Wszystkie pola: Piotr, Nowak - Katalog OPAC zbiorów

Skocz do pozycji: 1.

Tytuł:: Low-Anterior-Resection Syndrome. How Does Neoadjuvant Radiotherapy and Low Resection of the Rectum Influence the Function of Anal Sphincters in Patients with Rectal Cancer? Preliminary Results of a Functional Assessment Study
Autorzy:: Romaniszyn, Michał
Richter, Piotr
Walega, Piotr
Kenig, Jakub
Nowak, Marcin
Nowak, Wojciech
Powiązania:: https://bibliotekanauki.pl/articles/1396730.pdf
Data publikacji:: 2012-04-01
Wydawca:: Index Copernicus International
Tematy:: rectal cancer
low anterior resection
neoadjuvant radiotherapy
anal sphincter function
Opis:: The aim of the study was to assess the influence of neoadjuvant radiotherapy and resection of the rectum on the functional parameters of anal sphincters.Material and methods. 20 patients with rectal cancer, qualified for low anterior rectal resection with neoadjuvant radiotherapy were enrolled in the study group. The study protocol included an anorectal manometry, electromyography and fecal incontinence questionnaire (FISI) before radiotherapy, after radiotherapy, and after the operation.Results. Of the 20 patients 12 were included in the final analysis, because 8 patients were re-qualified to abdomino-perineal resection of the rectum after neoadjuvant treatment. There were no significant changes in anal pressures assessed 5 to 8 days after radiotherapy. In 3 cases (25%) pathological changes in RAIR reflex were found in the manometric examination. After low anterior resection mean basal anal pressures were significantly lower, whereas squeeze anal pressures did not change significantly. In 7 patients (58%) the RAIR reflex was pathological or even absent after low anterior resection. Changes in manometric parameters correlated with FISI incontinence assessment after the operation. In electromyographic examination action potentials of motoric units of the external anal sphincter were still present both after radiotherapy, and after operation.Conclusions. Fecal incontinence after low anterior resection of the rectum seems to be caused mostly by changes in autonomic functionality of anal sphincters and lack of compliance of the neorectum, since the influence of neoadjuvant radiotherapy and the operation itself on the somatic innervation of anal sphincters seems to be minimal.
Źródło:: Polish Journal of Surgery; 2012, 84, 4; 177-183
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 2.

Tytuł:: Intraoperative neuromonitoring of hypogastric plexus branches during surgery for rectal cancer – preliminary report
Autorzy:: Wałęga, Piotr
Romaniszyn, Michał
Wałęga, Maciej
Szymon Świrta, Jarosław
Nowak, Wojciech
Powiązania:: https://bibliotekanauki.pl/articles/1393195.pdf
Data publikacji:: 2017
Wydawca:: Index Copernicus International
Tematy:: rectal cancer
neuromonitoring
rectal resection
complications
Opis:: Aim: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. Materials and methods: We qualified 4 patients (2 women, 2 men; age 42 – 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery. Moreover, we inserted a standard, 18FR Foley’s urinary catheter to which a T-tube was connected to allow urine outflow and measurement of pressure changes in the bladder induced by detrusor contractions during stimulation. Results: Setting up neuromonitoring prolonged surgery time by 30 to 40 minutes, or even by 60 to 80 minutes in the case of the first two patients. Neuromonitoring itself took additional 20 to 30 minutes during surgery. In all patients, we stimulated branches of the inferior hypogastric plexus in their anatomical position during dissection. In three patients, we evoked responses both from the bladder and the sphincter in all planes of stimulation. In one patient, there was no response from the left side of the bladder, and in the same patient, we observed symptoms of neurogenic bladder. Conclusions: Based on the available literature and our own experience, we state that monitoring of bladder pressure and electromyographic signals from rectal sphincters enables visualization and preservation of autonomic nervous system structures, both sympathetic and parasympathetic. Intraoperative signals seem to be correlated with clinical presentation and functional examinations after surgery. In order to objectify our results, it is necessary to perform functional examinations before and after surgery in a larger group of patients.
Źródło:: Polish Journal of Surgery; 2017, 89, 2; 69-72
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 3.

Tytuł:: VAAFT: a new minimally invasive method in the diagnostics and treatment of anal fistulas – initial results
Autorzy:: Wałęga, Piotr
Romaniszyn, Michał
Nowak, Wojciech
Powiązania:: https://bibliotekanauki.pl/articles/1395691.pdf
Data publikacji:: 2014-01-01
Wydawca:: Index Copernicus International
Tematy:: anal fistula
surgical treatment
minimally invasive procedure
VAAFT
Opis:: The aim of the study was to present our own experience in the treatment of anal fistulas by means of VAAFT (Video-Assisted Anal Fistula Treatment). Material and methods. Twenty patients were qualified for the VAAFT procedure. All were subjected to diagnostics. Two patients after the diagnostic stage underwent classical fistula surgery. The remaining 18 patients were subjected to the full procedure (diagnostic fistuloscopy, supply of the internal ostium, and coagulation of the fistula canal). The mean observation period was 10 months. Results. In most cases the trans-sphincter fistula was observed during the diagnostic phase, including three with additional fluid compartments. There was one intersphincteric fistula. Considering the 18 patients subjected to the full VAAFT procedure the internal ostium was supplied by means of an advancement flap in 3 cases, while in 11 by means of a mattress suture, including one with additional tissue glue. In 4 cases the internal ostium was tightly covered by mucosa. Surgical complications were not observed during the procedure. During further observation a permanent fistula was observed in 4 (22%) patients, and in two (17%), recurrence of anal fistula. In the remaining 12 patients one observed healing without fistula recurrence. Complications were not observed, including stool and gas control deterioration (based on the FISI scoring). Conclusions. The VAAFT method does not affect sphincter efficiency, no intra- and postoperative complications were observed. As compared to other minimally invasive procedures a comparable recovery rate is observed without the risk of incontinence. It is the only method enabling the intraoperative identification of the internal ostium and fistula canal under visual control. Initial optimistic results require further investigations on a larger group of patients.
Źródło:: Polish Journal of Surgery; 2014, 86, 1; 7-10
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 4.

