Rozhledy v Chirurgii最新文献

{"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}

{"title":"Successful treatment of gastrosplenic fistula after sleeve gastrectomy.","authors":"D Toman, A Foltýs, P Ostruszka, L Tulinský, L Martínek","doi":"10.33699/PIS.2024.103.1.26-30","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.1.26-30","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic sleeve gastrectomy (LSG) is one of the most performed bariatric procedures. But it is also associated with serious and potentially life-threatening staple line-related complications, such as stomach leak and bleeding.</p><p><strong>Case report: </strong>The article describes a case of surgical treatment of an early fistula between the stomach and the spleen 3 weeks after LSG. We have focused our attention on the diagnosis and possible treatment options for this potentially life-threatening complication.</p><p><strong>Conclusion: </strong>Efforts to reduce the frequency of leakage after LSG include a number of different measures. It is advisable to have expert knowledge not only in primary bariatric surgery, but also in the management of problems and reoperations in gastrointestinal surgery. An individualized approach and multidisciplinary teamwork are essential for successful therapy.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177713","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":"Molecular testing of gastrointestinal tumours - current status and future prospects.","authors":"Aleš Ryška","doi":"10.48095/ccrvch2024437","DOIUrl":"https://doi.org/10.48095/ccrvch2024437","url":null,"abstract":"<p><p>In addition to the histological diagnosis, grade and stage, predictive testing plays a crucial role in gastrointestinal tumours today. This is mainly used to identify molecular targets for modern cancer therapy. In esophageal and gastric cancers, HER2 expression and amplification, mismatch repair (MMR) system protein deficiency and PD-L1 expression are tested routinely. In colorectal cancer, it is namely detection of RAS (KRAS and NRAS) and BRAF mutations, as well as the assessment of microsatellite instability; targetable gene fusions are found rarely only. In pancreatic cancer, cases of MMR deficiency, BRCA1/2 mutations and other targetable aberrations can be identified quite rarely. In gallbladder and biliary tract cancers, we are mainly looking for IDH1 and IDH2 mutations, FGFR2 gene fusions and mutations, HER2 amplifications or mutations, as well as mutations of BRAF or BRCA1/2. All results should be discussed within the molecular tumor board.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 11","pages":"437-442"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792721","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 extraction of a loose Fobi ring in a patient with gastric bypass.","authors":"K Knotková, E Machytka, J Martínek, Jan Král","doi":"10.48095/ccrvch2024358","DOIUrl":"10.48095/ccrvch2024358","url":null,"abstract":"<p><p>Obesity has become a worldwide problem with a growing incidence, posing a risk to health, especially for cardiovascular disease, diabetes, certain types of cancer, depres-sive syndrome, and others. The methods of obesity treatment are still expanding, in addition to diet and exercise measures, pharmacological, endoscopic and surgical treatment is possible. One of the commonly performed bariatric surgical procedures is the Roux-en-Y gastric bypass, which combines restrictive and malabsorptive effects. As part of the development of new methods, the banded gastric bypass using the Fobi ring has been introduced. Its advantage is greater efficiency in reducing and maintaining -weight. One of the described complications is the migration of the Fobi ring, which can be addressed endoscopically today.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 9","pages":"358-361"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677437","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":"Current clinical applications of 3D printing in the management of complex fractures.","authors":"M Chovanec, M Krtička, J Šrámek, J Kovařík","doi":"10.33699/PIS.2024.103.5.158-166","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.5.158-166","url":null,"abstract":"<p><p>The field of skeletal traumatology has undergone revolutionary changes worldwide over the last decade with the development of 3D printing technologies. This review aims to provide a comprehensive overview of how 3D printing is transforming fracture treatment and opening up new possibilities in the management of complex fractures. The use of 3D printing in medicine offers a new dimension in precision and customisation of treatment, enabling the creation of personalised surgical templates, individualised implants and tools. The development of 3D printing is closely linked to other technological advances, such as augmented reality methods, which represent a significant step forward in the visualisation and planning of surgical procedures. Although 3D printing offers many advantages, its integration into routine clinical practice still faces many challenges. This article examines the history and development of 3D printing technology, materials used in medicine, preoperative planning, the creation of surgical guides, the fabrication of patient-specific implants, and the integration of 3D printing and augmented reality in skeletal surgery, highlighting the technical, logistical, and ethical challenges of implementing this technology in surgical practice.