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[In memoriam Dr. Péter Küttel surgeon-anesthesiologist (1943–2022)]. [纪念pameter kttel外科麻醉师(1943-2022)]。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20019
Antal Hollósi
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引用次数: 0
Short term results of the FLOT neoadjuvant therapy on the surgical management of advanced gastro-oesophageal junction adenocarcinoma FLOT新辅助治疗晚期胃-食管交界区腺癌的近期疗效观察
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20008
Attila Paszt, Zsolt Simonka, Krisztina Budai, Márton Erdős, Márton Vas, Aurél Ottlakán, Zoltán Szepes, László Torday, László Tiszlavicz, György Lázár
{"title":"Short term results of the FLOT neoadjuvant therapy on the surgical management of advanced gastro-oesophageal junction adenocarcinoma","authors":"Attila Paszt,&nbsp;Zsolt Simonka,&nbsp;Krisztina Budai,&nbsp;Márton Erdős,&nbsp;Márton Vas,&nbsp;Aurél Ottlakán,&nbsp;Zoltán Szepes,&nbsp;László Torday,&nbsp;László Tiszlavicz,&nbsp;György Lázár","doi":"10.1556/1046.2022.20008","DOIUrl":"https://doi.org/10.1556/1046.2022.20008","url":null,"abstract":"<p><p>Introduction. Recently the therapeutic treatment for advanced, stage T2-T4 gastro-oesophageal junction cancer and those adjacent to the regional lymph nodes involves neoadjuvant chemotherapy with subsequent surgical intervention. Method. Neoadjuvant oncological treatment for gastro-oesophageal junction cancer previously consisted of the intravenous administration of epirubicin, cisplatin and fluorouracil (ECF) or epirubicin, cisplatin and capecitabine (ECX) combination (Group I). In the course of the new protocol (FLOT-, F: 5-FU, L: leucovorin, O: oxaliplatin, T: docetaxel), patients were included with resectable gastro-oesophageal junction cancer who had a clinical-stage cT2 or higher nodal positive cN+ disease (Group II). Between 31st of December 2013 and 1st of June 2021 we retrospectively analyzed the effect of these FLOT oncological protocols in terms of surgical outcomes in cases of T2-T4 tumors (n = 9). We compared the results of the randomly assigned nine patients from earlier ECF/ECX protocol (Group I). We analyzed the effect of the different neoadjuvant therapy on tumor regression, and evaluated the types of possible side effects, type of surgery, and the oncological radicality of surgical procedures (number of removed regional lymph nodes, resection margins). Results. Comparing the two groups we found that in cases of FLOT neoadjuvant chemotherapy complete regression was achieved significantly a higher number like in earlier ECX/ECF therapy. Furthermore, the average number of removed lymph nodes, and the safety resection margins (distal, circumferential) no significant difference was found between the two groups. Neutropenia was the most frequently encountered side effect. Leukopenia, neutropenia and nausea occurred more frequently in cases of the old protocol (Group I). Conclusions. As a result of the FLOT neoadjuvant oncological protocol for advanced gastro-oesophageal junction cancer, the number of cases with complete tumor regression has significantly increased. The present results strongly suggest a significant advantage in favor of FLOT neoadjuvant treatment following surgery. The prevalence of side effects was also appreciably lower in cases of the FLOT protocol.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"142-150"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10385334","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
[History of the Surgical Department (University of Szeged) in the light of the scientific results]. [从科学成果看外科(塞格德大学)的历史]。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20004
György Lázár, Gyula Baradnay
{"title":"[History of the Surgical Department (University of Szeged) in the light of the scientific results].","authors":"György Lázár,&nbsp;Gyula Baradnay","doi":"10.1556/1046.2022.20004","DOIUrl":"https://doi.org/10.1556/1046.2022.20004","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"104-116"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534148","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
Surgical treatment of gastroesophageal reflux disease and Barrett’s esophagus 胃食管反流病和巴雷特食管的外科治疗
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20007
Zsolt Simonka, Attila Paszt, Kornél Kovách, Illés Tóth, Zoltán Horváth, József Pieler, János Tajti, Ádám Leprán, László Tiszlavicz, István Németh, András Rosztóczy, Márton Lup, György Lázár
