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Wyświetlanie 1-5 z 5
Tytuł:
Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Departments Own Material
Autorzy:
Bobkiewicz, Adam
Krokowicz, łukasz
Banasiewicz, Tomasz
Kościński, Tomasz
Borejsza-Wysocki, Maciej
Ledwosiński, Witold
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1396002.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
iatrogenic bile duct injuries
cholecystectomy
complications
Opis:
Iatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased. The aim of the study was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014. Material and methods. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay. Results. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%). Conclusions. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.
Źródło:
Polish Journal of Surgery; 2014, 86, 12; 576-583
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Assessment of the Results of Surgical Treatment of Zenker’S Diverticulum in Own Material
Autorzy:
Bobkiewicz, Adam
Banasiewicz, Tomasz
Krokowicz, Łukasz
Dryjas, Andrzej
Wykrętowicz, Mateusz
Katulska, Katarzyna
Borejsza-Wysocki, Maciej
Malinger, Stanisław
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1395561.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
Zenker diverticulum
diverticulectomy
diverticulopexy
Opis:
Zenker diverticulum (ZD) is the most common type of diverticula of the esophagus. Most often refers to men with a peak incidence in the seventh and eighth decade of life. In the majority diverticula remains asymptomatic and in patients with symptomatic course of the disease symptoms are often nonspecific. Aim of the study was to present the authors’ own experience in surgical treatment of Zenker diverticulum. Material and methods. In this paper we present an analysis of 31 patients with confirmed ZD treated surgically at the Clinic in 2004-2014. Patients were analyzed in terms of age, gender, clinical symptoms, diverticulum size, type of surgery, the time to return to the oral intake, hospital stay and perioperative complications. Results. 22 men and 9 women were enrolled it this study. The mean age of the patients was 64.8 (SD, 10.7; in the range of 28 to 82 years). 29 patients (93.5%) underwent resection of the diverticulum, while diverticulopexy was performed in two patients. In 25 (80.6%) cases stapler device was used, while in 4 (12.9%) resection was performed manually. The average size of resected diverticulum was 4.9 cm (SD, 1.5). Following the surgery in four patients (12.9%) complications were present. The average operating time was 118.7 minutes (SD, 42.2, in the range of 50 to 240 minutes). The mean length of hospital stay was 9.3 (SD, 3.3). Conclusions. Surgical treatment of ZD is associated with high effectiveness and low recurrence rate. Despite the advantages of endoscopic techniques, surgical treatment is characterized by one- stage procedure. The use of mechanical suture (stapler) significantly improves the operation, although on the basis of our own analysis there was no superiority revealed over hand sewn. Unquestionable adventage of classical technique is the opportunity to histopathological evaluation of resected diverticulum what is impossible to achieve in endoscopic techniques.
Źródło:
Polish Journal of Surgery; 2015, 87, 3; 109-115
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Surgical methods of treatment of intestinal passage disturbances with the characteristics of constipation in patients with intestinal stoma based on own experience
Autorzy:
Krokowicz, Łukasz
Sławek, Sylwia
Ledwosiński, Witold
Bobkiewicz, Adam
Borejsza-Wysocki, Maciej
Kuczyńska, Barbara
Szmyt, Krzysztof
Paszkowski, Jacek
Drews, Michał
Banasiewicz, Tomasz
Powiązania:
https://bibliotekanauki.pl/articles/1395605.pdf
Data publikacji:
2015-04-01
Wydawca:
Index Copernicus International
Tematy:
end colostomy
loop colostomy
constipation
parastomal hernia
Opis:
