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Wyświetlanie 1-15 z 26
Tytuł:
An Evaluation of the Efficacy of Microvascular Breast Reconstruction Techniques
Autorzy:
Dobrut, Mirosław
Maciejewski, Adam
Półtorak, Stanisław
Powiązania:
https://bibliotekanauki.pl/articles/1396030.pdf
Data publikacji:
2013-01-01
Wydawca:
Index Copernicus International
Tematy:
breast reconstruction surgery
Opis:
The aim of the studywas to evaluate the efficacy of different microvascular techniques in breast reconstruction with the analysis of postoperative complications. The additional goal of the study is to analyze the quality of life of patients after microvascular breast reconstruction in comparison to the control group of patients who underwent only mastectomy without any reconstructive procedures. Also the algorithm of breast reconstruction is presented as the result of own experiences. Material and methods.Clinical material contain 2 groups of patients - women after surgical treatment in Department of Oncological and Reconstructive Surgery, Cancer Center in Gliwice in the year 2004-2009 where in 53 cases immediate and in 26 delayed breast microvascular reconstruction were performed. In all cases the diagnosis of cancer was proved by histopathological biopsy before the treatment. The type of radical resection (mastectomy) depended on histopathological type of cancer and its localization. The reconstruction - immediate vs delayed was carefully planned together with oncological treatment of the cases. Everywhere this plan was established based on carefully examinations of inferior epigastric vessels and theirs perforators. The choice between immediate and delayed microvascular reconstruction was based on prognosis and predictive factors. The QOL was analyzed due to own questionnaire when functional, aesthetics and social effects were evaluated. ResultsFree flap survival rate for all types of free flap was 95%. In cases where classic TRAM was used the rate was 85%, in cases where muscle sparring TRAM was chosen the survival rate was 100% and in remaining cases of DIEP reconstructions the rate was 89%. Generally the complications after microvascular reconstruction occurred in 13 cases (16%). In 9 cases the problems with flaps perfusion were notified. Total flap necrosis was observed in 2 TRAM and in 2 DIEP cases. In all those cases salvage surgery was administered in which the microanastomoses were explored and repaired. In 5 cases the cause of the complications was venous thrombosis, in 2 cases the vascular pedicle was kinked, and in remaining 1 the arterial thrombosis was found. The second type of complication was fat necrosis (<25% of flap volume) which was observed in 5 cases between 1 and 4 months after surgery, and it request minor plastic surgery. Donor site complications were noted in 4 cases. In two of those hernia in cicatrices was diagnosed (both were classic TRAM’s), in remaining 2 in which also fully muscle TRAM was classic the weakness of abdominal wall was observed. In group were msTRAM and DIEP were used no donor site complications occurred.
Źródło:
Polish Journal of Surgery; 2013, 85, 1; 6-11
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The Use of Three Free Flaps in the Simultaneous Reconstruction of the Nose after Extensive Resection Due to Malignant Cancer
Autorzy:
Grajek, Maciej
Maciejewski, Adam
Szumniak, Ryszard
Krakowczyk, Łukasz
Powiązania:
https://bibliotekanauki.pl/articles/1396699.pdf
Data publikacji:
2012-02-01
Wydawca:
Index Copernicus International
Tematy:
nasal reconstruction
free flaps
chimeric flaps
Opis:
Reconstructive techniques for extended posttraumatic or post-resectional nose defects are well described. Small defects can usually be closed using local flaps with a good esthetic result. Extended resections in the mentioned area require more complex reconstruction methods, including microvascular techniques. The Authors' presented a case of whole nose and partial cheek simultaneous reconstruction using three free flaps. Two auricular free flaps and one radial forearm free flap were used to cover the defect. Meticulous preoperative planning and harvesting of flaps enabled to achieve good esthetic and functional results.
Źródło:
Polish Journal of Surgery; 2012, 84, 2; 99-101
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of Outcomes and Treatment Safety of Patients with Metastatic Colorectal Cancer to the Liver with Estimation of Prognostic Factors
Autorzy:
Zeman, Marcin
Maciejewski, Adam
Półtorak, Stanisław
Kryj, Mariusz
Powiązania:
https://bibliotekanauki.pl/articles/1396271.pdf
Data publikacji:
2013-06-01
Wydawca:
Index Copernicus International
Tematy:
colorectal cancer liver metastases
liver resection
neutrophil to lymphocyte ratio
fibrinogen
Opis:
Liver resection is essential part of colorectal cancer liver metastases (CLM) treatment. Mean 5-year overall survival after resection achieves 30-45%. There are many factors influencing long-term outcomes, and among them the inflammatory response to tumor plays an important role. The aim of the study was evaluation of outcomes and treatment safety of patients with metastatic colorectal cancer to the liver with estimation of prognostic factors. Material and methods. 130 consecutive patients (70 men and 60 women) operated in MSC Institute and Cancer Center in Gliwice from 2001 to 2009 due to colorectal liver metastases were analysed. Age of the patients ranged from 33 to 82 years (median 60 years). 96 (74%) patients underwent potentially radical resection, and in remaining 34 (26%) was performed radiofrequency ablation (RFA) alone or combined with the resection. In the resection group 37 right hepatectomies, 11 left hepatectomies, 28 segmentectomies and 20 metastasectomies were performed. Disease-free survival (DFS) and overall survival (OS) were statistically analysed using the Kaplan-Meier method. Factors determining DFS and OS were analysed using Cox regression model. Results. In the resection group the 3- and 5-years OS was 64,5% and 46,6% respectively, and the 3- and 5-years DFS was 32% and 30,5% respectively. In the RFA group the 3- and 5-years OS was 33% and 9,5%. Statistically significant prognostic factors in the resection group in uni- and multivariate analysis were: grade and nodal involvement of the primary tumor, diameter of metastatic focus, positive and narrow (<1 mm) resection margins, preoperative fibrinogen level, preoperative neutrophil to lymphocyte ratio and leukocyte amount of the peripheral blood. The perioperative mortality rate was 3%. Conclusions. Liver resection due to colorectal liver metastases is a safe and effective method resulting in high survival rates. We confirmed some generally accepted prognostic factors influencing longterm outcomes and shown the impact of inflammatory response. We also confirmed the hypothesis that preoperative plasma fibrinogen level influences outcomes after liver resection due to CLM.
