Rozhledy v Chirurgii最新文献

{"title":"Malignant melanoma metastasis as a rare cause of abdominal pain.","authors":"T Kriegler, T Dušek, V Ninger, P Hanousek, M Podhola","doi":"10.48095/ccrvch2024313","DOIUrl":"10.48095/ccrvch2024313","url":null,"abstract":"<p><p>The authors present the case of a 71-year-old female patient who was operated on for 16 days of abdominal pain. The work points to malignant melanoma as a rare cause of abdominal pain and then shows the inscrutability of malignant melanoma and the importance of a multidisciplinary approach to this type of disease including subsequent dispensary by an oncologist. The emphasis on the prevention of this disease is an integral part of this approach.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 8","pages":"313-317"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309118","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":"Our experience with robotic-assisted thymic surgery.","authors":"M Podhráský, J Tvrdoň, J Schützner","doi":"10.33699/PIS.2024.103.2.40-47","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.2.40-47","url":null,"abstract":"<p><p>Thoracic surgery is increasingly influenced by the development of minimally invasive approaches which have also influenced surgery in the area of the anterior mediastinum. The previously standard approach to the thymus via partial sternotomy was gradually replaced by the videothoracoscopic approach in most cases. In recent years, robotically assisted surgery has been gaining ground worldwide in this area, as well. The aim of our paper is to provide a comprehensive overview of procedures in the field of the thymus, including their indications, and to share our first experience with robot-assisted thymus surgery. At the 3rd Department of Surgery, since the start of the robot-assisted thymus surgery program, 23 thymectomies have been performed using this approach, of which 17 were performed for thymoma, 3 for myasthenia gravis, and 3 for parathyroid adenoma localized in thymus tissue. From our experience and the available data, it follows that the length of hospitalization, the rate of complications and the resulting effect of robot-assisted procedures is comparable to VTS procedures; however, the robot-assisted surgery also allows for mini-invasive treatment even in significantly obese patients and in patients with advanced thymic tumors who would otherwise be indicated for open thymectomy.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 2","pages":"40-47"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865877","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":"Breast cancer in 80+ year olds.","authors":"P Kosáč, M Zábojníková, P Vážan, V Petrů, M Ratajský, K Lajmar, B Dudešek, P Kudlová, J Duben, L Podrazká, J Gatěk","doi":"10.48095/ccrvch2024258","DOIUrl":"https://doi.org/10.48095/ccrvch2024258","url":null,"abstract":"<p><strong>Introduction: </strong>The risk of breast cancer increases with increasing age. The aim of our retrospective study was to determine the extent of breast and axillary surgery, including subsequent adjuvant therapy, in 80-year and older patients.</p><p><strong>Methods: </strong>Between 2017 and 2021, 834 breast cancer patients were operated in the Surgical Department of the EUC Clinic. Ninety-eight women (2× with bilateral cancer) and 2 men were included in this retrospective study. A total of 102 breast cancer cases in patients older than 80 years were analyzed. The surgical procedure corresponded to the stage of the disease and the general condition of the patient. Adjuvant systemic therapy was indicated according to the same principles.</p><p><strong>Results: </strong>At the time of surgery, the patients were more than 80 years old (80-96 years). The predominant type of invasive ductal carcinoma was diagnosed 83×, lobular carcinoma 6×, mucinous 6×, papillary carcinoma 4×, other 3×, with luminal A, B predominating (89×). The breast-conserving procedures were performed 63×. Sentinel node biopsy was performed 65×, supplemented by axillary lymph node dissection 13×. Primary axillary lymph node dissection was performed 15×. No axillary procedure was performed 23×. Radiotherapy was given 49×, chemotherapy 9× and hormonal therapy 82×. Local and regional recurrences were each observed 2×. A total of 37 patients died, 10 of them from breast cancer.</p><p><strong>Conclusion: </strong>The most common cause of death in patients aged 80+ years is a cardiovascular disease, not breast cancer itself. This fact should be taken into account when determining the treatment plan.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 7","pages":"258-262"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983843","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 utilization of 3D printing in surgery as an innovative approach to preoperative planning.","authors":"J Hrubovčák, L Tulinský, M Pieš, R Hájovský, J Velička, K Chrz, T Bosek, J Szeliga, L Martínek","doi":"10.48095/ccrvch2024305","DOIUrl":"10.48095/ccrvch2024305","url":null,"abstract":"<p><strong>Introduction: </strong>3D printing, a concept over 40 years old, is finding broader application in clinical practice thanks to technological advancements. At University Hospital Ostrava, 3D printing is utilized to create anatomically accurate models of specific patients before surgical procedures based on imaging data.</p><p><strong>Case series: </strong>3D printing is employed as a complement to conventional imaging methods to produce morphologically precise models of anatomical structures of individual patients. These models primarily serve for preoperative planning in elective abdominal, vascular, and thoracic surgery. They are also used in planning osteosynthesis of complex fractures and corrective osteotomies. Multicolor printing, although increasing the process's time demands, allows better clarity and differentiation of individual anatomical structures within a single model.</p><p><strong>Discussion: </strong>Compared to 2D images, 3D models provide better spatial orientation and awareness of the operated structures, contributing to improved surgical outcomes. The benefits of 3D printing in preoperative planning and patient education are confirmed by studies across the fields ranging from cardiac surgery to traumatology.