{"title":"Surgical treatment of gastroesophageal reflux disease and Barrett’s esophagus","authors":"Zsolt Simonka,&nbsp;Attila Paszt,&nbsp;Kornél Kovách,&nbsp;Illés Tóth,&nbsp;Zoltán Horváth,&nbsp;József Pieler,&nbsp;János Tajti,&nbsp;Ádám Leprán,&nbsp;László Tiszlavicz,&nbsp;István Németh,&nbsp;András Rosztóczy,&nbsp;Márton Lup,&nbsp;György Lázár","doi":"10.1556/1046.2022.20007","DOIUrl":"https://doi.org/10.1556/1046.2022.20007","url":null,"abstract":"<p><p>For the centenary of the Department of Surgery, University of Szeged we have investigated and summarized the results and outcomes of 779 anti-reflux surgery cases between 1. January 2000 – 31. May 2021. The indication for surgery was made in close collaboration with the internal medicine workgroup depending on the results of endoscopy and functional tests. The primer indication for surgery was medical therapy-resistant reflux disease. Based on our clinical practice we performed laparoscopic Nissen fundoplication in 98,2% of the cases. Besides the long- and short-term postoperative complications, we investigated the long-term effect of anti-reflux surgery on acid and bile reflux, and the improvement of the patients' quality of life using the Visick score, and modified GERD-HRLQ score. Our investigations have proven the effect of acid and bile reflux in the pathogenesis of Barrett's esophagus and furthermore we have confirmed that laparoscopic anti-reflux surgery restores the function of the lower esophageal sphincter and eliminates acid and bile reflux, so in certain cases Barrett's esophagus regression can be achieved. But due to the heterogeneity of GERD and Barrett's esophagus long-term and regular endoscopic control is necessary.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"133-141"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380339","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
[Minimally invasive surgery for motility disorders of the oesophagus]. 微创手术治疗食道运动障碍。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20006
László Andrási, Szabolcs Ábrahám, Zsolt Simonka, Attila Paszt, Márton Erdős, László Rovó, András Rosztóczy, Georgina Ollé, György Lázár
{"title":"[Minimally invasive surgery for motility disorders of the oesophagus].","authors":"László Andrási,&nbsp;Szabolcs Ábrahám,&nbsp;Zsolt Simonka,&nbsp;Attila Paszt,&nbsp;Márton Erdős,&nbsp;László Rovó,&nbsp;András Rosztóczy,&nbsp;Georgina Ollé,&nbsp;György Lázár","doi":"10.1556/1046.2022.20006","DOIUrl":"https://doi.org/10.1556/1046.2022.20006","url":null,"abstract":"Vizsgálatunkban a nyelőcső motilitási betegségeinek minimálisan invazív műtéti kezelésében szerzett tapasztalatainkat mutatjuk be a pharingo-oesophagealis (Zenker-) diverticulum, az epiphrenalis nyelőcső diverticulum és az achalasia cardiae vonatkozásában, hangsúlyt fektetve a perioperatív eredményekre és az életminőségre. 2003. január 1. és 2020. december 31. között Zenker, epiphrenalis diverticulum és achalasia miatt műtéttel kezelt és gondozott betegeket vontunk be a vizsgálatokba. Zenker-diverticulum miatt transoralis stapler diverticulostomiát 17, transcervicalis diverticulectomiat és cricomyotomiat 23 esetben, epiphrenalis diverticulum miatt 14 betegnél laparoscopos transhiatalis diverticulectomiát és Heller–Dor-műtétet, míg 63 esetben achalasia cardiae miatt Heller–Dor-műtétet végeztünk. Elemeztük a perioperatív eredményeket, valamint közép- és hosszú távon a műtétek életminőségre kifejtett hatásait. A műtétek minimális vérvesztéssel, alacsony morbiditással, mortalitás nélkül voltak kivitelezhetők. Vizsgálatunk szerint mind a Zenker-diverticulumok mindkét megközelítésből végzett műtéte, mind az achalasia cardiae és az epiphrenalis gurdély kezelésében alkalmazott laparoscopos Heller–Dor-eljárás biztonságos és hatékony sebészi módszerek. A minimálisan invazív technikával operált betegek tüneti kontrollja hosszú távon is megfelelő, és csak a betegek alacsony százalékánál jelentkeznek recidív panaszok, amelyek kiegészítő gyógyszeres és/vagy korrekciós műtétet is igényelhetnek.","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"121-132"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827349","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
[Short history of liver surgery in the Department of Surgery of University of Szeged]. [塞格德大学外科学系肝脏手术简史]。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20013
András Petri, József Hőhn, Tibor Géczi, László Libor, György Lázár
