Magyar sebeszetPub Date : 2022-06-20DOI: 10.1556/1046.2022.20012
Zoltán Horváth, Attila Paszt, Zsolt Simonka, Melinda Látos, László Kaizer, Sándor Hamar, András Vörös, Katalin Ormándi, Zsuzsanna Fejes, Judit Oláh, György Lázár
{"title":"New trends in the surgical treatment of axilla in breast cancer","authors":"Zoltán Horváth, Attila Paszt, Zsolt Simonka, Melinda Látos, László Kaizer, Sándor Hamar, András Vörös, Katalin Ormándi, Zsuzsanna Fejes, Judit Oláh, György Lázár","doi":"10.1556/1046.2022.20012","DOIUrl":"https://doi.org/10.1556/1046.2022.20012","url":null,"abstract":"<p><p>Oncosurgical treatment of breast tumors involves the removal of metastatic axillary lymph nodes. In the last 30 years, the diagnosis and treatment of axillary lymph nodes have also undergone significant changes. The introduction of sentinel lymph node biopsy in 1993 made axillary block dissection with high morbidity safely omitted in a significant proportion of patients, and similarly, the staging of breast tumors and thus oncology and complex treatment became significantly more accurate. Shortly after the introduction of sentinel lymph node biopsy, intraoperative examination of sentinel lymph nodes (e.g. imprint cytology) also appeared, which significantly reduced the number of surgeries performed in the two sessions, thereby significantly reducing patient burden and surgical costs. The results of our study indicate that axillary block dissection is required in the treatment of axilla in an ever-decreasing group of patients and this proportion will decrease further in the future, with the increasing use of alternative axillary radiotherapy. The imprint cytological examination of sentinel lymph nodes taking into account current guidelines, no longer provides demonstrable benefits and its routine use is not justified. According to the latest international recommendations, intraoperative examination of the sentinel lymph node may be indicated in connection with mastectomy (when postoperative radiotherapy is not planned) and after neoadjuvant treatment. Our results suggest that the detection of suspected lymph nodes during preoperative axillary ultrasound may predict the stage of the disease. Based on our research results confirm that in patients receiving neoadjuvant therapy, in addition to the preoperative size of the tumour (≤20 mm, P = 0.002), the preoperative size of the lymph node (≤15 mm, P = 0.04) may also be used to predict that the stage of the disease is N0-1.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"169-178"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380336","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}
Magyar sebeszetPub Date : 2022-06-20DOI: 10.1556/1046.2022.20003
György Lázár
{"title":"Száz éves a Szegedi Tudományegyetem Sebészeti Klinikája - Köszöntő.","authors":"György Lázár","doi":"10.1556/1046.2022.20003","DOIUrl":"https://doi.org/10.1556/1046.2022.20003","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10827343","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}
Magyar sebeszetPub Date : 2022-06-20DOI: 10.1556/1046.2022.20015
Zsolt Palásthy, Róbert Sipka, Gábor Mihalovits, Tibor Takács, László Leindler, Zoltán Hódi, Rita Váradi, Áron Nyilas, Endre Nagy, András Nagy, Andrea Vass, Zoltán Ruzsa, Gábor Bogáts, György Lázár
{"title":"Changes in the care of peripheral vascular disease at the University of Szeged","authors":"Zsolt Palásthy, Róbert Sipka, Gábor Mihalovits, Tibor Takács, László Leindler, Zoltán Hódi, Rita Váradi, Áron Nyilas, Endre Nagy, András Nagy, Andrea Vass, Zoltán Ruzsa, Gábor Bogáts, György Lázár","doi":"10.1556/1046.2022.20015","DOIUrl":"https://doi.org/10.1556/1046.2022.20015","url":null,"abstract":"<p><p>Introduction and aims. In recent decades health care changes have accelerated enormously. Previously, by learning an effective procedure, the doctor could guarantee his patients the highest level of care for many years. Nowadays, due to the dynamics of development, the renewal cycles of the methods have been shortened, without continuous learning and training, it is already inconceivable to provide the up-to-date care required by patients. Patients and methods. Instead of vascular replacements with prosthetic grafts, which played an important role in vascular reconstructions, the primacy of endovascular techniques has become decisive. It can be significant for aortic aneurysms that can be operated with high invasiveness. The learning of catheter techniques by vascular surgeons made it possible to treat more successfully those limb-threatening cases, which are often associated with extensive vascular involvement, through the so-called hybrid operations. In addition to the increasing prevalence of diabetes worldwide, the higher proportion of critical limb ischemia and the highlighted pathogenic role of multi-resistant bacteria in the disease caused the marginaliation of the use of previously preferred prosthetic grafts. The effectiveness of the treatment of graft infections, which thus become less frequent, is improved by the use of homografts and negative pressure therapy. An effective method of preventing stroke is carotid endarterectomy, the morbidity of which is reduced by the introduction of locoregional anaesthesia allowing direct neuromonitoring. Results/conclusions. Although the acquisition and implementation of new methods has posed a continuous challenge for our specialists and doctors over the past 10 years, our achievements have made our department one of the leading vascular surgery centres in the country.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"185-193"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10377231","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}
