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Wyświetlanie 1-8 z 8
Tytuł:
Prediction of Survival in Patients with Unresectable Colorectal Liver Metastases
Autorzy:
Hołówko, Wacław
Grąt, Michał
Hinderer, Barbara
Orlińska, Izabela
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395796.pdf
Data publikacji:
2014-07-01
Wydawca:
Index Copernicus International
Tematy:
colorectal cancer
liver metastases
unresectable metastases
survival prediction
Opis:
Liver metastases are diagnosed synchronously with the primary tumour in 25% of patients with colorectal cancer. A half of the remaining patients develop liver metastases within 3 years following colectomy. At present, the only radical treatment of metastases is liver resection. Only 2.6% of patients survive 3 years if such treatment is not implemented. The aim of the study was to assess predictive factors of long-term survival in the group of patients with unresectable colorectal liver metastases carcinoma. Material and methods. Of 1029 patients with colorectal liver metastases, who were treated in the Department of General, Transplant and Liver Surgery of the Medical University of Warsaw in the years 2006-2012, cases of liver metastases assessed intraoperatively as unresectable were selected. The retrospective analysis included 85 patients. Based on the medical documentation, information concerning age, sex, characteristics of primary and secondary tumours, reasons for unresectability, neoadjuvant chemotherapy as well as local treatment of liver tumours was collected. Preoperative serum concentrations of CEA and CA 19-9 markers were considered. The Cox regression model, Kaplan- Meier estimator and log-rank test were applied in the statistical analyses. Results. The most common reason for unresectability were: number of metastases in 31 patients (36.5%) and extrahepatic metastases in 19 cases (22.4%). Overall survival in the entire group was 56.1% and 15.5% after 1 and 3 years respectively. A single-factor analysis showed that CEA serum levels (p=0.032; HR=1.002 per increase by 1 ng/ml) and the presence of extrahepatic metastases (p=0.037; HR=2.06) were predictors of worse survival. In a multivariate analysis, CEA concentration (p=0.017; HR=1.002 per increase by 1 ng/ml) was an independent predictor of death whereas the presence of extrahepatic metastases were not statistically significant (p=0.059; HR=2.09). Conclusions. Serum concentration of CEA marker is an independent predictor of worse survival, but the presence of extrahepatic metastases shows a similar tendency
Źródło:
Polish Journal of Surgery; 2014, 86, 7; 319-324
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Comparison of Total Tumor Volume, Size and Number of Colorectal Liver Metastases in Prediction of Survival in Patients after Liver Resection
Autorzy:
Hołówko, Wacław
Grąt, Michał
Wronka, Karolina Maria
Stypułkowski, Jan
Roszkowski, Rafał
Studnicki, Paweł
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395543.pdf
Data publikacji:
2015-02-01
Wydawca:
Index Copernicus International
Tematy:
colorectal liver metastases
liver resection
total tumor volume
Opis:
Liver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease. The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy. Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve. Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively. Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatment
Źródło:
Polish Journal of Surgery; 2015, 87, 2; 53-58
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Short and Long-Term Outcomes After Primary Liver Transplantation in Elderly Patients
Autorzy:
Grąt, Michał
Kornasiewicz, Oskar
Grąt, Karolina
Antczak, Arkadiusz
Ligocka, Joanna
Hołówko, Wacław
Wronka, Karolina Maria
Kobryń, Konrad
Skalski, Michał
Pączek, Leszek
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1396438.pdf
Data publikacji:
2013-10-01
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
outcomes
elderly patients
recipient age
malignancies
donor age
Opis:
The number of elderly patients undergoing liver transplantation (LT) is increasing worldwide. The aim of the study was to evaluate the impact of recipient age exceeding 60 years on early and long-term outcomes after LT. Material and methods. This study comprised data of 786 patients after primary LT performed at a single center between January 2005 and October 2012. Patients over and under 60 years of age were compared with respect to baseline characteristics and outcomes: postoperative mortality (90-day) and 5-year patient (PS) and graft (GS) survival. Associations between recipient age exceeding 60 years and LT results were assessed in multiple Cox regression models. Results. Recipients older than 60 years (n=107; 13.6%) were characterized by more frequent hepatitis C virus infections (p<0.001), malignancies (p<0.001), and cardiovascular comorbidities (p<0.001); less frequent primary sclerosing cholangitis (p=0.002) and Roux-en-Y hepaticojejunostomy (p<0.001); lower Model for End-stage Liver Disease (MELD; p=0.043); and increased donor age (p=0.012). Fiveyear PS of older and younger recipients was 72.7% and 80.6% (p=0.538), while the corresponding rates of GS were 70.3% and 77.5% (p=0.548), respectively. Recipient age exceeding 60 years was not significantly associated with postoperative mortality (p=0.215), PS (p=0.525) and GS (p=0.572) in multivariate analyses. The list of independent predictors comprised MELD (p<0.001) for postoperative mortality; malignancies (p=0.003) and MELD (p<0.001) for PS; and malignancies (p=0.003), MELD (p<0.001) and donor age (p=0.017) for GS. Conclusions. Despite major differences between elderly and young patients, chronological age exceeding 60 years alone should not be considered as a contraindication for LT.