{"title":"[Short history of liver surgery in the Department of Surgery of University of Szeged].","authors":"András Petri,&nbsp;József Hőhn,&nbsp;Tibor Géczi,&nbsp;László Libor,&nbsp;György Lázár","doi":"10.1556/1046.2022.20013","DOIUrl":"https://doi.org/10.1556/1046.2022.20013","url":null,"abstract":"<p><p>Introduction The authors introduce the history of liver surgery in Szeged on the occasion of the 100th anniversary of the Surgery Department's establishment. Material and methods After the initiation of liver surgery in Szeged by Professor Karácsonyi 1982 we are treating not only patients with benign and malignant focal liver diseases but also others with surgery required because of complications of portal hypertension. Patients are presented in two periods. Discussion We operated on 46.5% of the patients with malignant and 53.5% of the patients with benign diseases between 1981 and 1991. The surgical spectrum extended to trisegmentectomy. There were 14% of minor and 9.9% of major complications, the mortality was 3.23% which meets international standards. In the second period, 50.5% of the patients were operated on because of malignant and 46.5% of the patients suffered from benign focal diseases from 1992. Among the patients who had been operated on because of liver malignancy, there were 51% metastasis mostly of colorectal cancer, 22% were hepatocellular, 16% were cholangiocellular carcinoma and in 11% were other malignant tumors. In those patients who had been operated on because of benign focal liver diseases, there were 32% cysts, 25% echionococcus cysts, 26% haemangiomas, 8% adenomas, 7% FNH, and 2% because of others. The summarized mortality rate was 1.3%. There were peritoneo-venous shunt implantations in 126 cases because of therapy-refracter ascites. We performed oesophageal transection with a circular stapler after failed endoscopic haemostasis in 50 cases. Conclusion Chances of liver surgery have been basically widened because of the financial investment that is connected to the Department of Surgery's move to a new building. The liver unit in Szeged today can take care of patients in a full spectrum of liver surgery.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"179-181"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10812001","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
[Editor’s note]. [编者按]。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20020
Attila Oláh
{"title":"[Editor’s note].","authors":"Attila Oláh","doi":"10.1556/1046.2022.20020","DOIUrl":"https://doi.org/10.1556/1046.2022.20020","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"102"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827341","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
Unilateral video-assisted thoracoscopic thymoma resection – Indications, early and mid-term results 单侧胸腔镜胸腺瘤切除术-适应症,早期和中期结果
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20001
József Kas, Levente Bogyó, Csaba Fehér, Áron Ghimessy, Balázs Gieszer, Luca Karskó, Lóránt Kecskés, Viktor Lungu, László Mészáros, Ágoston Pataki, Péter Radetzky, Róbert Szegedi, Bernadett Tallósy, Klári Török, Attila Vágvölgyi, János Fillinger, Tünde Harkó, Ibolya Soltész, Erika Tóth, Csilla Rózsa, Jenő Elek, Erna Ganovszky, László Agócs, Ferenc Rényi-Vámos, Ákos Kocsis
{"title":"Unilateral video-assisted thoracoscopic thymoma resection – Indications, early and mid-term results","authors":"József Kas,&nbsp;Levente Bogyó,&nbsp;Csaba Fehér,&nbsp;Áron Ghimessy,&nbsp;Balázs Gieszer,&nbsp;Luca Karskó,&nbsp;Lóránt Kecskés,&nbsp;Viktor Lungu,&nbsp;László Mészáros,&nbsp;Ágoston Pataki,&nbsp;Péter Radetzky,&nbsp;Róbert Szegedi,&nbsp;Bernadett Tallósy,&nbsp;Klári Török,&nbsp;Attila Vágvölgyi,&nbsp;János Fillinger,&nbsp;Tünde Harkó,&nbsp;Ibolya Soltész,&nbsp;Erika Tóth,&nbsp;Csilla Rózsa,&nbsp;Jenő Elek,&nbsp;Erna Ganovszky,&nbsp;László Agócs,&nbsp;Ferenc Rényi-Vámos,&nbsp;Ákos Kocsis","doi":"10.1556/1046.2022.20001","DOIUrl":"https://doi.org/10.1556/1046.2022.20001","url":null,"abstract":"<p><p>Introduction. Thymoma is the most common tumour of the anterior mediastinum. Video-Assisted Thoracic Surgery technique of thymoma resection is spreading world-wide, but the thoracoscopic method is still contentious in many ways. Authors evaluate the early and mid-term results of a 17 years period of VATS unilateral approach at 2 Hungarian thoracic surgical centers. Method. Depending on the anatomical situation of the thymoma, we performed thymectomy, or partial thymectomy (thymomectomy) for the Masaoka–Koga I–II–III stage thymoma from the right or left side through 2 or 3 intercostal ports. We managed the operations with ultrasonic dissector and electrocauter. By using international standards we evaluated perioperative morbidity, mid-term oncological results and clinical symptoms of myasthenia. Results. 