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Tytuł:
Application of the Single Access Technique in Laparoscopic Surgery
Autorzy:
Strzałka, Marcin
Matyja, Maciej
Matłok, Maciej
Migaczewski, Marcin
Budzyński, Piotr
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1396053.pdf
Data publikacji:
2013-02-01
Wydawca:
Index Copernicus International
Tematy:
laparoscopy
single access technique
results
Opis:
Laparoscopic single access technique is a next step in development of minimally invasive surgery. The aim of the study was to present results of different laparoscopic single incision procedures and evaluate application of this technique. Material and methods. 102 patients (15 males and 87 females) who underwent laparoscopic single incision procedure from 15th October 2009 to 31st December 2012 were included in the study. Results. In the analyzed period we performed 72 cholecystectomies (70.6%), 8 left adrenalectomies (7.8%), 3 right adrenalectomies (2.9%), 7 splenectomies (6.9%), 5 spleen cysts unroofings (4.9%), 2 appendectomies (2%), 1 Nissen fundoplication procedure (1%), 1 removal of the adrenal cyst (1%) and 3 concomitant splenectomies and cholecystectomies (2.9%). There were 3 technical conversions to multiport laparoscopy, but no conversion to open technique. Complications were observed in 5 patients (4.9%). Average operation time was 79 min (SD=40), average hospitalization time 2.4 day (SD=1.4). Conclusions. Laparoscopic single incision technique is a safe method and can be used as a reasonable alternative to multiport laparoscopy in different minimally invasive procedures especially in young patients to whom an excellent cosmetic effect is particularly important.
Źródło:
Polish Journal of Surgery; 2013, 85, 2; 73-77
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Preoperative pancreatic duct stenting in patients undergoing laparoscopic pancreatic surgery – a preliminary report
Autorzy:
Rubinkiewicz, Mateusz
Migaczewski, Marcin
Pędziwiatr, Michał
Matłok, Maciej
Dembiński, Marcin
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1395645.pdf
Data publikacji:
2015-06-01
Wydawca:
Index Copernicus International
Tematy:
laparoscopic pancreatectomy
minimally invasive techniques
pancreatoduodenectomy
pancreatic tumor
Opis:
Laparoscopic surgery is becoming an approved technique in pancreatic surgery. It offers some advantages over an open approach due to shorter hospital stay and decreased complication rate. Regardless the technique the most significant problem of pancreatic surgery is postoperative pancreatic fistula. There are numerous methods attempted at reduction of its incidence. One of the possibilities is preoperative pancreatic duct stenting. It aims at decreasing the pressure in the pancreatic duct, which is supposed to facilitate pancreatic juice flow to the duodenum. The aim of the study was to determine the role of preoperative pancreatic duct stenting in pancreatic surgery. Material and methods. Nineteen patients undergoing laparoscopic pancreatic resection were enrolled into the study. Prior to the surgery, all of the patients were submitted for the Endoscopic Retrograde Choleangiopancreatography (ERCP) with pancreatic duct stenting. Following the subsequent laparoscopic pancreatic resection, all patients were monitored to detect the pancreatic fistula appearance. The pancreatic stent was removed 6‑8 weeks after the surgery. Results. With an exception of two patients, all other patients underwent successful ERCP with pancreatic duct stenting before the surgery. In one case the placement of the prosthesis failed due to a tortuous pancreatic duct. Five patients had an episode of acute pancreatitis including two severe courses as a complication of preoperative ERCP. One of the patient died due to severe GI bleeding 2 weeks after stenting. Among the procedures there were 15 distal pancreatectomies, two enucleations of the tumor localized in the uncinate process and in the body of the pancreas and one central pancreatectomy. The median time of surgery duration was 186 minutes (90‑300; ±56). No conversions to an open approach were necessary. Likewise, there was neither any major complications reported in a postoperative course nor incidence of pancreatic fistula in any of the patients undergoing surgery. Conclusions. Preoperative pancreatic duct stenting can decrease the incidence of pancreatic fistula. However, a number of serious complications exceed the potential benefit of this method.
