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    Wyświetlanie 1-14 z 14
    Tytuł:
    Risk of complications and 30-day mortality after laparoscopic and open appendectomy in a Danish region, 1998-2007; a population-based study of 18,426 patients
    Autorzy:
    Bregendahl, Sidse
    Nørgaard, Mette
    Laurberg, Søren
    Jepsen, Peter
    Powiązania:
    https://bibliotekanauki.pl/articles/1396234.pdf
    Data publikacji:
    2013-07-01
    Wydawca:
    Index Copernicus International
    Tematy:
    appendicitis
    laparoscopic appendectomy
    open appendectomy
    complications
    mortality
    Opis:
    Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. The aim of the study was to describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. Material and methods. Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. Results. We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. Conclusions. Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA
    Źródło:
    Polish Journal of Surgery; 2013, 85, 7; 395-400
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Laparoscopic Management of Appendicular Abscess (Clinical Observation)
    Autorzy:
    Tutchenko, Mykola
    Svitlychnyi, Eduard
    Wojcicka, Karolina
    Shavlovskyi, Oleksandr
    Powiązania:
    https://bibliotekanauki.pl/articles/1395821.pdf
    Data publikacji:
    2014-05-01
    Wydawca:
    Index Copernicus International
    Tematy:
    appendicular abscess
    laparoscopic appendectomy
    Opis:
    This article presents the diagnostics and laparoscopic management of appendicular abscess of 66 y.o. woman operated 3 weeks after the disease onset. The patient underwent surgery successfully. Purulent septic post-operative complications were not demonstrated. That confirms the benefits of minimally invasive surgery
    Źródło:
    Polish Journal of Surgery; 2014, 86, 5; 235-237
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Treatment of acute appendicitis in geriatric patients – literature review
    Autorzy:
    Kot, Anna
    Kenig, Jakub
    Wałęga, Piotr
    Powiązania:
    https://bibliotekanauki.pl/articles/1394143.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    appendectomy
    appendicitis
    geriatric patients
    elderly
    Opis:
    Demographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups. The aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old. Material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, „appendicitis (MeSH) AND elderly (MeSH)” was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age. Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons. Conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.
    Źródło:
    Polish Journal of Surgery; 2016, 88, 3; 136-141
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Laparosocopic appendectomy, cost-effectiveness of three different techniques used to close the appendix stump
    Autorzy:
    Matyja, Maciej
    Strzałka, Marcin
    Rembiasz, Kazimierz
    Powiązania:
    https://bibliotekanauki.pl/articles/1394238.pdf
    Data publikacji:
    2015
    Wydawca:
    Index Copernicus International
    Tematy:
    laparoscopic appendectomy
    cost-effectiveness
    results
    Opis:
    It is generally agreed that laparoscopic appendectomy is a valuable operative method. The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump. Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI. Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique. Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.
    Źródło:
    Polish Journal of Surgery; 2015, 87, 12; 634-637
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump
    Autorzy:
    Strzałka, Marcin
    Matyja, Maciej
    Rembiasz, Kazimierz
    Powiązania:
    https://bibliotekanauki.pl/articles/1395843.pdf
    Data publikacji:
    2014-12-18
    Wydawca:
    Index Copernicus International
    Tematy:
    laparoscopic appendectomy
    titanium clips
    results
    Opis:
    Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present the results of minimally invasive appendectomies performed with the use of titanium clips. material and methods. Patients operated on laparoscopically for acute appendicitis with the application of titanium clips between October 2012 and December 2013 were included in the study. We reviewed retrospectively patients` data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates. Results. There were 93 patients (mean age=33.8 years, SD=15.23) in the analyzed group, including 60 men (mean age=33.5 years, SD= 15.07) and 33 women (mean age=33.9 years SD=15.26). The aver-age duration of the surgical procedure was 66 min (SD= 33.15). The average length of hospital stay was 3.38 days (SD=1.62). No intraoperative complications were observed in the analyzed group. Post-operative complication rate was low (6 cases, 6.5%). No mortality was observed. Conclusions. Laparoscopic appendectomy with the application of titanium clips for closure of the appendicular stump is safe, associated with low complication rates and should be considered as a routine technique in everyday surgical practice.