Magyar sebeszetPub Date : 2022-06-20DOI: 10.1556/1046.2022.20016
Aurél Ottlakán, Attila Paszt, Zsolt Simonka, Szabolcs Ábrahám, Csenge Vass, Krisztina Varga, Bernadett Borda, Márton Vas, Ádám Balogh, György Lázár
{"title":"Minimally invasive adrenalectomy – Operative and perioperative results of transperitoneal and retroperitoneal adrenalectomies performed at the University of Szeged Department of Surgery during 23 years","authors":"Aurél Ottlakán, Attila Paszt, Zsolt Simonka, Szabolcs Ábrahám, Csenge Vass, Krisztina Varga, Bernadett Borda, Márton Vas, Ádám Balogh, György Lázár","doi":"10.1556/1046.2022.20016","DOIUrl":"https://doi.org/10.1556/1046.2022.20016","url":null,"abstract":"<p><p>Aim. Our goal was to evaluate operative and perioperative data of retroperitoneal (RP) and transperitoneal (TP) adrenalectomies performed at the University of Szeged Department of Surgery. Patients and method. During a retrospective cohort study including 174 adrenalectomies (28 RP; 146 TP) performed between 1998 and 2021, the following parameters were evaluated: rate of previous abdominal surgeries, conversion rate, operative time, intraoperative blood loss, tumor size, histology, hospital stay, early and late complications. Results. With significantly higher rate of previous abdominal surgeries [TP vs RP: 68 (46.57%) vs 4 (14%) P = 0.0021], there was no markable difference in conversion rate [TP vs RP: 7 (4.79%) vs 5 (18%), P = 0.312]. Significantly larger tumours were removed with TP (TP vs RP: 58.05 vs 34.8 mm, P = 0.016), with no markable difference in intraoperative blood loss (TP vs RP: 67.85 vs 50.2 ml, P = 0.157). Operative time was significantly shorter in TP (TP vs RP: 86.3 vs 134.5 min; P = 0.024). The most frequent histology was adenoma (TP vs RP: n = 95; 65.06% vs 64.3%). Pheochromocytoma occurred in 11 (7.53%) and 5 (17.8%) cases in TP and RP, respectively. We found no significant difference in hospital stay (TP vs RP: 5.125 vs 4.61 day; P = 0.413). Five- and 2 cases of early complications were seen in TP (splenic injury, postoperative fever, severe intraoperative bleeding, severe hypokalemia, surgical site infection) and RP (2 severe intraoperative bleeding), respectively. One lethal case of ventricular fibrillation and one delayed complication (postoperative abdominal wall hernia) were observed in TP. Conclusions. Both TP and RP are safe and simply reproducible minimally invasive techniques. According to our observation, RP adrenalectomy seems to be reserved for smaller lesions, while TP proves to be successful in removing enlarged and also malignant lesions with significantly shorter operative time.</p>","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":"75 2","pages":"194-199"},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380338","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}
Magyar sebeszetPub Date : 2022-03-24DOI: 10.1556/1046.2021.10010
Balázs Nemes, Zsolt Szentkereszty, Dezső Tóth
{"title":"Quo vadis chirurgia hepatobiliaria? A máj- és epeúti sebészet 100 éve és napjainkban a Debreceni Sebészeti Klinikán.","authors":"Balázs Nemes, Zsolt Szentkereszty, Dezső Tóth","doi":"10.1556/1046.2021.10010","DOIUrl":"https://doi.org/10.1556/1046.2021.10010","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":" ","pages":"50-57"},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327819","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}
Magyar sebeszetPub Date : 2022-03-24DOI: 10.1556/1046.2022.10015
Zsolt Szentkeresztesy
{"title":"Nagy Attila Professzor Úr 75 éves.","authors":"Zsolt Szentkeresztesy","doi":"10.1556/1046.2022.10015","DOIUrl":"https://doi.org/10.1556/1046.2022.10015","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":" ","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327823","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}
Magyar sebeszetPub Date : 2022-03-24DOI: 10.1556/1046.2021.10013
Zsigmond Tóth Csaba, Krisztina Litauszky, Zsolt Susán, Máté Farkas, Péter Nagy, Dániel Mátyási, Balázs Gergely, Dezső Tóth
{"title":"Az érsebészet története a Debreceni Egyetemen.","authors":"Zsigmond Tóth Csaba, Krisztina Litauszky, Zsolt Susán, Máté Farkas, Péter Nagy, Dániel Mátyási, Balázs Gergely, Dezső Tóth","doi":"10.1556/1046.2021.10013","DOIUrl":"https://doi.org/10.1556/1046.2021.10013","url":null,"abstract":"","PeriodicalId":74097,"journal":{"name":"Magyar sebeszet","volume":" ","pages":"65-66"},"PeriodicalIF":0.0,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327821","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}