Źródło:
Polish Journal of Surgery; 2015, 87, 6; 307-311
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Early results of liver resection using laparoscopic technique
Autorzy:
Stranek, Maciej
Pędziwiatr, Michał
Radkowiak, Dorota
Zychowicz, Anna
Budzyński, Piotr
Major, Piotr
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1394071.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
laparoscopy
liver resection
liver metastases
Opis:
The aim of the study was to present early outcomes of liver resection using laparoscopic technique. Material and methods. Retrospective analysis of patients who underwent liver resection using laparoscopic method was conducted. The analyzed group included 23 patients (11 women and 12 men). An average patient age was 61.3 years (37 – 83 years). Metastases of the colorectal cancer to the liver were the cause for qualification to the procedure of 15 patients, metastasis of breast cancer in 1 patient and primary liver malignancy in 5 patients. The other 2 patients were qualified to the liver resection to widen the surgical margins due to gall-bladder cancer diagnosed in the pathological assessment of the specimen resected during laparoscopic cholecystectomy, initially performed for other than oncology indications. Results. Hemihepatectomy was performed in 11 patients (9 right and 2 left), while the other 12 patients underwent minor resection procedures (5 metastasectomies, 4 nonanatomical liver resections, 1 bisegmentectomy, 2 resections of the gall-bladder fossa). An average duration of the surgical procedure was 275 minutes 65 – 600). An average size of the resected tumors was 28 mm (7 – 55 mm). In three cases conversion to laparotomy occurred, caused by excessive bleeding from the liver parenchyma. Postoperative complications were found in 4 patients (17.4%). Median hospitalization duration was 6 days (2 – 130 days). One patient (4.3%) was rehospitalized due to subhepatic abscess and required reoperation. Histopathology assessment confirmed radical resection (R0) in all patients in our group. Conclusion. Laparoscopic liver resections seem to be an interesting alternative in the treatment of focal lesions in the liver.
Źródło:
Polish Journal of Surgery; 2016, 88, 1; 20-25
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Laparoscopic gastric resections with per oral specimen extraction in treatment of intramural gastric tumors
Autorzy:
Stanek, Maciej
Major, Piotr
Wierdak, Mateusz
Pędziwiatr, Michał
Radkowiak, Dorota
Zychowicz, Anna
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1393418.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
laparoscopy
gastrointestinal stromal tumors
POSE
endoscopy
Opis:
Aim: The goal of this work was to present our experiences and results of treatment of gastric tumors using the per oral specimen extraction (POSE) technique. Material and methods: A retrospective analysis a group of patients treated with laparoscopic stomach wedge resection of gastrointestinal stromal tumor (GIST). During that time 50 patients underwent laparoscopy due to the suspicion of GIST. In 12 patients resected material was removed endoscopically per os (POSE). In the remaining 38 subjects it was evacuated through minilaparotomy. Mean age of patients treated using POSE technique was 65.6 years (48-81 years). There were 9 women and 3 men in this group Results: Mean time of the POSE procedure was 92.5 min (40-160 min). Size of removed tumors ranged from 14 mm to 40 mm (mean: 25 mm). The mean length of hospital stay was 3.2 days (2 to 8 days) for patients treated with POSE. One patient (8.3%) required longer hospitalization (8 days) due to the presence of a fluid collection at the site of gastric suture. This patient was treated conservatively. One patient (8.3%) was diagnosed with surgical site infection (navel wound after an optical trocar). Histopathological examination confirmed radical excision in all of our patients (R0). Conclusions: It seems that the POSE technique is the next stage of development of minimally invasive surgery and may constitute a link in evolution of natural orifice translumenal surgery techniques. Removal of excised material through oral cavity is an attractive, effective, and safe method despite its many limitations.