    Źródło:
    Polish Journal of Surgery; 2014, 86, 9; 418-421
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Laparoscopic Appendectomy as an Alternative to Conventional Procedure – Results in our own Material
    Autorzy:
    Merenda, Marcin
    Litarski, Andrzej
    Kabziński, Piotr
    Janczak, Dariusz
    Powiązania:
    https://bibliotekanauki.pl/articles/1396260.pdf
    Data publikacji:
    2013-06-01
    Wydawca:
    Index Copernicus International
    Tematy:
    laparoscopic appendectomy
    minimally invasive surgery
    Opis:
    Appendectomies are the most common surgical procedures performed in the emergency surgery setting. Since more than one decade laparoscopic appendectomy appeared as an alternative procedure to commonly used conventional appendectomy as a recognized method of treatment of acute appendicitis. Despite multiple papers and studies comparing these techniques, still no clear indications and eligibility criteria exist for either of them. The aim of the study was to evaluate results of treatment of acute appendicitis using the laparoscopic method versus the conventional appendectomy, basing on parameters affecting treatment results and costs, such as duration of hospitalization, complications, use of medications. Material and methods. The analysis included patients who underwent surgical treatment for acute appendicitis at the Department of Surgery of 4th Military Clinical Hospital in Wrocław between 2006 and 2012. Since 2006, 128 laparoscopic appendectomies (group 1) were performed, while 189 patients underwent conventional procedure during this time (including 11 who underwent a diagnostic laparoscopy - group 2). The study was based on retrospective analysis of medical records of patients. Treatment results were evaluated basing on the following parameters: duration of hospitalization, amount of used analgesics, duration and type of antibiotic therapy, peri- and postoperative complications. Results and conclusions. Results obtained at our Clinic, similar to results obtained at other sites, warrant use of laparoscopic appendectomy. Use of minimally invasive techniques provides better treatment results, mainly with regard to shorter duration of hospitalization, lower use of antibiotics and analgesics, which also contributes to lower overall treatment costs.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 6; 323-328
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis
    Autorzy:
    Ozkan, Atakan
    Gokce, Aylin Hande
    Gokce, Feridun Suat
    Powiązania:
    https://bibliotekanauki.pl/articles/1391807.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    acute abdomen
    acute appendicitis
    appendectomy
    obesity
    Opis:
    Background: Acute appendicitis is the most common cause of acute abdomen. Delay in diagnosis increases the mortality and morbidity. Aim: In this study, we aimed to investigate whether the body mass index is useful in diagnosis and whether the neutrophil /lymphocyte and platelet/lymphocyte ratios can help in determining the inflammation level of acute appendicitis. Meterial and Methods: Cases of appendectomy performed between June 2012 and December 2018 in our clinic were analyzed retrospectively. Based on the pathology results of the cases included in the study, 4 groups were formed, i.e.: Group 1 (initial stage), Group 2 (catarrhal stage), Group 3 (phlegmonous-gangrenous stage) and Group 4 (perforation). The study compared age, body mass index, leukocyte values, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), platelet /lymphocyte ratio (PLR), and mean platelet volume (MPV) between groups. Results: 828 cases were included in the study. When compared between groups, the values of Group 3 and Group 4 were higher than those of Group 1 and Group 2 for PLR and NLR. There was no difference in RDW and MPV values in the blood. When Body Mass Index (BMI) was compared between groups, it was found to be significantly higher with increasing histopathological stage. Conclusion: In acute appendicitis, the blood leukocyte value, elevated PLR and NLR are helpful in diagnosis. We aimed to emphasize that the diagnosis of acute appendicitis is delayed in patients with a BMI above 30 and/or at age of over 40 years, with the perforation rate being determined more frequently.
    Źródło:
    Polish Journal of Surgery; 2020, 92, 6; 7-11
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Primary Adenocarcinoma of the Appendix – A Case Report
    Autorzy:
    Pasternak, Artur
    Pach, Radosław
    Szura, Mirosław
    Solecki, Rafał
    Tomaszewski, Krzysztof A.