Źródło:
Polish Journal of Surgery; 2013, 85, 10; 581-588
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Reoperations for intraabdominal bleeding following deceased donor liver transplantatio
Autorzy:
Figiel, Wojciech
Grąt, Michał
Wronka, Karolina
Patkowski, Waldemar
Krasnodębski, Maciej
Masior, Łukasz
Stypułkowski, Jan
Grąt, Karolina
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1393849.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
bleeding
reoperation
mortality
outcomes
Opis:
Intraabdominal hemorrhage remains one of the most frequent surgical complications after liver transplantation. The aim of the study was to evaluate risk factors for intraabdominal bleeding requiring reoperation and to assess the relevance of the reoperations with respect to short- and long-term outcomes following liver transplantation. Material and methods. Data of 603 liver transplantations performed in the Department of General, Transplant and Liver Surgery in the period between January 2011 and September 2014 were analyzed retrospectively. Study end-points comprised: reoperation due to bleeding and death during the first 90 postoperative days and between 90 postoperative day and third post-transplant year. Results. Reoperations for intraabdominal bleeding were performed after 45 out of 603 (7.5%) transplantations. Low pre-transplant hemoglobin was the only independent predictor of reoperation (p=0.002) with the cut-off of 11.3 g/dl. Postoperative 90-day mortality was significantly higher in patients undergoing reoperation as compared to the remaining patients (15.6% vs 5.6%, p=0.008). Post-transplant survival from 90 days to 3 years was non-significantly lower in patients after reoperation for bleeding (83.3%) as compared to the remaining patients (92.2%, p=0.096). Nevertheless, multivariable analyses did not reveal any significant negative impact of reoperations for bleeding on short-term mortality (p=0.589) and 3-year survival (p=0.079). Conclusions. Surgical interventions due to postoperative intraabdominal hemorrhage do not appear to affect short- and long-term outcomes following liver transplantation. Preoperative hemoglobin concentration over 11.3 g/dl is associated with decreased risk of this complication, yet the clinical relevance of this phenomenon is doubtful.
Źródło:
Polish Journal of Surgery; 2016, 88, 4; 196-201
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Reoperacje z powodu krwawienia do jamy brzusznej po przeszczepieniu wątroby od dawcy zmarłego
Autorzy:
Figiel, Wojciech
Grąt, Michał
Wronka, Karolina
Patkowski, Waldemar
Krasnodębski, Maciej
Masior, Łukasz
Stypułkowski, Jan
Grąt, Karolina
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1393903.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
transplantacja wątroby
krwawienie
reoperacja
śmiertelność
wyniki
Opis:
Krwawienie do jamy otrzewnej jest jednym z najczęstszych powikłań chirurgicznych po transplantacji wątroby. Celem pracy była analiza czynników ryzyka krwawienia do jamy otrzewnej po transplantacji wątroby wymagającego reoperacji oraz zbadanie znaczenia tego powikłania w kontekście wczesnych i odległych wyników przeszczepień. Materiał i metodyka. Dane 603 przeszczepień wątroby wykonanych w Klinice Chirurgii Ogólnej, Transplantacyjnej i Wątroby w okresie od stycznia 2011 do września 2014 r. poddano analizie retrospektywnej. Do punktów końcowych badania należały: reoperacja z powodu krwawienia oraz zgon w okresie do 90 dni i od 90 dni do 3 lat po transplantacji. Wyniki. Reoperacje z powodu krwawienia wewnątrzbrzusznego konieczne były po 45 z 603 (7,5%) transplantacji. Niższe stężenie hemoglobiny przed operacją było jedynym niezależnym predykatorem reoperacji (p=0,002), z wartością odcięcia wynoszącą 11,3 g/dl. Odsetek śmiertelności pooperacyjnej w grupie biorców poddanych relaparotomii z powodu krwawienia był istotnie wyższy (15,6% vs 5,6%, p=0,008) w porównaniu do pozostałych