Źródło:
Polish Journal of Surgery; 2017, 89, 1; 16-21
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Cystic Adrenal Lesions - Analysis of Indications and Results of Treatment
Autorzy:
Major, Piotr
Pędziwiatr, Michał
Matłok, Maciej
Ostachowski, Mateusz
Winiarski, Marek
Rembiasz, Kazimierz
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1396728.pdf
Data publikacji:
2012-04-01
Wydawca:
Index Copernicus International
Tematy:
cystic adrenal lesions
laparoscopic adrenalectomy
endocrinological surgery
minimally invasive surgery
adrenal gland surgery
indications for surgery
Opis:
Cysts are a rare pathology of adrenal glands. As the development of new diagnostic techniques takes place, the occurrence of adrenal cystic lesions has been rapidly increasing. The majority of them are solid adrenal lesions, but localized fluid collections are also more frequently diagnosed. In case of solid adrenal lesions, there are straight indications for surgery, but on the other hand there are no clear guidelines and recommendations in case of adrenal cysts.The aim of the study was to analyze surgical methods and evaluate treatment effects in patients who were qualified for laparoscopic adrenalectomy due to adrenal cystic lesions.Metarial and methods. Identical criteria were used to qualify patients with solid and cystic lesions of the adrenal gland for surgery. Out of the whole number of 345 patients who underwent laparoscopic surgery for adrenal tumors, 28 had adrenal cysts. 16 of them (57%) were women and 12 (43%) men. The average age of the studied group was 46.4 years (25-62 years). The average cyst diameter in CT was 5.32 cm (1.1-10 cm). Most of the lesions were hormonally inactive (22 patients), but in 6 cases increased level of adrenal hormones was observed.Results. Pathological analysis revealed 4 (14%) pheochromocytomas and 2 (7%) dermoid cysts. In case of 22 (79%) patients, the postoperative material was profiled by pathologists as insignificant according to potential neoplasmatic transformation risk: 5 (17.5%) - endothelial vascular cysts, 3 (11%) endothelial lymphatic cysts, 7 (25.5%) pseudocysts, 3 (11%) simple cysts, 2 (7%) bronchogenic cysts, 1 (3.5%) - cortical adenoma and 1 (3.5%) cyst was of myelolipoma type.Conclusions. Based on the performed research and previous experience in treating patients with adrenal lesions we can conclude that application of the same evaluating algorithm for both cystic and solid lesions is valid.
Źródło:
Polish Journal of Surgery; 2012, 84, 4; 184-189
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Learning curve for laparoscopic Roux-en-Y gastric bypass based on the experience of a newly created bariatric center
Autorzy:
Dworak, Jadwiga
Wysocki, Michał
Rzepa, Anna
Pędziwiatr, Michał
Radkowiak, Dorota
Budzyński, Andrzej
Major, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/1391721.pdf
Data publikacji:
2020
Wydawca:
Index Copernicus International
Tematy:
bariatric center
clinical competence
laparoscopic Roux-en-Y gastric bypass
learning curve
perioperative complications
surgical training
Opis:
Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common treatments for morbid obesity. The learning curve for this procedure is 50–75 cases for an independent surgeon, and it is considered the most important factor in decreasing complications and mortality. We present our experience and learning curve with LRYGB for a newly established bariatric center in Poland. Material and methods: A prospectively collected database containing 285 LRYGB procedures performed in the II Department of General Surgery of the Jagiellonian University MC in Krakow between 06.2010 and 03.2019 was retrospectively reviewed. Patients were divided into groups of 30 (G1–G10) in the order of the procedures performed by each surgeon. The study analyzed the course of the operation and patient hospitalization, comparing those groups. Learning curve for the newly created bariatric center was established. Results: Operative time in G1–G3 differed significantly from G4–G10 (P < 0.0001). The stabilization point was the 90th procedure. Perioperative complications were observed in 36 (12.63%) patients. Perioperative complications, intraoperative difficulties and adverse events did not differ importantly among groups. Liberal use of “conversions of the operator” from a surgeon to a senior surgeon provides reasonable safety and prevents complications. Conclusions: The institutional learning process stabilization point for LRYGB in a newly established bariatric center is around the 90th operation. LRYGB can be a safe procedure from the very beginning in newly established bariatric centers. Specific bariatric training with active proctoring by an experienced surgeon in a bariatric centre can improve the laparoscopic gastric bypass outcome during the learning curve.