</p><p><strong>Conclusion: </strong>After overcoming initial challenges, 3D printing has become a reliable component of the surgical arsenal at University Hospital Ostrava for elective surgery. While 3D printing does not represent a universal answer to all medical challenges, its role is highly beneficial and promising in many indicated cases.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 8","pages":"305-312"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309120","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":"Fractures of the posterior malleolus as a part of complex ankle fractures: Trends in diagnosis and treatment at our institution.","authors":"V Kunc, L Kopp","doi":"10.33699/PIS.2024.103.5.175-180","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.5.175-180","url":null,"abstract":"<p><strong>Introduction: </strong>The management of posterior malleolus fractures has experienced notable advancements in recent years, predominantly driven by the CT-based Bartoníček-Rammelt classification. This study aims to systematically document the evolving trends in the approach to these fractures within the context of our institution.</p><p><strong>Methods: </strong>A comprehensive retrospective analysis was undertaken involving 66 patients who underwent surgical intervention for posterior malleolus fractures at our institution during the years 2020 and 2021. Patient classification was conducted based on the Lauge-Hansen classification, with additional categorization according to the Bartoníček-Rammelt classification in instances where CT scans were performed.</p><p><strong>Results: </strong>CT examinations were performed in 30 patients (45.45%); according to the Bartoníček-Rammelt classification they revealed type I in 2 cases, type II in 7 cases, type III in 12 cases, and type IV in 9 cases. Patients lacking specific fixation for type III posterior malleolus fractures, as per the Bartoníček-Rammelt classification, exhibited the most unfavorable treatment outcomes.</p><p><strong>Conclusion: </strong>Our findings elucidate a progressive trend in the utilization of CT examinations between 2020 and 2021, although this escalation remained insufficient during this period. Consequently, we have intensified efforts to advocate for increased use of CT scans. The issues with not optimally treated type III fractures, as classified by Bartoníček-Rammelt, are quite clear from our study. We were surprised by how often these cases occurred, and they often led to more complications. These fractures diagnosed by CT scans were not treated optimally, as surgeons tend to be reluctant in adopting modern treatment procedures. This emphasizes the importance of ongoing and thorough education in all kinds of healthcare settings, including those that specialize in ankle and foot surgery.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"175-180"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400639","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 neoadjuvant treatment in localized pancreatic cancer.","authors":"R Němeček, M Eid","doi":"10.48095/ccrvch2024429","DOIUrl":"https://doi.org/10.48095/ccrvch2024429","url":null,"abstract":"<p><p>Pancreatic carcinoma is a prognostically unfavorable cancer disease with growing incidence and mortality, which is the 3rd most common cause of cancer-related death in developed countries. The 5-year survival rate does not exceed 11% and is the lowest across all cancer diagnoses. Only about 20-30% of patients have resectable (RPC) or borderline resectable (BRPC) disease at the time of diagnosis. Radical resection is an essential therapeutic modality in these cases and is considered the only potentially curative procedure. Neoadjuvant chemotherapy and/or chemoradiotherapy is established mainly in BRPC. The role of neoadjuvant therapy in RPC is currently under investigation. This review article describes the current options, advantages and disadvantages of neoadjuvant treatment in BRPC and RPC.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 11","pages":"429-436"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792774","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":"Intraosseous ganglion cyst of the scaphoid with an extraosseous component -an uncommon cause of volar wrist pain: case report and literature review.","authors":"D Ira, B Čechová, M Krtička, J Kovařík","doi":"10.33699/PIS.2024.103.5.193-198","DOIUrl":"10.33699/PIS.2024.103.5.193-198","url":null,"abstract":"<p><p>Intraosseous ganglion is a relatively rare cause of chronic wrist pain. The ganglion is most commonly found in the os lunatum and os scaphoideum and in many cases includes an extraosseous component, both of which can be a source of clinical difficulty. In our case report, we present a patient with atypical chronic volar wrist pain who was diagnosed to have an intraosseous ganglion of the os scaphoideum with a volar extraosseous component as the main source of her problems. The patient had both components of the ganglion removed and the defect in the os scaphoideum was filled with an autogenous cancellous bone graft resulting in resolution of the clinical complaints and elimination of the risk of os scaphoideum fracture. The diagnostic and therapeutic considerations in patients found to have an intraosseous ganglion of the wrist with an extraosseous component are described and discussed in relation to the relevant literature.