Źródło:
Polish Journal of Surgery; 2013, 85, 6; 333-339
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Maxillary Reconstruction Using a Multi-Element Free Fibula Flap Based on a Three-Dimensional Polyacrylic Resin Model
Autorzy:
Jędrzejewski, Piotr
Maciejewski, Adam
Szymczyk, Cezary
Wierzgoń, Janusz
Powiązania:
https://bibliotekanauki.pl/articles/1396585.pdf
Data publikacji:
2012-01-01
Wydawca:
Index Copernicus International
Tematy:
microvascular surgery
maxillary reconstruction
polyacrylic models
Opis:
Preoperative preparation of working models of the skull and free bone flaps using the digital print technology and photocured polyacrylic resins may be of a great benefit to the patient, for whom a virtual resection and reconstruction procedure may be planned in detail and performed. The purpose of mid-facial reconstruction using 3D models is to plan a functional mid-facial reconstruction procedure in order to restore supportive function of intraorbital structures and to make placement of dental implants and further prosthetic rehabilitation possible.Maxillary and mid-facial reconstruction using a free fibula flap based on a three-dimensional working model was performed in a patient diagnosed with a squamous cell carcinoma of the left maxillary sinus penetrating to the orbit, the ethmoid complex, and the pterygopalatine fossa. The use of three-dimensional polyacrylic models allowed for detailed preoperative planning and a virtual resection and reconstruction procedure with a highly satisfying functional and cosmetic effect.A procedure based on methods discussed here may be significantly shorter and more precise.
Źródło:
Polish Journal of Surgery; 2012, 84, 1; 49-55
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The use of anterolateral thigh flap (ALTF) for functional tongue reconstruction with postoperative quality of live evaluati
Autorzy:
Krakowczyk, Łukasz
Maciejewski, Adam
Szymczyk, Cezary
Wierzgoń, Janusz
Półtorak, Stanisław
Powiązania:
https://bibliotekanauki.pl/articles/1394335.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
free flap
reconstructive surgery
anterolateral thigh flap
Opis:
The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live. Material and methods. Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status. Results. The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points. Conclusions. Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.
Źródło:
Polish Journal of Surgery; 2015, 87, 8; 384-388
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The Use of a Pedunculated, Extended Latissimus Dorsi Flap in Primary and Secondary Breast Reconstruction Procedures - Case Report
Autorzy:
Maciejewski, Adam
Ulczok, Rafał
Dobrut, Mirosław
Szumniak, Ryszard
Półtorak, Stanisław
Powiązania:
https://bibliotekanauki.pl/articles/1396681.pdf
Data publikacji:
2012-07-01
Wydawca:
Index Copernicus International
Tematy:
breast reconstruction surgery
LD flap
Opis:
The extended latissimus dorsi flap (LD) is used in breast reconstruction since the 70's. LD flap is often used in corrective surgery in cases of unsatisfactory cosmetic results after breast-conserving therapy. In our department LD flap has several uses. In addition to free microvascular flaps - which applies in breast reconstructive surgery is routine, there are clinical situations where the use of pedicled LD flap is justified. The main indications for its use are: the inability to apply microvascular flap, the general condition (diabetes, advanced atherosclerosis), smoking, previous surgery of abdominal wall, abdominal obesity, patient preferences. Approximately 30% of patients after breast reconstruction require corrective procedures. Group which uses extended LD flap account for 24 patients. In 16 cases it was used for elective breast reconstruction. In the remaining eight cases it was used in the corrective procedures symmetry and shape of the previously reconstructed breast. Based on our own experience it can be concluded that the LD flap with an alternative to microvascular techniques. Complication rate when using the LD flap is relatively low and includes: seroma and slight motor disability of the shoulder girdle.
Źródło:
Polish Journal of Surgery; 2012, 84, 7; 367-370
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-15 z 26

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