Źródło:
Polish Journal of Surgery; 2020, 92, 4; 23-30
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Endoscopic Insertion Of A Self-Expandable Stent Combined With Laparoscopic Rinsing Of Peritoneal Cavity As A Method For Staple Line Leaks Treatment In Patients Post Laparoscopic Sleeve Gastrectomy
Autorzy:
Matłok, Maciej
Major, Piotr
Pędziwiatr, Michał
Winiarski, Marek
Budzyński, Piotr
Małczak, Piotr
Hynnekleiv, Leif
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1395616.pdf
Data publikacji:
2015-05-01
Wydawca:
Index Copernicus International
Tematy:
bariatric surgery
laparoscopic sleeve gastrectomy
post-bariatric surgery complications
staple line leaks
Opis:
Currently, laparoscopic sleeve gastrectomy is one of bariatric surgeries most commonly performed in the world. The most frequent complications of surgeries of this type, with the highest mortality rate, include bleeding into the GI tract and peritoneal cavity, and sleeve staple line leaks. These severe complications prolong the hospital stay, and often are a cause of patient’s death. While in a case of bleeding the procedure appears to be obvious, so far no uniform and standard guidelines have been established for the group of patients with staple line leaks. The aim of the study was to report results of treatment for staple line leaks following laparoscopic sleeve gastrectomy with a laparoscopic procedure and simultaneous endoscopic insertion of a self-expandable stent. Material and methods. 152 laparoscopic sleeve gastrectomies were performed from April 2009 to December 2014. The BMI median was 46.9, and the age median was 42 years. Staple line leaks developed in 3 out of 152 people (1.97%). All patients who developed this complication were included in the study. The treatment involved laparoscopic revision surgery with simultaneous endoscopic insertion of a self-expandable stent (Boston Scientific, Wallflex Easophageal Stent, 150×23 mm) into the gastric stump during gastroscopy. Results. Leaks following laparoscopic sleeve gastrectomy were diagnosed on day 5 after the procedure, on average. Intervention consisting of laparoscopy and endoscopic insertion of a self-expandable stent was initiated within 14 hours of diagnosing the leak, on average. The mean time for which the stent was kept was 5 weeks (4–6 weeks). Stenting proved to be fully effective in all patients, where after discharging home, a cutaneous fistula, periodically (every 2-3 weeks) discharging several millilitres of matter, persisted in one patient. The mean time for the leak healing in 2 patients, in whom the described method was successful in treatment of this complication, was 37 days. No patient died in the perioperative or follow-up period. Conclusions. The proposed method for treatment of staple line leaks following laparoscopic sleeve gastrectomy by combined laparoscopic rinsing and draining of the peritoneal cavity and endoscopic insertion of a self-expandable stent is an interesting and worth recommending method for treatment of this complication.
Źródło:
Polish Journal of Surgery; 2015, 87, 5; 238-244
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The usefulness of the Mannheim Peritonitis index score in assessing the condition of patients treated for peritonitis
Autorzy:
Budzyński, Piotr
Dworak, Jadwiga
Natkaniec, Michał
Pędziwiatr, Michał
Major, Piotr
Migaczewski, Marcin
Matłok, Maciej
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1395648.pdf
Data publikacji:
2015-06-01
Wydawca:
Index Copernicus International
Tematy:
peritonitis
mortality
Mannheim Peritonitis Index (MPI)
Opis:
The aim of the study was to verify the Mannheim Peritonitis Index (MPI) suitability to determine the probability of death among patients in Polish population operated due to peritonitis and to assess the possibility of using the Index to determine the risk of postoperative complications, relaparotomy and need for postoperative hospitalization in intensive care unit. Material and methods. Retrospective analysis covered 168 patients (M: F = 83: 85, mean age = 48.45 years, SD ± 22.2) treated for peritonitis. The MPI score was calculated for each patient. According to MPI results, patients were divided to the appropriate groups (<21, 21‑29, > 29) and within analyzed. The statistical analysis used Chi-square, Mann Withney U and Kolmogorov-Smirnov test. The best cut-off point for MPI was calculated on the basis of ROC analisys. Results. Mortality in the study group was 13.1%. In groups <21, 21‑29 and > 29 points according to MPI mortality was 1.75%, 28.13% and 50% respectively, the difference was statistically significant (p = 0.0124). Significant differences were observed in mortality depending on the diagnosis. Based on the ROC curve the cut-off point was identified as 32 with an accuracy of 85.9% and AUC = 81%. There has been a significant correlation between the MPI count and and the occurrence of: cardio-respiratory failure, acidosis, electrolyte imbalance, surgical wound complications, the need for treatment in the intensive care unit after surgery. Conclusions. The MPI is a simple and effective predictor of death among patients operated due to peritonitis. It can also provide assistance in assessing the risk of postoperative complications and the need for treatment in the intensive care unit.
