R Novysedlák, J Tavandžis, P Valášek, R Hudák, J Vachtenheim, R Lischke, J Schützner
{"title":"Chest drainage - indications, technique, and management of complications.","authors":"R Novysedlák, J Tavandžis, P Valášek, R Hudák, J Vachtenheim, R Lischke, J Schützner","doi":"10.48095/ccrvch2025139","DOIUrl":"https://doi.org/10.48095/ccrvch2025139","url":null,"abstract":"<p><p>Although the insertion of a chest drain is a minor and common surgical procedure performed across all types of surgical departments, it continues to raise some uncertainties in clinical practice regarding indications, optimal timing of removal, and management of potential complications. Moreover, chest drainage is often performed by physicians from non-surgical specialties, particularly in intensive care settings or pulmonary departments. The aim of this review article is to clarify the key aspects of chest drainage through easily applicable recommendations based on current scientific evidence. The publication primarily focuses on the acute insertion of chest drains for pneumothorax and pleural effusion, addressing the anatomical and technical specifics of the procedure, proper localization of the drainage site, selection of an appropriate drain, principles of patient care, prevention and recognition of potentially serious conditions, and management of the most common complications.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 4","pages":"139-145"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638670","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":"Robotic pancreaticoduodenectomy with a portal vein resection.","authors":"M Rousek, P Záruba, K Pončáková, R Pohnán","doi":"10.48095/ccrvch202530","DOIUrl":"https://doi.org/10.48095/ccrvch202530","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic pancreaticoduodenectomy ranks among the routinely performed surgical procedures in world pancreatic centres. Since 2023, it has also been performed in the Czech Republic.</p><p><strong>Case report: </strong>We present a case of a 65-year-old patient with accidentally found dilatation of the pancreatic duct. During the examination, a small tumor in the head of the pancreas was diagnosed. A robotic pancreaticoduodenectomy was performed. Due to the perioperative suspicion of invasion into the portal vein, the resection was performed. The operation and the course of hospitalization were uncomplicated, the patient was discharged on the 9th postoperative day.</p><p><strong>Conclusion: </strong>Robotic pancreaticoduodenectomy is a method that combines the advantages of a minimally invasive approach and meets the requirements for safety and oncological radicality. Suspected venous invasion is not an obstacle to completing robotic surgery.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 1","pages":"30-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008203","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":"Colon cancer - neoadjuvant treatment of non-metastatic disease.","authors":"J Tomášek, L Fiala","doi":"10.48095/ccrvch202597","DOIUrl":"https://doi.org/10.48095/ccrvch202597","url":null,"abstract":"<p><p>Neoadjuvant treatment for colon cancer, unlike rectal cancer, is rarely used. Its position in the treatment algorithm is not precisely defined. This treatment should be considered for locally significantly advanced tumors (cT4) with extensive nodal involvement. The neoadjuvant treatment plan should be determined in a multidisciplinary team setting. We describe the main clinical trials focused on neoadjuvant chemotherapy in colon cancer. A special subgroup is dMMR/MSI-high tumors, patients with such cancers are candidates for immunotherapy treatment. Immunotherapy can induce complete remission, but can also be accompanied by long-term or permanent toxicity of the treat-ment. Neoadjuvant immunotherapy of non-metastatic colon cancer is the subject of a number of clinical trials. Currently, no immunotherapy is registered in the EU for the neoadjuvant treatment of early colon cancer.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 3","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063242","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":"View of current vascular surgery on asymptomatic carotid stenosis.","authors":"R Vlachovský, T Novotný, R Staffa","doi":"10.48095/ccrvch2025252","DOIUrl":"10.48095/ccrvch2025252","url":null,"abstract":"<p><p>In recent years, the significant progress in the outcomes of conservative treatment for patients with asymptomatic carotid stenosis has sparked discussions about the most effective invasive treatment. The necessity of such treatment is still being debated in certain cases. Several studies have already been conducted to find the most appropriate approach for asymptomatic patients with carotid stenosis, while others are still randomizing and awaiting results. A major unanswered question is whether revascularization is more beneficial than intensive conservative treatment, particularly in view of the lower stroke rates achieved in recent years without conventional or endovascular intervention. The long-term goal should be to identify a subset of patients who would benefit from conservative treatment. In this text, we summarize the issue in the context of the results of two recently completed pivotal studies.