    Szczepański, Wojciech
    Matyja, Andrzej
    Kulig, Jan
    Powiązania:
    https://bibliotekanauki.pl/articles/1395798.pdf
    Data publikacji:
    2014-07-01
    Wydawca:
    Index Copernicus International
    Tematy:
    adenocarcinoma
    appendix
    laparoscopic appendectomy
    right hemicolectomy
    Opis:
    Primary adenocarcinoma of the vermiform appendix is a rare clinical condition. It usually presents as an acute abdominal process or as a mass in the right lower quadrant. The gross pathologic and microscopic characteristics of this disease are the same as for colon carcinoma and carry a serious prognosis. We report a case of a 64-year old male patient presenting symptoms of acute appendicitis. The patient underwent laparoscopic appendectomy that revealed a severely inflamed appendix. Histopathological examination has shown that it was a poorly differentiated, high grade adenocarcinoma invading the periappendicular fat. According to the histopathological findings, a right hemicolectomy was further advised and performed. Right hemicolectomy is the generally recommended method of treatment for invasive adenocarcinoma of the appendix
    Źródło:
    Polish Journal of Surgery; 2014, 86, 7; 333-336
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Effect of BMI on the Quality of Life in Patients After Appendectomy Depending on Surgical Modality
    Autorzy:
    Hańczewski, Marcin
    Marciniak, Ryszard
    Powiązania:
    https://bibliotekanauki.pl/articles/1396034.pdf
    Data publikacji:
    2013-02-01
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    appendectomy
    BMI
    quality of life
    Opis:
    Acute appendicitis is one of the most common diseases requiring rapid surgical intervention. The disease occurs most often in people between 10 and 30 years of age, the risk of acute appendicitis during the whole life is 6-20%. The aim of the study was to assess the impact of BMI on the quality of life of patients operated for acute appendicitis according to the method of operation (LA- Laparoscopical Appendectomy OA - Open Appendectomy) and follow-up time after surgery. Material and methods. The study was conducted on a group of 86 randomly selected patients- 40 operated conventionally (18 women and 22 men) and from 46 patients undergoing laparoscopy (33 women and 13 men), which were operated during the period between 15 July 2007 and 27 February 2009. Each patient was assessed by BMI, recognizing the value of > 25 kg/m2 as overweight. In this study the basis of quality of life was a form Medical Outcomes Study36 -the Short Form or SF-36v.2. Results. Patients operated on in LA for 6 months observation to better assessed general health (GH) independently of BMI, while those with BMI ≤ 25 better assessed social functioning (SF) (p =0.027), an overall assessment of Physical Component Summary (PCS) (p = 0.048),Mental Component Summary (MCS) (p = 0.022) as well as an overall indicator of quality of life (p =0.025). The relationships that was not found in observations of more than 6 months after surgery (ns). Conclusions. Questionnaire SF-36v.2 facilitated an objective assessment of quality of life of patients operated on for acute appendicitis. Patients operated on by laparoscopic in observation for 6 months above assessed the quality of life regardless of BMI. The relationships that was not found in observations of more than 6 months after surgery (ns).
    Źródło:
    Polish Journal of Surgery; 2013, 85, 2; 58-64
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Surgical treatment of acute appendicitis in older patients
    Autorzy:
    Dowgiałło-Wnukiewicz, Natalia
    Kozera, Piotr
    Wójcik, Weronika
    Lech, Paweł
    Rymkiewicz, Przemysław
    Michalik, Maciej
    Powiązania:
    https://bibliotekanauki.pl/articles/1392218.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    older patients
    elderly patients
    laparoscopic appendectomy
    Opis:
    Introduction: Acute appendicitis (AA) is the most common indication for emergency surgery and it occurs more often in children and young adults than in patients of advanced age. AA in older patients is a challenging surgical problem because of its atypical presentation. This study was performed to determine whether the age of a patient impacts the outcomes and whether laparoscopic appendectomy (LA) is a feasible method for treatment of patients > 65 years. Material and methods: We performed a retrospective study of 355 patients with AA who were admitted to the Department of General, Minimally Invasive and Elderly Surgery in Olsztyn from 2014 to 2017. The patients were divided into three age groups: 18 to 40, 41 to 65 and >65 years. The histopathological diagnoses were divided into three types: simple AA, phlegmonous AA, and gangrenous AA. Results. LA was performed in 96% of young adults and in 67% of older patients. The patients older than 65 years had higher preoperative white blood cell counts, higher C-reactive protein (CRP) levels and had a longer length of stay (LOS) than younger patients (P=0.05, P=0.03, and P=0.03, respectively). We found a positive correlation among the CRP levels, open appendectomy (OA), and gangrenous appendicitis. Conclusions: Patients older than 65 years more frequently underwent OA than LA, had higher preoperative CRP levels and had a longer LOS than younger patients. Higher CRP levels were associated with a greater risk of gangrenous appendicitis. LA is a safe and feasible treatment method for patients older than 65 years.
