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    Wyświetlanie 1-4 z 4
    Tytuł:
    The Influence of Splenectomy Performed Simultaneously with Gastrectomy on Postoperative Complications in Patients with Gastric Cancer Undergoing Surgery with the Intention to Treat
    Autorzy:
    Głuszek, Stanisław
    Kot, Marta
    Kuchinka, Jakub
    Matykiewicz, Jarosław
    Powiązania:
    https://bibliotekanauki.pl/articles/1395800.pdf
    Data publikacji:
    2014-07-01
    Wydawca:
    Index Copernicus International
    Tematy:
    splenectomy
    gastrectomy
    surgical complications
    general complications
    gastric cancer
    Opis:
    Despite the growing understanding of the pathophysiological processes in the perioperative period and significant advancements in surgical techniques, operative treatment for gastric cancer remains a challenge for surgeons, especially because the primary procedure of total or nearly total gastrectomy must at times be extended by the resection of other organs. The aim of the study was to asses the influence of concomitant splenectomy in patients undergoing curative surgery for gastric cancer on postoperative complications. Material and methods. The study population consisted of 258 patients who underwent surgical treatment for gastric cancer with the intention to treat. The study assessed the influence of extending the surgical intervention by splenectomy on postoperative complications, both general and surgical, including the most severe of these, i.e. oesophago-gastric anastomotic leakage, duodenal stump leakage and peritoneal fluid infections. Results. Among the 258 gastric cancer patients receiving curative surgical treatment, the most common simultaneous intervention was splenectomy: 42/258 (16.3%), which was also accompanied by partial pancreatectomy in 8 cases. The number of surgical postoperative complications, major and minor, was similar in both subgroups: with and without splenectomy. Minor general complications, such as pyrexia with no clinically apparent reason, atelectasis, pneumonia and pleural effusion were statistically significantly more common in the subgroup with splenectomy (p=0.0001). Conclusion. Splenectomy performed concomitantly with gastrectomy for gastric cancer increases the risk of minor general complications. However, it does not increase the risk of severe surgical complications, such as oesophago-intestinal anastomotic leakage and does not increase the risk of death
    Źródło:
    Polish Journal of Surgery; 2014, 86, 7; 312-318
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Severe vascular complications of acute pancreatiti
    Autorzy:
    Głuszek, Stanisław
    Nawacki, Łukasz
    Matykiewicz, Jarosław
    Kot, Marta
    Kuchinka, Jakub
    Powiązania:
    https://bibliotekanauki.pl/articles/1394278.pdf
    Data publikacji:
    2015
    Wydawca:
    Index Copernicus International
    Tematy:
    Acute pancreatitis
    complications
    bleeding into the pancreatic tumour
    Opis:
    Acute pancreatitis (AP) develops as a result of the imbalance of the mechanisms inhibiting the activity of enzymes in the pancreatic cells, which causes their autoactivation in the pancreas. The incidence of AP ranges from 10 up to 100 cases per 100,000 population per year in different parts of the world. The overall mortality rate for acute pancreatitis is 10- 15%. The mortality rate in patients diagnosed with the severe form of acute pancreatitis is up to 30- 40%. Material and methods. The study included 10 patients treated due to acute pancreatitis in two surgical departments run by one of the authors (S.G.) in the years 2004-2014, who developed a serious complication in the form of haemorrhage into the inflammatory tumour/pancreatic cyst or an adjacent organ. Haemorrhage was diagnosed based on the clinical picture, most often a sudden drop in blood pressure, peritonitis symptoms and imaging findings – abdominal ultrasound and abdominal computed tomography. Therapeutic methods included conservative treatment, endovascular embolisation and, in the absence of efficacy of the above mentioned methods, surgical treatment. Patients age and gender, the etiological factor, comorbidities, Atlanta Classification, treatment outcomes and mortality rate were assessed. Results. Alcohol was the most common etiological factor in the investigated AP cases. The patients received conservative treatment, interventional radiology treatment (endovascular embolisation) or surgical treatment. In the study group, 6 patients required surgical treatment, 3 patients received invasive radiology treatment, and conservative treatment was used in one patient. The mortality rate in the study group was 30%. Conclusions. Haemorrhages into the inflammatory cisterns or adjacent organs (stomach, transverse colon mesentery) secondary to AP are the most severe complications, which are difficult to manage. The successful use of interventional radiology methods to inhibit and prevent the recurrence of bleeding in some of the patients is a significant milestone.