Źródło:
Polish Journal of Surgery; 2015, 87, 6; 301-306
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Ograniczenia w leczeniu chirurgicznym raka jajnika
Limitations in the treatment of ovarian carcinoma
Autorzy:
Makarewicz, Michał
Koper, Krzysztof
Śpiewankiewicz, Beata
Budzyński, Andrzej
Rajs, Tomasz
Kojs, Zbigniew
Bieda, Tomasz
Wicherek, Łukasz
Powiązania:
https://bibliotekanauki.pl/articles/1031602.pdf
Data publikacji:
2014
Wydawca:
Medical Communications
Tematy:
całkowita cytoredukcja
rak jajnika
limfadenektomia okołoaortalna
splenektomia
zmodyfikowane wytrzewienie tylne
complete cytoreductive surgery
ovarian carcinoma
para-aortic lymphadenectomy
splenectomy
modified posterior exenteration
Opis:
Removal of all foci of ovarian carcinoma during the first surgery considerably improves overall survival. Obtaining complete cytoreduction is not, however, possible in each case. When the procedure is performed in a referral center, complete cytoreduction is obtained in as many as 75–90% of patients. A lot of recent studies indicate that experience of the physician who performs the first procedure affects the degree of cytoreduction. Moreover, the experience of the center in which treatment is started also influences overall survival. Therefore, one might contribute to the improvement of the therapy outcome by refining one’s surgical skills. The experience of a surgeon is essential in resecting metastatic foci in sites such as the hepatoduodenal ligament, omental foramen, splenic recess of the peritoneum, superior omental recess, splenic hilum, tail of the pancreas as well as areas of the diaphragmatic and renal vessels. For a procedure to be effective, it must involve the entire peritoneum with all its recesses. The essential elements of the procedure which decide about the degree of cytoreduction are: 1) removing the rectum and peritoneum of the lower recess (modified posterior exenteration); 2) resection of the ovarian vessels and para-aortic lymphadenectomy; 3) removing the peritoneum of the diaphragm and partial resection of the diaphragm; 4) fragmentary resection of the gastrointestinal tract; 5) splenectomy with resection of foci in the lesser sac. The paper presents anatomic limitations that affect surgical treatment of ovarian carcinoma in these regions.
Usunięcie wszystkich ognisk raka jajnika w czasie pierwszej operacji wydłuża znamiennie całkowite przeżycie. Doprowadzenie do całkowitej cytoredukcji nie jest jednak możliwe w każdym przypadku. Gdy zabieg przeprowadza się w ośrodku referencyjnym, całkowita cytoredukcja osiągana jest nawet u 75–90% operowanych chorych. Wiele ostatnich badań wskazuje, że o stopniu cytoredukcji decyduje doświadczenie lekarza, który wykonał pierwszą operację. Istotne dla całkowitego przeżycia jest także doświadczenie ośrodka, w którym rozpoczyna się leczenie. Dlatego dbając o warsztat chirurgiczny, można przyczynić się do poprawy wyników terapii. Doświadczenie chirurga jest niezbędne w resekcji ognisk przerzutowych w takich miejscach, jak więzadło wątrobowo-dwunastnicze, otwór sieciowy, zachyłek śledzionowy otrzewnej, zachyłek górny torby sieciowej, wnęka śledziony, ogon trzustki, okolice naczyń przeponowych i naczyń nerkowych. Aby zabieg zakończył się sukcesem, powinien dotyczyć całej otrzewnej i wszystkich jej zachyłków. Kluczowe elementy tej operacji, decydujące o stopniu cytoredukcji, to: 1) usunięcie odbytnicy i otrzewnej zachyłka dolnego (zmodyfikowane wytrzewienie tylne); 2) resekcja naczyń jajnikowych i limfadenektomia okołoaortalna; 3) usunięcie otrzewnej z przepony i częściowe resekcje przepony; 4) resekcje odcinkowe przewodu pokarmowego; 5) splenektomia wraz z resekcją ognisk z torby sieciowej. W pracy przedstawiono anatomiczne ograniczenia wpływające na przebieg leczenia chirurgicznego raka jajnika w tych obszarach.
