrvch2024331","url":null,"abstract":"<p><p>Obesity is a global problem with a rising prevalence, which has serious implications not only for individuals' health but also for society as a whole. The increased incidence of overweight and obesity leads to higher healthcare costs and limits the employment opportunities of individuals, affecting their quality of life. The treatment of obesity encompasses various approaches, including diet, exercise, pharmacotherapy, and surgical bariatric procedures. New and promising methods of treatment include endoscopic sleeve gastroplasty (ESG). ESG offers a safe, minimally invasive method that reduces the volume of the stomach and has long-term results in terms of weight reduction. Thanks to significant advances in the field of endoscopy and endoscopic suturing, we can expect new and improved devices to be used in ESG. This will make ESG even safer, less dependent on the expertise of physicians, and its outcomes will significantly approach those of traditional bariatric surgery.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 9","pages":"331-335"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677441","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":"Endoscopic treatment of complications after bariatric surgery - overview of issues and retrospective analysis of our own results.","authors":"V Nosek, M Řehoř, J Pintová, M Man, M Vraný, R Procházka","doi":"10.48095/ccrvch2024336","DOIUrl":"https://doi.org/10.48095/ccrvch2024336","url":null,"abstract":"<p><p>Bariatric and metabolic surgery is the most invasive but also the most effective treat-ment for severe obesity and associated comorbidities. The most common procedures performed are laparoscopic sleeve gastrectomy and Roux-Y gastric bypass. Postoperative complications occur in 4-10% cases. The majority of them are mild and are treated conservatively. Complex management of severe complications often involves surgical re-intervention, which is associated with high morbidity. Technological advancements in therapeutic endoscopy expand the options for minimally invasive treatment of these complications and, in selected cases, may even be the method of choice in their management. The authors present a summary of current endoscopic procedures for managing ulcerations, leaks, fistulas, strictures, and other complications. Based on a cohort of 45 patients treated over a period of 10 years (11/2013-11/2023) at the district hospital in Jablonec nad Nisou, an overview of the endoscopic methods used, procedure numbers, duration, and outcomes of endoscopic treatment is provided. The author's commentary describes trends leading to further improvement in the outcomes of endoscopic treatment.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 9","pages":"336-345"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677446","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":"Pancreatic surgery at the University Hospital Kralovske Vinohrady: 10-year review with a survival analysis for pancreatic ductal adenocarcinoma.","authors":"R Gürlich, A Whitley, Z Šubrt, M Oliverius","doi":"10.33699/PIS.2024.103.4.132-137","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.4.132-137","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to summarize the results of pancreatic surgery over a ten-year period at the surgical department of the university hospital Kralovske Vinohrady and analyse the prognostic factors of pancreatic ductal adenocarcinoma.</p><p><strong>Methods: </strong>From October 2012 to December 2022, 331 patients underwent proximal pancreatectomy, 142 patients underwent distal pancreatectomy, and 84 patients underwent total pancreatectomy. Of the total number of resected patients, the analysis was performed only in patients with proven findings of ductal adenocarcinoma of the pancreas (221 patients). Survival analysis was conducted using the Kaplan-Meier method, and prognostic factors were assessed using Cox analysis for these patients.</p><p><strong>Results: </strong>The average length of hospitalization was 13 days (3-53 days). According to the Clavien-Dindo classification, 90 patients had an uncomplicated postoperative course, 65 had minor complications (grade I and II), and 66 patients had major complications (grade III-V). Based on TNM staging, 27 patients were in stage I, 136 in stage II, 41 in stage III, and 17 in stage IV. The median survival was 304 days. Overall, 1-, 2-, 3-, and 5-year survival rates were 62.7% (95% confidence interval (CI) 55.9%-70.4%), 39.0% (95% CI: 31.9-47.6%), 27.3% (95% CI: 20.7-36.0%), and 12.8% (95% CI: 6.9%-24.0%), respectively. Using the Cox model, the following negative prognostic factors were identified: severe postoperative complications, positive lymph nodes, T stage, and positive resection margins.</p><p><strong>Conclusion: </strong>Pancreatic ductal adenocarcinoma is an aggressive tumour. Radical resection represents the only chance for long-term survival. The best results are achieved in specialized centres with a high volume of pancreatic resections.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 4","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The variable histogenesis and biology of selected bland fibroblastic lesions of the breast - pitfalls in the differential diagnostics and optimal therapeutic approach (three case reports).","authors":"Z Kinkor","doi":"10.48095/ccrvch2024275","DOIUrl":"10.48095/ccrvch2024275","url":null,"abstract":"<p><p>Presented are three casuistics of seemingly identical breast lesions which even by adopting advanced laboratory techniques may represent diagnostic challenge. Microscopic features of some bland spindle cell lesions of different histogenesis (epithelial or mesenchymal) are misleading and a potential source of unaware errors, which might affect optimal therapeutic strategy. In the setting of three diverse entities (low-grade spindle cell metaplastic carcinoma, desmoid fibromatosis and phyllodes tumor) is documented both demanding diagnostic algorithm and revealing molecular landscape on one side as well as evolving predictive/prognostic parameters on the other one. Close interdisciplinary cooperation is inevitable for accurate interpretation/understanding of revealed diagnostic facts which is required for adjustment of competent rational and individualized therapy.