Stoma is an intestinal fistula created in emergency or by elective indications, and it is done to drain out the digestive tract content. In some patients there is a disturbance passage of gastric contents through the stoma, which may take the form of chronic constipation or even periodic subileus that will sooner or later require surgical treatment. The aim of the study was the assessment of the causes and method of treatment of constipation in patients with intestinal stoma. Material and methods. A total of 331 patients with stoma followed by Ostomy and Proctology Outpatient Clinic were included in the study in the years 2011-2014. The study included 146 women and 185 men and the average age was 61.3 ± 12.7 years. Within the entire froup, 273 patients had the end stoma performed whereas in 58 patients the loop stoma was created. The highest percentage of patients were the ones with diverticulosis and colorectal cancer, i.e. 132 and 114 patients respectively. A stoma was created in 35 patients due to inflammatory bowel disease (IBD), in 23 patients because of cancer, in 14 as a result of injuries and in 13 due to rectovaginal fistula. Results. Out of the entire group subject to study (331 patients) 93 patients (28.1%) suffered from constipation. 50 patients with constipation required surgical intervention. The most common indication for surgical treatment was the parastomal hernia (36 patients, 72%), other indications were the narrowing of the stoma (5 patients, 10%), its collapse (6 patients, 12%) or prolapse (3 patients, 6%). Parastomal hernia was responsible for 84% of constipation within the stoma and 86.1% were treated with laparotomy (31 out of 36 patients). Other causes of constipation were the stomal stenoses (5 patients), collapse of the stoma (6 patients) and stomal prolapse (3 patients). All patients were treated surgically with a good final result. Conclusions. Constipation associated with dysfunction of the stoma in most cases should be treated surgically. Parastomal hernia is the most common cause of constipation in the stoma. Treatment should be performed in due time because of the possibility of developing complications, especially dangerous one is a strangulated parastomal hernia and ischemia of stoma.
Źródło:
Polish Journal of Surgery; 2015, 87, 4; 160-165
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The influence of rifaximin on diverticulitis rate and quality of life in patients with diverticulosis
Autorzy:
Banasiewicz, Tomasz
Francuzik, Wojciech
Bobkiewicz, Adam
Krokowicz, Łukasz
Borejsza-Wysocki, Maciej
Paszkowski, Jacek
Studniarek, Adam
Krokowicz, Piotr
Grochowalski, Marcin
Zastawna, Kinga
Szczepkowski, Marek
Lorenc, Zbigniew
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1393466.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
diverticulitis
diverticulosis
rifaximin
prevention
Opis:
Diverticulosis, its associated symptoms and complications are one of the most common pathologies of the gastrointestinal tract in more economically developed countries. Presence of diverticuli and their clinical consequences can be divided into four categories: 1) diverticulosis, i.e. an asymptomatic presence of diverticuli that are usually found by accident 2) symptomatic uncomplicated diverticulosis 3) diverticulitis (acute uncomplicated diverticulitis) 4) complications of diverticulitis (conditions requiring hospital stay). The aim of this study was to retrospectively analyze the efficacy of rifaximin in preventing diverticulitis in patients visiting proctology clinics. The diagnostic criterium for diverticulosis was confirmation by colonoscopy, barium enema or CT colography (virtual colonoscopy) as well as history of at least one documented episode of diverticulosis. History of diverticulosis was evaluated based on medical records, clinical symptoms, elevated level of CRP (>5.0) and/or diagnostic imaging (ultrasound, CT). After setting strict exclusion criteria, 248 patients were qualified for the study out of 686, and they were later divided into two groups: control group (group I – 145 patients) and studied group (group II – 103 patients receiving rifaximin prophylaxis). Diverticulitis rate was comparable in both groups over a period of 6 months before study (p = 0.1306) and 6 months of treatment (p=0.3044). Between the 6th and 12th month of treatment, a significantly lower rate of diverticulitis was noted in the group receiving rifaximin compared to control group (p<0.0001). Patients receiving rifaximin reported higher quality of life (which was assessed using the VAS scale) compared to control group after 12 months. The results confirmed the efficacy of riaximin in prevention of diverticulitis, even in the scheme of repeated courses every 3 months. Not only did application of rifaximin lower the rate of diverticulitis and its complications in patients after an episode of diverticulitis, but also it improved the patients’ quality of life. It seems that diverticulitis prophylaxis based on rifaximin can be economically efficient, however, it requires further research.