Źródło:
Current Gynecologic Oncology; 2014, 12, 2; 140-154
2451-0750
Pojawia się w:
Current Gynecologic Oncology
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Impact of bariatric surgery on non-alcoholic fatty liver disease
Autorzy:
Major, Piotr
Pędziwiatr, Michał
Rubinkiewicz, Mateusz
Stanek, Maciej
Głuszewska, Anna
Pisarska, Magdalena
Małczak, Piotr
Budzyński, Andrzej
Budzyński, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/1393188.pdf
Data publikacji:
2017
Wydawca:
Index Copernicus International
Tematy:
non-alcoholic fatty liver disease
bariatric surgery
morbid obesity
Opis:
Introduction; p to 300 million people have the body mass index (BMI) greater than 30 kg/m2. Obesity is the cause of many serious diseases, such as type 2 diabetes, hypertension, and non-alcoholic fatty liver disease (NAFLD). Bariatric surgery is the only effective method of achieving weight loss in patients with morbid obesity. Objectives: The aim of the study was to assess the impact of bariatric surgery on non-alcoholic fatty liver disease in patients operated on due to morbid obesity. Material and Methods: We included 20 patients who were qualified for bariatric procedures based on BMI > 40 kg/ m2 or BMI > 35kg/m2 with the presence of comorbidities. The average body weight in the group was 143.85kg, with an average BMI of 49.16kg/m2. Before the procedure, we evaluated the severity of non-alcoholic fatty liver disease in each patient using the Sheriff-Saadeh ultrasound scale. We also evaluated the levels of liver enzymes. Follow-up evaluation was performed twelve months after surgery. Results: Twelve months after surgery, the average weight was 102.34 kg. The mean %WL was 33.01%, %EWL was 58.8%, and %EBMIL was 61.37%. All patients showed remission of fatty liver disease. Liver damage, evaluated with ultrasound imaging, decreased from an average of 1.85 on the Sheriff-Saadeh scale, before surgery, to 0.15 twelve months after surgery (p < 0.001). As regards liver enzymes, the level of alanine aminotransferase decreased from 64.5 (U/l) to 27.95 (U/l) (p < 0.001), and the level of aspartate aminotransferase decreased from 54.4 (U/l) to 27.2 (U/l). Conclusions: Bariatric procedures not only lead to a significant and lasting weight loss, but they also contribute to the reduction of fatty liver disease and improve liver function.
Źródło:
Polish Journal of Surgery; 2017, 89, 2; 1-4
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Elective laparoscopic cholecystectomy – is it safe in the hands of residents during training?
Autorzy:
Kisielewski, Michał
Pędziwiatr, Michał
Pisarska, Magdalena
Major, Piotr
Rubinkiewicz, Mateusz
Matłok, Maciej
Migaczewski, Marcin
Budzyński, Piotr
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1394419.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
laparoscopic cholecystectomy
resident education
conversion of operator
Opis:
The aim of the study was to assess safety of elective laparoscopic cholecystectomy (LC) performed by residents that are undergoing training in general surgery. Material and methods. A retrospective analysis was conducted on 330 patients operated electively due to cholelithiasis. Patients with acute cholecystitis, choledocholithiasis, undergoing cholecystectomy as a part of more extensive operation and patients with gall-bladder cancer were excluded. Group 1 included patients operated by resident, group 2 – by specialist. Duration of operation, mean blood loss, number of major complications, number of conversions to the open technique and conversions of the operator, reoperations and length of hospital stay were analyzed. Results. Mean operative time overall was 81 min (25 – 170, SD±28.6) and 71 min (30-210, SD±29.1) in groups 1 and 2 respectively (p=0.00009). Mean blood loss in group 1 was 45±68.2 ml and in group 2 – 41±73.4 ml (p=0.23). Six major complications has occurred (1.81%) – 2 (2%) in group 1 and 4 (1.7%) in group 2. 18 cases (15.5%) of conversion of the operator occurred in group 1, and 6 cases (2.6%) of conversion of the operator happened in group 2. Average LOS was 1.9 days in group 1 and 2.3 days in group 2 (p=0.03979). Conlcusions. Elective LC performed by a supervised resident is a safe procedure. Tactics of “conversion of operator” allowed to prevent major complications. Longer LC by residents is natural during the learning curve. Modifications of residency program in the field of laparoscopy may increase its accessibility.