chorych. Przeżycie ogólne od 90 dni do 3 lat po transplantacji w grupie chorych poddanych relaparotomii z powodu krwawienia (83,3%) było nieistotnie niższe w porównaniu do pozostałych chorych (92,2%, p=0,096). Niezależnie jednak od gorszych obserwowanych wyników transplantacji, analizy wieloczynnikowe nie potwierdziły istotnego wpływu relaparotomii wykonywanych z powodu krwawienia do jamy brzusznej na wczesną śmiertelność pooperacyjną (p=0,589) oraz 3-letnie przeżycie chorych (p=0,079). Wnioski. Interwencje chirurgiczne z powodu krwawienia do jamy brzusznej nie wpływają obecnie negatywnie na wczesne i odległe wyniki transplantacji wątroby. Przedoperacyjne stężenie hemoglobiny powyżej 11,3 g/dl jest czynnikiem istotnie zmniejszającym ryzyko wystąpienia tego powikłania, jednak przydatność kliniczna tego parametru wydaje się być wątpliwa.
Źródło:
Polish Journal of Surgery; 2016, 88, 4; 196-201
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evolution Of The Results Of 1500 Liver Transplantations Performed In The Department Of General, Transplant And Liver Surgery Medical University Of Warsaw
Autorzy:
Krawczyk, Marek
Grąt, Michał
Grąt, Karolina
Wronka, Karolina
Krasnodębski, Maciej
Stypułkowski, Jan
Masior, Łukasz
Hołówko, Wacław
Ligocka, Joanna
Nyckowski, Paweł
Wróblewski, Tadeusz
Paluszkiewicz, Rafał
Patkowski, Waldemar
Zieniewicz, Krzysztof
Pączek, Leszek
Milkiewicz, Piotr
Ołdakowska-Jedynak, Urszula
Najnigier, Bogusław
Dudek, Krzysztof
Remiszewski, Piotr
Grzelak, Ireneusz
Kornasiewicz, Oskar
Kotulski, Marcin
Smoter, Piotr
Grodzicki, Mariusz
Korba, Michał
Kalinowski, Piotr
Skalski, Michał
Zając, Krzysztof
Stankiewicz, Rafał
Przybysz, Marta
Cieślak, Bartosz
Nazarewski, Łukasz
Nowosad, Małgorzata
Kobryń, Konrad
Wasilewicz, Michał
Raszeja-Wyszomirska, Joanna
Piwowarska, Jolanta
Giercuszkiewicz, Dorota
Sańko-Resmer, Joanna
Rejowski, Sławomir
Szydłowska-Jakimiuk, Monika
Górnicka, Barbara
Wróblewska-Ziarkiewicz, Bogna
Mazurkiewicz, Michał
Niewiński, Grzegorz
Pawlak, Jacek
Pacho, Ryszard
Powiązania:
https://bibliotekanauki.pl/articles/1395614.pdf
Data publikacji:
2015-05-01
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
survival
outcomes
donors
center experience
center volume
Opis:
Liver transplantation is a well-established treatment of patients with end-stage liver disease and selected liver tumors. Remarkable progress has been made over the last years concerning nearly all of its aspects. The aim of this study was to evaluate the evolution of long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery (Medical University of Warsaw). Material and methods. Data of 1500 liver transplantations performed between 1989 and 2014 were retrospectively analyzed. Transplantations were divided into 3 groups: group 1 including first 500 operations, group 2 including subsequent 500, and group 3 comprising the most recent 500. Five year overall and graft survival were set as outcome measures. Results. Increased number of transplantations performed at the site was associated with increased age of the recipients (p<0.001) and donors (p<0.001), increased rate of male recipients (p<0.001), and increased rate of piggyback operations (p<0.001), and decreased MELD (p<0.001), as well as decreased blood (p=0.006) and plasma (p<0.001) transfusions. Overall survival was 71.6% at 5 years in group 1, 74.5% at 5 years in group 2, and 85% at 2.9 years in group 3 (p=0.008). Improvement of overall survival was particularly observed for primary transplantations (p=0.004). Increased graft survival rates did not reach the level of significance (p=0.136). Conclusions. Long-term outcomes after liver transplantations performed in the Department of General, Transplant and Liver Surgery are comparable to those achieved in the largest transplant centers worldwide and are continuously improving despite increasing recipient age and wider utilization of organs procured from older donors.