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 6","pages":"252-256"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638659","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":"Anatomical eponyms of the abdomen - part 1.","authors":"D Kachlík, V Musil","doi":"10.48095/ccrvch2025355","DOIUrl":"https://doi.org/10.48095/ccrvch2025355","url":null,"abstract":"<p><p>Anatomical terminology is a key tool for describing the human body. It uses Latin and Greek terms, with the second latest version, Terminologia Anatomica from 1998, being the officially recognized nomenclature version in our country. The development of the anatomical terminology has been long and complex, and challenges still persist. An eponym (a name derived from a person) is a commonly used linguistic tool; in anatomy, eponyms are practical due to their brevity, but they can be unclear to non-experts. This article discusses the use of eponyms in anatomy, which were completely excluded from the official anatomical nomenclature in 1955 (Parisiensia Nomina Anatomica), yet they continue to be used in clinical practice and anatomical literature. In some cases, -eponyms have made their way into official nomenclature, such as Purkinje layer and cel-ls or Schwann cells. However, this article primarily provides an overview of anatomical eponyms, their Latin equivalents, and basic information about the individuals behind the eponyms related to abdominal and pelvic structures, particularly the body sur-face, organ projection, abdominal wall structure, fasciae, peritoneal cavity and its recesses and folds.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 8","pages":"355-364"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088134","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}
N Newland, M Pýchová, D Heroldová, M Kynčl, M Rygl
{"title":"Congenital lumbar hernia in a child.","authors":"N Newland, M Pýchová, D Heroldová, M Kynčl, M Rygl","doi":"10.48095/ccrvch202520","DOIUrl":"https://doi.org/10.48095/ccrvch202520","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar hernia in the pediatric population is an extremely rare diagnosis and therefore requires specific diagnostic and therapeutic approaches. This case report describes the first published case of a pediatric lumbar hernia in the Czech Republic.</p><p><strong>Case description: </strong>A 22-month-old boy was examined at a pediatric surgical clinic due to a soft reducible mass in the right lumbar region, which, according to his mother, has been present from birth. An ultrasound scan confirmed a defect in the anatomical localization of the superior lumbar triangle (the triangle of Grynfeltt-Lesshaft) measur-ing 17 × 11 mm with a bowel loop herniation. The patient underwent a skeletal X-ray and an abdominal ultrasound in order to rule out associated malformations, following which he was scheduled for an open hernioplasty. Given the small size of the defect, a primary closure without mesh hernioplasty was performed. The postoperative course was uneventful and at clinical follow-ups the patient showed no signs of hernia recurrence or growth asymmetry.</p><p><strong>Conclusion: </strong>Lumbar hernia in children is congenital and frequently occurs with other associated malformations, which must be ruled out. The type of operation depends on the size of the defect and its purpose is to provide a tension-free closure.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 1","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042952","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":"Neoadjuvant therapy for oligometastatic colorectal cancer.","authors":"J Tomášek, T Staněk","doi":"10.48095/ccrvch2025101","DOIUrl":"https://doi.org/10.48095/ccrvch2025101","url":null,"abstract":"<p><p>Every patient with oligometastatic disease should be discussed within a multidisciplinary team.The intention of treating oligometastatic disease is curative in most cases. Surgical treatment is essential, and can be combined with ablation methods. Oncological criteria that describe the risk of progression/relapse help select patients who benefit most from neoadjuvant/perioperative chemotherapy. For optimal selection of systemic treatment for metastatic colorectal cancer, knowledge of predictive molecular factors is necessary. These include determination of RAS, BRAF and MMR/MSI. The basis of systemic treatment is chemotherapy based on combinations of fluoropyrimidines, oxaliplatin or irinotecan. A special group includes patients with dMMR/MSI-high tumors, which are very sensitive to the treatment with modern immunotherapy with checkpoint inhibitors. The question of the indication of immunotherapy in the case of resectable metastases has not been resolved yet.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 3","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057262","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":"Diverticulitis of the colon.","authors":"J Hoch","doi":"10.48095/ccrvch202547","DOIUrl":"10.48095/ccrvch202547","url":null,"abstract":"<p><p>Diverticulitis of the colon, i.e. inflammation of one or more diverticula, is the most common manifestation of diverticulosis, which affects more than 60% of people over the age of 70 in developed countries. Acute diverticulitis includes a range of degrees of inflammatory involvement, from mild diverticulitis to stercoral erythematosis. The diagnosis of diverticulitis of the colon has changed, especially in the last 30 -years. Imaging using ultrasound and computed tomography allows the assessment of the severity and extent of inflammation without surgery expressed by classification