Źródło:
Polish Journal of Surgery; 2015, 87, 9; 429-433
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Laparoscopic cholecystectomy in the treatment of gallbladder polypoid lesions – 15 years of experience
Autorzy:
Matłok, Maciej
Migaczewski, Marcin
Major, Piotr
Pędziwiatr, Michał
Budzyński, Piotr
Winiarski, Marek
Ostachowski, Mateusz
Budzyński, Andrzej
Rembiasz, Kazimierz
Powiązania:
https://bibliotekanauki.pl/articles/1396486.pdf
Data publikacji:
2013-11-01
Wydawca:
Index Copernicus International
Tematy:
gall-bladder polyps
laparoscopic cholecystectomy
gall-bladder cancer
gall-bladder ultrasound
Opis:
Due to the constant increase of public health awareness and widespread “cancerophobia”, the progressively larger number of incidentally diagnosed gall-bladder polyps became the source of anxiety, which leads patients and physicians to undertake therapeutic decisions, despite the absence of symptoms. The majority of gall-bladder polyps are benign. It is estimated that only 3 to 5% of polyps are malignant. Currently, there is lack of randomized control trials based on which the clear-cut criteria of qualification of patients with gall-bladder polyps for surgical procedure can be created. The aim of the study was to analyze gall-bladder polyps in patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum. Material and methods. The retrospective study was conducted on 5369 patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum with special attention to 152 (2.8%) patients in whom gall-bladder polyps were diagnosed preoperatively. Qualification criteria for surgery, surgical treatment results, and histopathological examination results were also analyzed. Results. Amongst the 5369 patients qualified for laparoscopic cholecystectomy, 152 (2.8%) were diagnosed with gall-bladder polyps during the preoperative ultrasound examinations. Postoperative histopathological examinations of 41 (27%) patients confirmed the presence of gall-bladder polyps. In 102 (67%) patients, only gall-stones were diagnosed without previously described polyps during the ultrasound examination. Analysis of the histopathological examination results revealed the presence of benign lesions in 35 (23.35%) patients. In 5 (3%) patients the presence of an adenoma, and in one (0.65%) the presence of adenocarcinoma were confirmed. Conclusions. Based on the conducted study and previous personal experience in the treatment of patients with gall-bladder polyps, we believe that due to the potential risk of neoplastic transformation, patients with polyps larger than 10 mm in diameter and polyps of proven rapid growth should be qualified for laparoscopic cholecystectomy. Indications for surgical treatment also seem reasonable in case of patients with present polyps and coexisting right upper quadrant pain, even though the above-mentioned is connected with gall-bladder deposits.
Źródło:
Polish Journal of Surgery; 2013, 85, 11; 625-629
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The use of the enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic surgery for colorectal cancer – a comparative analysis of patients aged above 80 and below 55
Autorzy:
Pędziwiatr, Michał
Pisarska, Magdalena
Wierdak, Mateusz
Major, Piotr
Rubinkiewicz, Mateusz
Kisielewski, Michał
Matyja, Maciej
Lasek, Anna
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1394301.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
ERAS protocol
fast track protocol
postoperative care
colorectal cancer
colorectal surgery
advanced age
laparoscopic surgery
Opis:
Age is one of the principal risk factors for colorectal adenocarcinoma. To date, older patients were believed to achieve worse treatment results in comparison with younger patients due to reduced vital capacity. However, papers have emerged in recent years which confirm that the combination of laparoscopy and postoperative care based on the ERAS protocol improves treatment results and may be particularly beneficial also for elderly patients. The aim of the study was to compare the outcomes of laparoscopic surgery for colorectal cancer in combination with the ERAS protocol in patients aged above 80 and below 55. Material and methods. The analysis included patients aged above 80 and below 55 undergoing elective laparoscopic colorectal resection for cancer at the 2nd Department of General Surgery of the Jagiellonian University. They were divided into two groups according to their age: ≥80 years of age (group 1) and ≤55 years of age (group 2). Both groups were compared with regard to the outcome of surgery: length hospital stay, complications, hospital readmissions, degree of compliance with the ERAS protocol, and recovery parameters (tolerance of oral nutrition, mobilisation, need for opioids, restored gastrointestinal function). Results. Group 1 comprised 34 patients and group 2, 43 patients. No differences were found between both groups in terms of gender, BMI, tumour progression or surgical parameters. Older patients typically had higher ASA scores. No statistically significant differences were found with regard to the length hospital stay following surgery (5.4 vs 7 days, p=0.446481), the occurrence of complications (23.5% vs 37.2%, p=0.14579) or hospital readmissions (2.9% vs 2.4%). The degree of compliance with the ERAS protocol in group 1 and 2 was 85.2% and 83.0%, respectively (p=0.482558). Additionally, recovery parameters such as tolerance of oral nutrition (82.4% vs 72.1%, p=0.28628) and mobilisation (94.1% vs 83.7%, p=0.14510) within 24 hours of surgery did not differ among the groups. However, a smaller proportion of older patients required opioids in comparison with younger patients (26.5% vs 55.8%, p=0.00891). Conclusions. Similar levels of compliance with the ERAS protocol may be achieved among patients aged ≥80 and younger patients. When laparoscopy is combined with the ERAS protocol, age does not seem to be a significant factor that could account for worse utcomes. Therefore, older patients should not be excluded from perioperative care based on ERAS principles.