    Źródło:
    Polish Journal of Surgery; 2019, 91, 2; 12-15
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The Value of Scoring Systems for the Diagnosis of Acute Appendicitis
    Autorzy:
    Walczak, Dominik A.
    Pawełczak, Dariusz
    Żółtaszek, Agata
    Jaguścik, Rajmund
    Fałek, Wojciech
    Czerwińska, Monika
    Ptasińska, Karolina
    Trzeciak, Piotr W.
    Pasieka, Zbigniew
    Powiązania:
    https://bibliotekanauki.pl/articles/1395540.pdf
    Data publikacji:
    2015-02-01
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    scoring systems
    diagnosis
    appendectomy
    symptoms
    signs
    Opis:
    Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis
    Źródło:
    Polish Journal of Surgery; 2015, 87, 2; 65-70
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Management of solitary cecum diverticulitis – Single-Center Experience
    Autorzy:
    Gonullu, Emre
    Yigit, Merve
    Mantoglu, Baris
    Capoglu, Recayi
    Harmantepe, Tarik
    Gunduz, Yasemin
    Altintoprak, Fatih
    Bayhan, Zulfu
    Erkorkmaz, Unal
    Powiązania:
    https://bibliotekanauki.pl/articles/1391561.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    acute appendicitis
    appendectomy
    cecum diverticulitis
    cecum diverticulum
    diverticulitis
    Opis:
    Objective: Cecal diverticulitis may be encountered as a real etiological factor in 1/300 appendectomies. Differential diagnosis of acute appendicitis and cecal diverticulitis is crucial because of the different treatment methods. Our aim is to reveal the importance of distinguishing acute appendicitis from cecal diverticulitis. Methods: The data of patients who were admitted to the hospital between 2015 and 2019 with the complaint of abdominal pain and then finally diagnosed with colon diverticular disease, colon diverticulitis, or acute appendicitis, analyzed retrospectively. Results: A total of 19 cecum diverticulitis patients were detected during surgery for acute appendicitis or during clinical and radiological evaluation. 1247 appendectomies were evaluated; the final diagnosis was observed as cecal diverticulitis in 5 patients (0,4%). One hundred nineteen patients diagnosed with colonic diverticulitis at admission were evaluated, while 105 (88,2%) of them had left-sided diverticulitis, 14 (11,7%) of them had solitary cecal diverticulitis. All of the solitary cecal diverticulitis patients were treated conservatively, except one patient who has Hinchey 3 diverticulitis. Conclusion: Differential diagnosis of cecum diverticulitis with acute appendicitis is important because cecum diverticulitis can be managed as conservatively in most cases. In order to prevent unnecessary surgical interventions, this importance has increased, especially during the COVID-19 pandemic period.
    Źródło:
    Polish Journal of Surgery; 2021, 93, 4; 15-20
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Zmiany morfologiczne w węzłach chłonnych krętniczo-kątniczych u szczurów po appendektomii
    Autorzy:
    Kamieński, T.
    Waniczek, D.
    Nawrocki, P.
    Rudzki, M.