Źródło:
Polish Journal of Surgery; 2017, 89, 1; 22-31
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Wpływ profilaktycznego stosowania rifaksyminy na występowanie zapaleń uchyłków i jakość życia chorych z chorobą uchyłkową
Autorzy:
Banasiewicz, Tomasz
Francuzik, Wojciech
Bobkiewicz, Adam
Krokowicz, Łukasz
Borejsza-Wysocki, Maciej
Paszkowski, Jacek
Studniarek, Adam
Krokowicz, Piotr
Grochowalski, Marcin
Zastawna, Kinga
Szczepkowski, Marek
Lorenc, Zbigniew
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1393500.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
zapalenie uchyłków
choroba uchyłkowa
rifaksymina
profilaktyka
Opis:
Uchyłki jelita grubego i związane z nimi dolegliwości kliniczne oraz powikłania to jedna z najczęstszych patologii przewodu pokarmowego w krajach wysokorozwiniętych. Obecność uchyłków jelita grubego oraz związane z nimi konsekwencje kliniczne podzielić można na cztery podstawowe postacie: 1) uchyłkowatość, czyli obecność uchyłków jelita grubego nie dających objawów klinicznych i wykrywanych zazwyczaj przypadkowo, 2) objawowa niepowikłana choroba uchyłkowa, 3) zapalenie uchyłków (ostre niepowikłane zapalenie uchyłków), 4)powikłania zapalenia uchyłków (obejmujące stany wymagające hospitalizacji). Celem niniejszej pracy była retrospektywna analiza efektywności stosowania rifaksyminy w profilaktyce występowania zapalenia uchyłków u  pacjentów leczonych w  poradniach proktologicznych. Kryterium rozpoznania choroby uchyłkowej stanowiło potwierdzenie występowania uchyłków jelita grubego na podstawie badania kolonoskopowego, wlewu kontrastowego lub kolografii KT (wirtualnej kolonoskopii) oraz co najmniej jednego przebytego (udokumentowanego) epizodu zapalenia uchyłków. Przebyte zapalenie uchyłków stwierdzano na podstawie dokumentacji medycznej, potwierdzającej obecność objawów klinicznych, oraz podwyższonej wartości CRP (>5,0), lub/i wyników badań obrazowych (USG, KT). Spośród 686 pacjentów leczonych w poradni, po przyjęciu restrykcyjnych kryteriów wykluczenia, do badania zakwalifikowano 248 chorych, których podzielono na dwie grupy: kontrolną (grupa I –145 chorych) i badaną (grupa II – 103 pacjentów stosujących profilaktycznie rifaksyminę). Liczba zapaleń uchyłków u pacjentów w obu grupach była zbliżona w okresie 6 miesięcy przed rozpoczęciem badania (p=0,1306) i w pierwszych 6 miesiącach terapii (p=0,3044). Między 6. a 12. miesiącem terapii, odnotowano istotnie mniejszą liczbę zapaleń uchyłków u pacjentów stosujących profilaktycznie rifaksyminę, w porównaniu do grupy kontrolnej (p<0,0001). Pacjenci, którym podawano rifaksyminę, mieli istotnie wyższą jakość życia (mierzoną wg. skali VAS) niż w ci w grupie kontrolnej po 12 miesiącach zażywania rifaksyminy. Wyniki badania potwierdziły efektywność stosowania rifaksyminy w profilaktyce zapalenia uchyłków, nawet w schemacie kuracji powtarzanej co 3 miesiące. Stosowanie rifaksyminy u pacjentów z epizodem zapalenia uchyłków nie tylko zmniejszało częstość występowania zapaleń i ich powikłań, ale również poprawiało jakość życia tych chorych. Wydaje się również, że profilaktyka zapaleń uchyłków oparta o rifaksyminę może być efektywna ekonomicznie, wymaga to jednak dalszej analizy i badań.
Źródło:
Polish Journal of Surgery; 2017, 89, 1; 22-31
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-5 z 5

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