Tytuł:: Zastosowanie śródoperacyjnego neuromonitoringu gałęzi splotu podbrzusznego dolnego w leczeniu chirurgicznym raka odbytnicy – doniesienie wstępne
Autorzy:: Wałęga, Piotr
Romaniszyn, Michał
Wałęga, Maciej
Szymon Świrta, Jarosław
Nowak, Wojciech
Powiązania:: https://bibliotekanauki.pl/articles/1393199.pdf
Data publikacji:: 2017
Wydawca:: Index Copernicus International
Tematy:: rak odbytnicy
neuromonitoring
wycięcie odbytnicy
powikłania
Opis:: Cel: Celem pracy jest przedstawienie własnych, wstępnych doświadczeń z zastosowaniem techniki śródoperacyjnego neuromonitoringu w trakcie wycięcia odbytnicy. Materiał i metody: Do zabiegu ze śródoperacyjnym neuromonitoringiem zakwalifikowano 4 pacjentów z rakiem odbytnicy (2 kobiety, 2 mężczyzn) w wieku od 42 do 53 lat. U wszystkich chorych przed zabiegiem przeprowadzono badania czynnościowe okolicy anorektalnej. Potencjały czynnościowe kompleksu zwieraczy wywołane stymulacją włókien nerwowych odczytywano z pomocą implantowanych przed zabiegiem elektrod. Ponadto do pęcherza moczowego zakładano standardowy cewnik Foleya nr 18, do którego podłączano trójnik rozdzielający odpływ moczu i przewód z podłączonym przekaźnikiem ciśnieniowym odczytującym zmiany ciśnienia w pęcherzu moczowym wskutek skurczów wypieracza pęcherza w trakcie stymulacji. Wyniki: Przygotowanie do neuromonitoringu wydłużyło czas zabiegu o 30–40 minut, a w przypadku dwóch pierwszych zabiegów o 60–80 minut. Faza neuromonitoringu w trakcie zabiegu zabiera dodatkowo 20 do 30 minut. U wszystkich chorych w trakcie preparowania przeprowadzono stymulacje gałęzi splotu podbrzusznego dolnego w ich anatomicznym położeniu. U trzech chorych uzyskano odpowiedź zarówno z pęcherza, jak i zwieracza we wszystkich płaszczyznach stymulacji. U jednego chorego stwierdzono brak odpowiedzi z pęcherza po stronie lewej. U tego chorego po zabiegu wystąpiły objawy pęcherza neurogennego. Wnioski: Bazując na dostępnej literaturze oraz naszych pierwszych doświadczeniach, stwierdzamy, że monitorowanie ciśnienia w pęcherzu moczowym oraz zapis sygnału elektromiograficznego ze zwieraczy umożliwia wizualizację i zaoszczędzenie struktur nerwowych układu autonomicznego, zarówno w części sympatycznej, jak i parasympatycznej. Sygnał uzyskany śródoperacyjnie wydaje się wykazywać korelacje z obrazem klinicznym i badaniami czynnościowymi po zabiegu. Celem obiektywizacji wyników niezbędne są badania czynnościowe przed i po zabiegu oraz ocena na większej liczbie chorych.
Źródło:: Polish Journal of Surgery; 2017, 89, 2; 69-72
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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Skocz do pozycji: 5.

Tytuł:: Efficacy of Lift (Ligation of Intersphincteric Fistula Tract) for Complex and Recurrent Anal Fistulas - A Single-Center Experience and A Review of the Literature
Autorzy:: Romaniszyn, Michał
Walega, Piotr Julian
Nowak, Wojciech
Powiązania:: https://bibliotekanauki.pl/articles/1395977.pdf
Data publikacji:: 2015-02-03
Wydawca:: Index Copernicus International
Tematy:: fistula-in-ano
anal fistula
ligation of intersphincteric fistula tract
LIFT
fistulotomy
Opis:: Ligation of intersphincteric fistula tract in treatment of anal fistulas (LIFT) is being said to have satisfactory results in short and long follow up, with low risk of complications. This study was designed to evaluate the results in patients with complex and recurrent fistulas in comparison with simple transsphincteric anal fistulas. The aim of the study was to present a single-center experience in LIFT procedure in treatment of both simple and complex anal fistulas, including recurrent fistulas, in comparison with a review of current literature. Material and methods. A series of 17 patients were qualified to LIFT procedure. 5 patients were treated for simple transsphincteric, 6 for complex fistulas, 6 with fistulas recurrent after fistulotomy. Median age was 47, most of the patients were male (16/17). Mean follow up was 11 months. Results. Mean operating time was 55 minutes counting from surgical site disinfection to final dressing of the wound. Of the 17 patients the overall success rate was 53%. As expected, best results were achieved in patients with simple fistulas (80% success rate), then complex (50%), and recurrent fistulas (only 33%). There were no early nor late complications of the surgery. Conclusion. As expected, in simple transsphincteric fistulas the results were satisfactory, taking into account low complication rate. Complex and recurrent fistulas seem to be risk factors of LIFT failure. The results are consistent with data published by other authors, based on the review of the current literature, and it seems there is still room for improvement, so further research is required.
Źródło:: Polish Journal of Surgery; 2014, 86, 11; 532-536
0032-373X
2299-2847
Pojawia się w:: Polish Journal of Surgery
Dostawca treści:: Biblioteka Nauki

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