Źródło:
Polish Journal of Surgery; 2015, 87, 5; 221-230
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
1000 Liver Transplantations at the Department of General, Transplant and Liver Surgery, Medical University of Warsaw - Analysis of Indications and Results
Autorzy:
Krawczyk, Marek
Grąt, Michał
Barski, Krzysztof
Ligocka, Joanna
Antczak, Arkadiusz
Kornasiewicz, Oskar
Skalski, Michał
Patkowski, Waldemar
Nyckowski, Paweł
Zieniewicz, Krzysztof
Grzelak, Ireneusz
Pawlak, Jacek
Alsharabi, Abdulsalam
Wróblewski, Tadeusz
Paluszkiewicz, Rafał
Najnigier, Bogusław
Dudek, Krzysztof
Remiszewski, Piotr
Smoter, Piotr
Grodzicki, Mariusz
Korba, Michał
Kotulski, Marcin
Cieślak, Bartosz
Kalinowski, Piotr
Gierej, Piotr
Frączek, Mariusz
Rdzanek, Łukasz
Stankiewicz, Rafał
Kobryń, Konrad
Nazarewski, Łukasz
Leonowicz, Dorota
Urban-Lechowicz, Magdalena
Skwarek, Anna
Giercuszkiewicz, Dorota
Paczkowska, Agata
Piwowarska, Jolanta
Gelo, Remigiusz
Andruszkiewicz, Paweł
Brudkowska, Anna
Andrzejewska, Renata
Niewiński, Grzegorz
Kilińska, Beata
Zarzycka, Aleksandra
Nowak, Robert
Kosiński, Cezary
Korta, Teresa
Ołdakowska-Jedynak, Urszula
Sańko-Resmer, Joanna
Foroncewicz, Bartosz
Ziółkowski, Jacek
Mucha, Krzysztof
Senatorski, Grzegorz
Pączek, Leszek
Habior, Andrzej
Lechowicz, Robert
Polański, Sławomir
Leowska, Elżbieta
Pacho, Ryszard
Andrzejewska, Małgorzata
Rowiński, Olgierd
Kozieł, Sławomir
Żurakowski, Jerzy
Ziarkiewicz-Wróblewska, Bogna
Górnicka, Barbara
Hevelke, Piotr
Michałowicz, Bogdan
Karwowski, Andrzej
Szczerbań, Jerzy
Powiązania:
https://bibliotekanauki.pl/articles/1396689.pdf
Data publikacji:
2012-06-01
Wydawca:
Index Copernicus International
Tematy:
liver transplantation
indications
results
mortality
Opis:
The aim of the study was to analyze indications and results of the first one thousand liver transplantations at Chair and Clinic of General, Transplantation and Liver Surgery, Medical University of Warsaw.Material and methods. Data from 1000 transplantations (944 patients) performed at Chair and Clinic of General, Transplantation and Liver Surgery between 1994 and 2011 were analyzed retrospectively. These included 943 first transplantations and 55 retransplantations and 2 re-retransplantations. Frequency of particular indications for first transplantation and retransplantations was established. Perioperative mortality was defined as death within 30 days after the transplantation. Kaplan-Meier survival analysis was used to estimate 5-year patient and graft survival.Results. The most common indications for first transplantation included: liver failure caused by hepatitis C infection (27.8%) and hepatitis B infection (18%) and alcoholic liver disease (17.7%). Early (< 6 months) and late (> 6 months) retransplantations were dominated by hepatic artery thrombosis (54.3%) and recurrence of the underlying disease (45%). Perioperative mortality rate was 8.9% for first transplantations and 34.5% for retransplantations. Five-year patient and graft survival rate was 74.3% and 71%, respectively, after first transplantations and 54.7% and 52.9%, respectively, after retransplantations.Conclusions. Development of liver transplantation program provided more than 1000 transplantations and excellent long-term results. Liver failure caused by hepatitis C and B infections remains the most common cause of liver transplantation and structure of other indications is consistent with European data.
Źródło:
Polish Journal of Surgery; 2012, 84, 6; 304-312
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-8 z 8

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