Źródło:
Polish Journal of Surgery; 2015, 87, 11; 565-572
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Randomized Clinical Trial to Compare the Effects of Preoperative Oral Carbohydrate Loading versus Placebo on Insulin Resistance and Cortisol Level after Laparoscopic Cholecystectomy
Autorzy:
Pędziwiatr, Michał
Pisarska, Magdalena
Matłok, Maciej
Major, Piotr
Kisielewski, Michał
Wierdak, Mateusz
Natkaniec, Michał
Budzyński, Piotr
Rubinkiewicz, Mateusz
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1394369.pdf
Data publikacji:
2015
Wydawca:
Index Copernicus International
Tematy:
laparoscopic cholecystectomy
insulin resistance
preoperative carbohydrate loading
perioperative care
Opis:
Postoperative insulin resistance, used as a marker of stress response, is clearly an adverse event. It may induce postoperative hyperglycemia, which according to some authors can increase the risk of postoperative complications. One of the elements of modern perioperative care is preoperative administration of oral carbohydrate loading (CHO-loading), which shortens preoperative fasting and reduces insulin resistance. The aim of the study is to establish the influence of CHO-loading on the level of insulin resistance and cortisol in patients undergoing elective laparoscopic cholecystectomy. Material and methods. Patients were randomly allocated to one of 2 groups. The intervention group included 20 patients who received CHO-loading (400 ml Nutricia pre-op®) 2 hours prior surgery. The control group received a placebo (clear water). In every patient blood samples were taken 2 hours prior to surgery, immediately after surgery, and on the 1st postoperative day. Levels and changes in glucose, cortisol and insulin resistance were analyzed in both groups. Results. Although there were differences in the levels of cortisol, insulin, and insulin resistance, no statistically significant differences were observed between groups in every measurement. The length of stay and postoperative complications were comparable in both groups. Conclusions. We believe that CHO-loading is not clinically justified in case of laparoscopic cholecystectomy. No effect on the levels of glucose, insulin resistance and cortisol was observed. Even though such procedure is safe, in our opinion there is no clinical benefit from CHO-loading prior to laparoscopic cholecystectomy.
Źródło:
Polish Journal of Surgery; 2015, 87, 8; 402-408
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
A periampullary duodenal diverticula in patient with choledocholithiasis – single endoscopic center experience
Autorzy:
Major, Piotr
Dembiński, Marcin
Winiarski, Marek
Pędziwiatr, Michał
Rubinkiewicz, Mateusz
Stanek, Maciej
Dworak, Jadwiga
Pisarska, Magdalena
Rembiasz, Kazimierz
Budzyński, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1393717.pdf
Data publikacji:
2016
Wydawca:
Index Copernicus International
Tematy:
choledocholithiasis
digestive system endoscopic surgery
diverticulum
endoscopic retrograde cholangiopancreatography
prevalence
Opis:
The reported prevalence of periampullary duodenal diverticula varies between 9 and 32.8%. The aim of the study was to evaluate the prevalence of periampullary diverticula in the studied population and establish whether their presence influence the risk of choledocholithiasis and the risk of Endoscopic Retrograde Cholangio Pancreatography (ERCP) related complications. Material and methods. The study group of 3788 patients who underwent ERCP between 1996 and 2016at the 2nd Department of General Surgery Jagiellonian University Medical College in Kraków were analyzed. The group comprised of 2464 women (mean age 61.7 years) and 1324 men (mean age 61.8 years). The patients were divided into two groups. Group A included patients in whom there were no periampullary diverticula detected. Group B included patients in whom the opening of the bile duct was in the vicinity of a duodenal diverticulum. Results. There were 3332 patients included in group A (2154 women and 1178 men) and 456 patients in group B (310 women and 146 men). The prevalence of periampullary duodenal diverticula in the analyzed group was 12.8%. The presence of stones or biliary sludge was diagnosed in 1542 patients (47.6%) in group A and 290 patients (68.1%) in group B. Recurrence of choledocholithiasis occurred in 4.5% of patients (70/1542) in group A and 10.3% of patients (30/290) in group B. Complications occurred in a total of 76 patients in group A (2.3%) and 22 patients in group B (4.8%). Conclusions. The presence of choledocholithiasis and the risk of ERCP related complications are significantly higher in the group with duodenal diverticula.
Źródło:
Polish Journal of Surgery; 2016, 88, 6; 576-586
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-15 z 17

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