23 of the 54 patients were man, 31 were woman, the average age was 58 (26–79) years, 23 of them had myasthenia. The conversion rate was 11,5% (7/61). The average operation time was 84 (39–150) minutes. The average hospitalisation time was 5.5 (3–19) days. The average size of the thymomas was 46 (18–90) mm. The histology resulted thymoma type A in 2 cases, AB in 19 cases, B1/2/3 in 11/11/1 cases, mixed B in 10 cases. The examination of the resection line was R0/1/2 in 42/11/1 cases. The Masaoka–Koga stages were: I (17), IIA (28), IIB (2), III (7). There was 25 thymomectomies, and 29 thymectomies. In seven cases there were extension of the operation to the pericardium (2), to the lung (2), to the phrenic nerve (6), and to innominate vein (1). The in-hospital mortality over 30 day was in 1 case (1.85%). The morbidity was 11/54 (20.4%). The average follow-up time was 62.56 (5–198) months. In the group with myasthenia the effectivity of the operation was 18/21 (85.7%), including complete remission of 5/21 (23.8%). Post-thymectomy myasthenia gravis developed in 2/31 cases (6.5%). The average 5 years survival was 100%, tumour-free 5 years survival was 96%. Conclusions. The higher proportion of the thymomectomy in the early results, higher conversion rate and lower R0 proportion might be in connection with the attitude of the surgeons, with the learning curve and with the limitations of the unilateral method. After a longer follow-up time late results may become more real and comparable. Instead of unilateral VATS technique we have changed to the subxyphoideal approach of VATS because of its better visualisation.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"79-95"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10753818","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
Laparoscopic splenectomy in our practice at the University of Szeged Department of Surgery 腹腔镜脾切除术在塞格德大学外科的实践
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20017
Áron Nyilas, Attila Paszt, Zsolt Simonka, Szabolcs Ábrahám, Bernadett Borda, Eszter Mán, Ágnes Bereczki, Dóra Földeák, György Lázár
{"title":"Laparoscopic splenectomy in our practice at the University of Szeged Department of Surgery","authors":"Áron Nyilas,&nbsp;Attila Paszt,&nbsp;Zsolt Simonka,&nbsp;Szabolcs Ábrahám,&nbsp;Bernadett Borda,&nbsp;Eszter Mán,&nbsp;Ágnes Bereczki,&nbsp;Dóra Földeák,&nbsp;György Lázár","doi":"10.1556/1046.2022.20017","DOIUrl":"https://doi.org/10.1556/1046.2022.20017","url":null,"abstract":"<p><p>Since its introduction in 1991, laparoscopic splenectomy has been considered the gold standard in spleen surgery, and the advantages of this technique over open surgery are indisputable. The technique was initiated in the Department of Surgery, University of Szeged in 1994 and since then our working group has gained one of the greatest experiences in this field in Hungary. Based on our results, similarly to literature data, it may be established that laparoscopic splenectomy can be considered a surgical procedure with low morbidity after gaining the necessary experience. In our study, the bowel motility recovered earlier, and hospital stay was significantly shorter after laparoscopic procedures. We proved laparoscopic splenectomy is a safe method in cases of extremely large spleens, and the Pfannenstiel incision is a cosmetically acceptable alternative for the retrieval of the spleen. Although several medications are available for second-line ITP therapy, laparoscopic splenectomy provides the longest-lasting results. In our study, young age and a preoperative response to steroids (steroid-dependent cases) were positive predictors for the success of splenectomy. Based on our experiences in the case of an immediate complete response to splenectomy, relapse occurred significantly less often.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"200-207"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10753817","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
Hasnyálmirigy-sebészet. 胰腺手术。
Magyar sebeszet Pub Date : 2022-06-20 DOI: 10.1556/1046.2022.20014
Gyula Farkas, László Leindler, János Márton, Gyula Farkas
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