and facilitates the decision on the choice of treatment. Treatment has also changed. Uncomplicated diverticulitis can now be treated without antibiotics and without hospitalization, abscesses can be evacuated by percutaneous guided drainage. The basis of the surgical treatment of peritonitis of diverticular origin remains the arrest of contamination and sanitation of the abdominal cavity. Mere diversion is insufficient. An effective solution is resection of the inflamed or perforated segment of the intestine, a new option is laparoscopic lavage. The best results are -achieved by intestinal resection with primary anastomosis; which should be established only if certain conditions can be met. Exclusion of the anastomosis reduces the demands of the operation, but generally leads to worse results. Despite the recommendations -based on EBM, opinions on the choice of operation are still not clear today. The text presents the development of diverticulitis treatment, arguments in favor of or against resection with anastomosis, resection with exclusion of the anastomosis and laparoscopic lavage. The conditions of the procedures, especially the safe establishment of the anastomosis, and current recommendations are presented.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674167","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}
R Novotný, K Sutoris, D Kostrouch, P Růžička, H Čermáková, J Froněk-, L Janoušek
{"title":"Treatment of coral reef aorta with open surgical endarterectomy - case report of a unique clinical entity.","authors":"R Novotný, K Sutoris, D Kostrouch, P Růžička, H Čermáková, J Froněk-, L Janoušek","doi":"10.48095/ccrvch202567","DOIUrl":"10.48095/ccrvch202567","url":null,"abstract":"<p><strong>Introduction: </strong>Coral reef aorta (CRA) is a rare clinical entity characterised by hard, protruding calcifications in the juxta and supra-renal aorta, which cause haemodynamically significant stenosis of the aorta and its branches. We are presenting a case report of a 65-year-old female patient with bilateral 30-meter claudication on both lower extremities and a haemodynamically significant stenosis of the left renal artery.</p><p><strong>Case report: </strong>The patient underwent computed tomography angiography (CTAG) of the abdominal aorta and lower extremities. CTAG revealed severe abdominal aortic wall calcification with circular atherosclerotic calcification in the area of the renal arteries branch off, causing haemodynamically significant stenosis of the aorta and the left renal artery. The patient was scheduled for an elective open surgery. The left retroperitoneal approach dissects the abdominal aorta, including both renal arteries. -Cross-clamps were placed on both renal arteries, the subrenal aorta and the suprarenal aorta, just below the superior mesenteric artery. Circular aortic calcifications protruded through the aortotomy, and aortal endarterectomy was performed. The calcific plaques extend-ing to the left renal artery were dissected similarly. Identically, an endarterectomy of both common iliac arteries orifice was performed.</p><p><strong>Result: </strong>The patient was discharged on the 8th postoperative day with excellent renal parameters, normal left kidney perfusion, and without limiting claudications on both lower extremities. Currently, we have a 12-month follow-up with the patient.</p><p><strong>Conclusion: </strong>CRA is a rare clinical entity. The optimal treatment has yet to be established. Up-to-date, the gold standard treatment for CRA is surgical endarterectomy.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 2","pages":"67-70"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674486","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 brief history of carotid artery disease and carotid endarterectomy.","authors":"V Přibáň, J Moláček","doi":"10.48095/ccrvch2025235","DOIUrl":"https://doi.org/10.48095/ccrvch2025235","url":null,"abstract":"<p><strong>Introduction: </strong>The authors discuss the history of carotid disease and injuries and focus on historical milestones of carotid endarterectomy worldwide and in Bohemia.</p><p><strong>Results: </strong>The first part discusses the carotid artery and ischemic stroke, beginning with Hippocrates' description of apoplexy. It then highlights Willis's discovery of the collateral circulation, followed by the 19th-century thromboembolic theory of ischemic stroke caused by carotid artery occlusion, which is associated with the work of Wirchow and Chiari. Then, in the 1950s, C. M. Fisher visionarily pointed out the possible surgical management of carotid stenosis in the prevention of stroke. In the second part, carotid ligature, treatments for arterial injuries are mentioned, starting with A. Paré in 1552, to ligature of the extracranial carotid artery for intracranial aneurysm by V. Horsley in 1885. The third part describes the history of reconstructive carotid surgery, especially carotid endarterectomy worldwide, with the priorities of Carrea, Eastcott and DeBakey in the early 1950s. The priority in Bohemia belongs to Jaroslav Lhotka, who published his results in 1962.</p><p><strong>Conclusion: </strong>The authors summarize the history of carotid disease, especially carotid endarterectomy, worldwide and in Bohemia.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"104 6","pages":"235-237"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638653","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}