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"158-166"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400588","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":"Imaging methods in the diagnosis and treatment of pancreatic cancer.","authors":"D Girsa, J Weichet","doi":"10.33699/PIS.2024.103.4.117-121","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.4.117-121","url":null,"abstract":"<p><p>Surgery is the only potentially curative treatment of pancreatic cancer. Imaging methods, especially computed tomography (CT), play an essential role in the detection and staging of pancreatic cancer. The primary CT finding determines the treatment strategy, namely the resectability of the cancer with a potentially curative outcome. Imaging (CT) assessments are important also throughout oncological treatment of the patients and after the surgery, as well. Our paper summarizes the current state of the art of computed tomography and magnetic resonance imaging in pancreatic cancer, including a structured CT report proposal in pancreatic cancer.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 4","pages":"117-121"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383937","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":"Prophylactic osteosynthesis of long bones in patients with multiple myeloma.","authors":"V Nekuda, D Ira, M Štork, V Válek, Z Knechtová, M Cvanová, L Pour, M Krtička","doi":"10.33699/PIS.2024.103.5.187-192","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.5.187-192","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple myeloma (MM) is a neoplastic disease caused by clonal proliferation of plasma cells in the bone marrow. The median age of newly diagnosed patients is 69 years. Bone involvement occurs in most patients during the course of the disease. The management of bone involvement in MM includes surgical intervention. Bones affected by osteolytic lesions are weakened and require stabilization through implants or endoprostheses. The intramedullary osteosynthesis method appears to be an ideal choice for stabilizing osteolytic lesions in long bones. The aim of our study was to analyze whether prophylactic fixation of these lesions improves the quality of life of the patients and has any impact on bone changes.</p><p><strong>Methods: </strong>Patients undergoing prophylactic intramedullary osteosynthesis were operated on at the University Hospital Brno between 2013 and 2023. Patients included in this study had osteolytic lesions in long bones, Mirels' score equal to or greater than 8, and a minimum follow-up of 12 months. We evaluated the intensity of pain using a visual analog scale (VAS) assessed before the operation, after the operation, and one-year post-operation. The Musculoskeletal Tumour Society score (MSTS) score was assessed just before the planned stabilization procedure and one year later.</p><p><strong>Results: </strong>At the time of the assessment, a statistically significant difference was found between the VAS score before the operation and 14 days post-operation (p.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"187-192"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400663","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":"Acute hand infections and surgical treatment.","authors":"A Schmoranzová, T Hellmuth, D Horáčková, L Smrčková, F Hájek, E Čermáková","doi":"10.48095/ccrvch2024369","DOIUrl":"https://doi.org/10.48095/ccrvch2024369","url":null,"abstract":"<p><p>Hand infection is a common and frequent problem encountered by surgeons in their outpatient clinics. The causes are varied, ranging from trauma to surgical intervention and to the spread of infection from elsewhere on the body. The causative agents of infection are also varied, and although bacteria are the most common ones, viruses, fungi, and, of course, the problem of diagnosis after parasite infestation as well as rare causes of infections must also be considered. The diagnosis should be quick and the treatment should be as aggressive as possible without undue delay in a justified situation. This will avoid serious complications and consequences of infection on such a complex structure as the hand. The aim of this article is to provide an overview of the problem, and to provide information to support early diagnosis. Therapeutic options and interventions are proposed, with an emphasis on a modern, i.e. active, approach to the problem. Possible prevention of infection on the hand is mentioned. The article aims to improve clinical practice in the care of the hand with infection.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 10","pages":"369-380"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958623","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}