    Powiązania:
    https://bibliotekanauki.pl/articles/271558.pdf
    Data publikacji:
    2011
    Wydawca:
    Górnośląska Wyższa Szkoła Pedagogiczna im. Kardynała Augusta Hlonda
    Tematy:
    appendektomia
    układ odpornościowy
    GALT
    morfologia
    węzły chłonne
    limnologia
    appendectomy
    immune system
    morphology
    lymph nodes
    lymphology
    Opis:
    Wstęp: Przeprowadzone badania miały na celu wyjaśnienie czy wycięcie wyrostka robaczkowego u szczurów w okresie 63 dni wywołuje zmiany morfologiczne w węzłach chłonnych krętniczo-kątniczych i czy wycięcie wyrostka zaburza w istotny sposób ich budowę i działanie. Materiały i metody: Zwierzętom doświadczalnym usunięto wyrostek robaczkowy lub wszystkie węzły chłonne krętniczo-kątnicze. Uśmiercono je po 63 dniach od pobrania. Badano obraz makro- i mikroskopowy wyrostków robaczkowych i węzłów chłonnych metodami klasycznymi i przy użyciu przeciwciał monoklonalnych. Wyniki: Morfologia węzłów chłonnych krętniczo-kątniczych 63 dni po wycięciu wyrostka robaczkowego nie uległa żadnym istotnym zmianom jakościowym. Zastosowanie analizatora komputerowego pozwoliło na odkrycie pewnych różnic o charakterze ilościowym, stwierdzono wyraźne zmniejszenie się średniej liczby limfocytów B w stosunku do węzłów grupy kontrolnej. W węzłach tych zwierząt uległ tym samym zmianie stosunek ilościowy limfocytów B do limfocytów T, co wydaje się mieć wpływ na funkcjonowanie węzła. Wnioski: Wycięcie wyrostka robaczkowego u szczurów nie pociąga za sobą widocznych zmian morfologicznych o charakterze zaniku lub rozrostu węzłów chłonnych krętniczo-kątniczych, powoduje natomiast zmiany immunologiczne w miąższu węzłów krętniczo-kątniczych. Zmniejszenie się średniej liczby limfocytów B w porównaniu do węzłów chłonnych krętniczo-kątniczych zwierząt grupy kontrolnej, może być przejawem zmian czynnościowych zachodzących w tych narządach. Może to świadczyć o zachwianiu równowagi i zaburzeniu kooperacji pomiędzy limfocytami B i T w procesie odpowiedzi immunologicznej. Jednak w świetle dostępnej wiedzy znaczenie i wymowa tego faktu są niepewne i wymagają dalszych badań.
    Introduction: The research was done to investigate whether the appendectomy carried out on rats leads to morphological changes in ileocaecal lymph nodes within 63 days following the operation and whether it causes serious disfunctions and structure disorders in lymph nodes. Materials and methods: Either appendectomy or the removal of all ileocaecal lymph nodes were carried out on experimental animals. The animals were killed on day 63 after the surgery. Both macro- and microscopic images of appendices and lymph nodes were analysed using classical methods and monoclonal antibodies. Results: No significant qualitative changes were observed in the morphology of ileocaecal lymph nodes on day 63 following the appendectomy. Some quantitative changes were noticed thanks to computer analysis; significant reduction in the mean number of B lymphocytes was observed compared with the number of B lymphocytes in the lymph nodes of the control animals. The quantitative ratio of B lymphocytes and T lymphocytes has changed, which seems to influence the node function. Conclusions: Appendectomy in rats does not result in any significant morphological changes of ileocaecal lymph nodes. They demonstrate neither marked atrophy nor proliferation. However , some immunological changes can be observed. The reduction in the mean number of B lymphocytes compared with the mean number of B lymphocytes in the control animals can be considered a manifestation of functional changes in the organs. That might suggest that the balance and the cooperation between B and T lymphocytes has been disturbed in the immune response process. However, the problem needs further study.
    Źródło:
    Journal of Ecology and Health; 2011, R. 15, nr 2, 2; 97-102
    2082-2634
    Pojawia się w:
    Journal of Ecology and Health
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Zanik powłok brzusznych po zabiegach operacyjnych
    Abdominal integument atrophy after operative procedures
    Autorzy:
    Smereczyński, Andrzej
    Kołaczyk, Katarzyna
    Lubiński, Jan
    Bojko, Stefan
    Gałdyńska, Maria
    Bernatowicz, Elżbieta
    Powiązania:
    https://bibliotekanauki.pl/articles/1061355.pdf
    Data publikacji:
    2012
    Wydawca:
    Medical Communications
    Tematy:
    abdominal integument atrophy
    appendectomy
    cholecystectomy
    laparotomy
    nephrectomy
    ultrasound
    appendektomia
    badanie ultrasonograficzne
    cholecystektomia
    laparotomia
    nefrektomia
    zanik powłok brzusznych
    Opis:
    The aim of the study was to analyze clinical material concerning postoperative atrophy of abdominal integument. Material and methods: The evaluated group consisted of 29 patients with sonographically revealed atrophy of the abdominal wall. Those changes were observed after various surgical procedures: mainly after long, anterolateral laparotomies or several classical operations. Ultrasound examinations up to the year 2000 were performed with analog apparatus, in the latter years only with digital apparatus with linear transducers (7–12 MHz) and sometimes convex type conducers (3–5 MHz). The location, size and intestine stratified wall structure were evaluated. In each case the integument thickness was measured in millimeters in the site of the greatest atrophy and it was compared with the integument thickness from the side that had not been operated which enabled the calculation of the percentage reduction of integument in the area of the scar. Results: In 3 patients who underwent several laparotomies there was a total reduction of muscular mass in the operated area. In these cases we stated only skin and slightly echogenic subcutaneous strand; probably corresponding to fibrous tissue – the thickness of integument in this area was in the range from 3 to 8 mm. In the remaining 26 patients the integument atrophy on the scar level included muscles in a greater extent and covered an extensive area after classical urological procedures on the upper urinary tract: after nephrectomy and even ureter stone evacuation or kidney cyst excision by means of classical anterolateral approach with the integument incision on the length of almost 20 cm. Reduction in the integument thickness was observed on the smaller area after classical cholecystectomies, appendectomies and other surgical procedures with the incision across the integument. The integument atrophy in the operated sites expressed in absolute numbers was in the range of 7–20 mm (average 14 mm). These values are markedly lower than the comparative integument thickness on the not operated side: 17–52 mm (average 25.4 mm). The percentage value of the integument thickness reduction oscillated in the range of 32–67% (average 44.2%). In most cases the atrophy involved all layers of the abdominal wall, what demonstrated as regional prominence of the integument, mimicking the presence of hernia. Conclusions: Ultrasonography allows precise evaluation of the size and extent of atrophy as well as depiction of other lesions simulating that effect. Establishing the correct diagnosis should prevent the unnecessary reconstructions of the abdominal integument.
    Celem pracy była analiza materiału klinicznego dotyczącego zaniku powłok brzusznych po zabiegach operacyjnych. Materiał i metoda: Zgromadzono grupę 29 chorych z wykazanym ultrasonograficznym zanikiem powłok brzusznych. Zmiany te obserwowano po różnych procedurach operacyjnych, najczęściej po długich nacięciach laparotomijnych przednio‑bocznych lub kilkukrotnych operacjach klasycznych. Badania ultrasonograficzne wykonano do 2000 roku na aparatach analogowych, a w następnych latach wyłącznie aparatami cyfrowymi, z głowicami linowymi (7–12 MHz) i niekiedy głowicami typu konweks (3–5 MHz). Określano lokalizację, rozległość, warstwową budowę ściany jelita. W każdym przypadku mierzono grubość powłok w milimetrach w miejscu największego zaniku i porównywano ją z grubością powłok po stronie nieoperowanej, co pozwalało na obliczenie procentowej redukcji powłok w okolicy blizny. Wyniki: U 3 pacjentów po kilku laparotomiach doszło do całkowitej redukcji masy mięśniowej w miejscu operacji. W tych przypadkach stwierdzano jedynie skórę i lekko echogeniczne pasmo podskórne, prawdopodobnie odpowiadające zwłókniałym tkankom – grubość powłok w tym miejscu wahała się od 3 do 8 mm. U pozostałych 26 pacjentów zanik powłok na poziomie blizny pooperacyjnej dotyczył w największym stopniu mięśni i obejmował rozległy obszar po klasycznych zabiegach urologicznych na górnych drogach moczowych: po usunięciu nerki, a nawet po ewakuacji złogu z moczowodu lub wycięciu torbieli nerki z dostępu klasycznego przednio‑bocznego z nacięciem powłok na długości prawie 20 cm. Na mniejszym obszarze obserwowano redukcję grubości powłok po klasycznych cholecystektomiach, appendektomiach i innych operacjach z nacięciem powłok na całej grubości. Zanik powłok w miejscach operacji wyrażał się w liczbach bezwzględnych w zakresie 7–20 mm (średnio 14 mm). Wartości te są wyraźnie mniejsze od porównawczej grubości powłok po stronie nieoperowanej: 17–52 mm (średnio 25,4 mm). Procentowa wielkość redukcji grubości powłok wahała się w granicach 32–67% (średnio 44,2%). W większości przypadków zanik obejmował wszystkie warstwy ściany brzucha, co manifestowało się uwypukleniem powłok w tym rejonie pozorującym istnienie przepukliny. Wnioski: Ultrasonografia pozwala z dużą precyzją określić stopień zaniku, jego rozległość oraz zmiany, które mogą pozorować taki efekt. Ustalenie właściwego rozpoznania powinno zapobiec zbędnej rekonstrukcji powłok brzusznych.
    Źródło:
    Journal of Ultrasonography; 2012, 12, 50; 262-268
    2451-070X
    Pojawia się w:
    Journal of Ultrasonography
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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