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 7","pages":"275-280"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983880","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":"Meckel's diverticulum as a cause of gastrointestinal bleeding in an adolescent patient.","authors":"D Sovadinová, T Limprechtová, K Borůvková, V Horáková, M Machart, T Pešl","doi":"10.33699/PIS.2024.103.4.138-142","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.4.138-142","url":null,"abstract":"<p><p>Meckel's diverticulum (MD) is one of the most common malformations of the gastrointestinal tract. Most cases are asymptomatic; clinical symptoms occur only in about 4% of patients, presenting as gastrointestinal bleeding, intestinal obstruction, inflammation, or perforation. Bleeding is most frequently observed in children under 2 years of age. Older patients tend to experience inflammatory complications. Here, we present the case report of a 17-year-old male patient with life-threatening acute gastrointestinal bleeding due to MD. Based on this case report, we performed a retrospective study of a small group of patients admitted to the Department of Pediatric Surgery and Traumatology, Third Faculty of Medicine, Charles University and Thomayer University Hospital in Prague (KDCHT FTN) between January 2012 and March 2023 with the primary or secondary diagnosis of MD.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 4","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of thoracic surgery in the management of complicated acute and post-acute COVID-19 pneumonia (PASC).","authors":"J Herzinger, V Hytych, J Mališ, K Pavlíčková, J Čermák, R Demeš, P Svoboda, P Hedánková, Š Žbánková, K Česlarová, A Tašková","doi":"10.33699/PIS.2024.103.2.57-64","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.2.57-64","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 is considered a respiratory virosis in its classic form, although it may present with heterogeneous symptoms. Thoracic complications occur in a small percentage of patients. Our objective was to evaluate existing experience with this disease and its thoracic manifestations and to determine the real-world status of care of these patients.</p><p><strong>Methods: </strong>This study is a retrospective, single-institution analysis of a group of patients hospitalized with acute and post-acute COVID-19 pneumonia at Thomayer Hospital in Prague in the period from December 2020 to March 2022 and indicated for a thoracic surgical procedure.</p><p><strong>Results: </strong>During the peak of COVID-19 pandemic, a thoracic intervention was performed in 46 admitted patients. Thoracic drainage (due to pneumothorax in 18 cases, fluidothorax in 3 cases, CT-guided lung abscess drainage in 2 cases, and CT-guided pneumatocele drainage in 2 cases) were the most common thoracic surgical procedures. Pleurectomy/decortication surgery was done in 10 cases. Additionally, 12 lung parenchyma-sparing resections were performed, while lobectomy was required in 2 cases. Resection of postintubation tracheal stenosis due to a severe course of COVID-19 pneumonia was indicated in 2 patients.</p><p><strong>Conclusion: </strong>Even mild COVID-19 may cause a considerable morphological a functional alteration of the respiratory system. The most common complications of COVID-19 pneumonia that require a thoracic surgical intervention include pathologies associated with an air leak and accumulation of air (pneumothorax, pneumomediastinum and subcutaneous emphysema). The development of pulmonary necrosis, symptomatic bronchiectasis, pneumatocele, and bullous-fibrotic formations may result in pneumothorax, hemothorax or thoracic empyema in sporadic cases. An early thoracic surgical intervention to treat thoracic complications of COVID-19 pneumonia can improve the survival of COVID-19 patients.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 2","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873470","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":"Spontaneous pneumomediastinum - Hamman´s syndrome.","authors":"R Birka, M Králíková, O Slyvka, M Sedláček","doi":"10.33699/PIS.2024.103.2.65-67","DOIUrl":"10.33699/PIS.2024.103.2.65-67","url":null,"abstract":"<p><p>This case study presents a rare case of a 29-year-old woman with spontaneous pneumomediastinum who was treated in the emergency department for subjective dyspnea, rhinitis, and a subjectively reported increasing swelling of the throat. The clinical presentation was only characterized by crepitus in the neck and supraclavicular areas. CT scan of the neck and chest revealed massive emphysema of the soft tissues of the neck, chest, the right side of the face, and pneumomediastinum extending to the diaphragm. Based on the clinical presentation and imaging findings, which were consulted with thoracic surgeons, we assessed the condition as benign spontaneous pneumomediastinum. The patient was treated conservatively and discharged from the hospital on the third day of hospitalization with the need of aftercare.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 2","pages":"65-67"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873607","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":"Pancreatic carcinoma, its variants and precursors: Overview of the current WHO classification.","authors":"J Hrudka","doi":"10.33699/PIS.2024.103.6.208-218","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.6.208-218","url":null,"abstract":"<p><p>Pancreatic carcinoma is a relatively common malignant tumor with increasing incidence and mortality. The tumor is usually diagnosed at an advanced stage and generally has a poor prognosis, with only 5% of patients surviving 5 years from the time of diagnosis. The stage of the disease at the time of diagnosis is a crucial factor for the prognosis; 25% of patients with localized tumors survive 3 years from diagnosis, compared to only 1% of those with generalized tumors. Radical surgical removal of the tumor (partial or total pancreatectomy) is a key factor in improving survival. Therefore, the topic is highly relevant to surgeons. Statistics on pancreatic carcinoma mainly focus on ductal adenocarcinoma, which is the most common and least favorable malignant tumor of the pancreas. This review focuses on ductal adenocarcinoma, its variants, and precancerous lesions. The article summarizes information from the latest WHO classification of 2019, which was released 11 years after the previous edition. Compared to the previous version, this new WHO classification introduced rather minor changes in the field of ductal adenocarcinoma. The delineation of rare variants of ductal adenocarcinoma is justified based on genetic and morphological similarities and clinical relevance, as individual subtypes significantly differ in prognosis. The article also includes a description of macroscopic and microscopic precursors of ductal adenocarcinoma and their definitions. Genetic and immunohistochemical differential diagnostic aspects are briefly discussed, as these are more relevant to pathologists than to surgeons.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 6","pages":"208-218"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592053","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}