    Źródło:
    Polish Journal of Surgery; 2015, 87, 10; 485-490
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Fournier gangrene – a challenge for the surgeon
    Autorzy:
    Kuchinka, Jakub
    Matykiewicz, Jarosław
    Wawrzycka, Iwona
    Kot, Marta
    Karcz, Włodzimierz
    Głuszek, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1391522.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    Fourniere gangrene
    hyperbaric oxygen treatment
    early surgical approach
    Opis:
    Introduction. Fournier gangrene (FG) is life - threatening condition, defined as the necrotizing fascitis of perineum and can spread to the adjacent areas. It is rare disease and infection is caused by mixed bacterial flora, seldom by fungal infection. Risk factors are: male sex, diabetes, hypertension, malignant neoplasms, alcoholism, immunospression. Material and methods. The analysis of four group patients treateted for Fournier gangrene was made about diagnostic and therapeutic process, assessment of prognosis based on Fournier’s Gangrene Severity Index). Results. All patients were males. Average age at the moment of diagnosis was 60 years. All of them had comorbidities resulting with the higher risk of susceptibility to FG. Morbitity was 50%, despite of all of patients had less than 9 points in FGSI. Discussion. The FG, despite of better diagnostic tools and technological progres remaines the significant clinical issue because of the mortality - 80%. „The golden standard” is surgical excision of necrotic tissues, antibiotics support, equation of fluid, electrolytes and base – acid balance, level of glycemia is very important. The treating results were assessed on the base of FGSI. The significance has the moment of performing the surgical intervention – it is proven, that should be carried out during 24 hours. The hyperbaric oxygen therapy is controversial. Seem to be appropriate if the infection is caused by anaerobic bacteria. Conclusions. Fournier syndrome is significant clinical issue. Its treatment requires early surgical approach with exicision of necrotic tissues, antibiotics support and treatment of hyperbaric oxygen in some cases.
    Źródło:
    Polish Journal of Surgery; 2021, 93, 1; 55-60
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Iatrogenic bile duct injuries – clinical problems
    Autorzy:
    Głuszek, Stanisław
    Kot, Marta
    Bałchanowski, Norbert
    Matykiewicz, Jarosław
    Kuchinka, Jakub
    Kozieł, Dorota
    Wawrzycka, Iwona
    Powiązania:
    https://bibliotekanauki.pl/articles/1395690.pdf
    Data publikacji:
    2014-01-01
    Wydawca:
    Index Copernicus International
    Tematy:
    laparoscopic surgery
    cholecystectomy
    iatrogenic bile duct injury
    Opis:
    Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures in surgical wards. Iatrogenic bile duct injuries (IBDI) incurred during the procedures are among postoperative complications that are most difficult to treat. The risk of bile duct injury is 0.2-0.4%, and their consequences are unpleasant both for the surgeon and for the patient. The aim of the study was analysis of iatrogenic bile duct injuries and methods of their repair,taking into consideration the circumstances, under which the injuries occur. Material and methods. The study group consisted of 16 patients who had suffered IBDI during surgery. The analysed parameters included sex, age, indications for surgery, the setting of the surgical procedure and the type of bile duct injury. Additionally, the time of injury diagnosis, type of repair and treatment outcome were assessed. The IBDI analysis used the EAES classification of injuries. The time of IBDI repair was defined as immediate, early or late,depending on the time that had passed from the injury. The analysis included complications seen after bile duct repair. Results. The study group consisted of 10 women and 6 men, aged 29-84. Patients underwent 6 classic cholecystectomies, 8 laparoscopic cholecystectomies, one gastrotomy to remove oesophageal prosthesis and one laparotomy due to peptic ulcer. IBDI was diagnosed intraoperatively in 4 patients. In 12 patients IBDI was diagnosed within 1-7 days. The diagnosis was based on endoscopic retrograde cholangiopancreatography and the results of biochemistry tests. According to the EAES classification, the injuries were of type 1 (4 patients), type 2 (8 patients), type 5 (3 patients) and type 6 (1 patients). Reconstruction procedures were performed during the same anaesthesia session in 3 patients, and in the early period in 13 patients. The main procedure was Roux-en-Y anastomosis (12 patients), with the remaining including bile-duct suturing over a T-tube (3 patients) and underpinning of an accessory bile duct in the pocket left after gallbladder removal (1 patient). The most common reconstruction complications included bile leak (3 patients), recurrent cholangitis (3 patients) and bile duct stricture (2 patients). Mortality in the study group was 12.5%. Conclusions. The procedures of laparoscopic and classic cholecystectomy are associated with a risk of IBDI, especially in the presence of inflammatory state of the gall-bladder. IBDI is a complex complication: its treatment poses a challenge for the operating surgeon, and even the most careful treatment adversely affects the patient’s lifedue to complications.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 1; 17-25
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-4 z 4

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