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"193-198"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400644","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":"Deep neck infections - case reports.","authors":"E Amirkhanian, T Kostlivý, L Hauer, J Šafránek, D Slouka","doi":"10.48095/ccrvch2024508","DOIUrl":"https://doi.org/10.48095/ccrvch2024508","url":null,"abstract":"<p><strong>Introduction: </strong>Deep neck infections represent severe inflammatory involvement of defined fascial spaces of the neck and are potentially life-threatening diseases. The etiology is most commonly odontogenic or tonsillogenic. The main complications are mediastinitis, septic shock and upper airway obstruction. Treatment is based on the administration of intravenous antibiotics and, in indicated cases, surgical drainage of abscess sites. Case report 1: A 7-year-old girl was treated by a general practitioner for acute tonsil-litis. CT scan with contrast medium was indicated due to worsening of the condition and neck movement. A large retropharyngeal abscess was not reliably found from the external approach, so the procedure was extended to tonsillectomy and transoral drain-age. The cause was probably a multilocular abscess with rigid membranous septa. Case report 2: A 65-year-old man with diabetes mellitus presents with odynophagia and infiltrate of the left side of the neck. CT scan showed a phlegmon in the left carotid space. Surgery was indicated after 24 hrs of ineffective conservative treatment. During the operation, extensive formed abscess lesions were found and drained. Case report 3: A 60-year-old woman was treated as an outpatient for tonsillitis, then at the regional ENT department with an incipient epiglottitis, and finally at a tertiary department with a diagnosis of deep neck infection extending from the epiglottis to the hyoid according to imaging examinations. Peroperative findings revealed even larger extent of abscess that extended down to the jugulum. Case report 4: A 57-year-old patient with peritonsillar abscess treated by incision and antibiotics in the regional ENT department. Despite the treatment instituted, the condition progressed and a parapharyngeal abscess developed, which had to be managed by tonsillectomy and external incision at a tertiary department, including postoperative intubation and several days of hospitalization in an ICU ward.</p><p><strong>Conclusion: </strong>Medical history, otorhinolaryngological examination and early head and neck contrast enhanced CT are essential in the diagnosis of deep cervical inflamma-tion. Modern therapeutic algorithms including a multidisciplinary approach, repeated CT scans and surgical revisions lead to reduced mortality, including patients with mediastinitis.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 12","pages":"508-514"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028177","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":"Breast cancer localization by iodine seed 125I vs. wire- -guided localization - retrospective case-control study.","authors":"J Žatecký, Z Heralt, D Sekret, E Sehnálková, M Peteja","doi":"10.48095/ccrvch2024263","DOIUrl":"https://doi.org/10.48095/ccrvch2024263","url":null,"abstract":"<p><strong>Introduction: </strong>For many years, the gold standard in the localization of non-palpable malignant breast tumors has been the use of wire-guided method. However, this has recently been replaced by more modern localization techniques in many institutions.</p><p><strong>Methods: </strong>This is a retrospective case-control study comparing two localization techniques (iodine seed 125I and wire-guided localization) for localizing non-palpable tumors in patients with histologically verified breast carcinoma.</p><p><strong>Results: </strong>The study included 62 patients - 31 with localization of malignant breast tumor by iodine seed (subgroup 125I) and 31 by wire-guided localization (subgroup FV). The average volume of the resected tissue in subgroup 125I (46.2 cm3) was statistically significantly smaller compared to subgroup FV (83.7 cm3; P = 0.0063). R0 resection was achieved in 29 cases (93.5%) in subgroup 125I and in 24 cases (77.4%) in subgroup FV (P = 0.0714). In subgroup 125I, re-resection was not indicated in any case, while in subgroup FV, re-resection due to tumor reaching the margin was indicated in 6 cases (19.4%; P = 0.01).</p><p><strong>Conclusion: </strong>Our initial experience show that the use of iodine seeds for localizing non-palpable breast tumors is associated with the removal of a smaller volume of resected tissue compared to wire-guided localization, with a trend towards more frequent achievement of R0 resection. In the subgroup of patients localized with iodine seeds, there was a smaller proportion of re-resections due to inadequate safety margins.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 7","pages":"263-268"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983844","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 surgical mesh placement as a prevention of parastomal hernia in open radical cystectomy with ileal conduit diversion - pilot study.","authors":"M Louda, P Navrátil, Š Šachová, L Holub, A Fibír, M Balík, M Broďák","doi":"10.33699/PIS.2024.103.3.91-95","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.3.91-95","url":null,"abstract":"<p><strong>Introduction: </strong>This study examines the efficacy of prophylactic mesh implantation during open radical cystectomy with ileal conduit diversion in preventing parastomal hernias (PH). Despite PH being a common complication, prophylactic methods have been underexplored.</p><p><strong>Methods: </strong>A pilot, single-center, prospective cohort study was conducted involving five patients undergoing surgery with mesh implantation. Demographic and clinical characteristics were monitored, including the incidence of PH, operation time, blood loss, and hospitalization duration.</p><p><strong>Results: </strong>During the mean follow-up period of 9.1±3.2 months post-operation, no occurrences of PH were observed in the patient group. Despite the risks associated with implanting foreign material in an area of surgery involving open small intestine, no infectious complications were noted.</p><p><strong>Conclusion: </strong>Prophylactic mesh implantation in radical cystectomy with ileal conduit diversion appears to be an effective preventive measure against PH. Further extensive studies are required to definitively confirm the efficacy and safety of mesh use in this context.</p>","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 3","pages":"91-95"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421860","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}