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Biomedical subjects

A Lewandowski

Publications and source records attributed to A Lewandowski.

At least 19 recordsLinked to original sources
PubMed1999

[Comparative evaluation of postoperative complication in the reconstructive surgery of the esophagus].

The paper presents 78 patients with stenosis of the middle thoracic segment of the esophagus. The substitute, being pedunculated intestinal graft, was brought to the neck through the retrosternal space. Early post-operative complications occurred in 8.9% of patients. Post-operative mortality rate was 7.6%. The most dangerous complication after esophageal plastic surgery is blood supply insufficiency. It was observed in 2 cases. Other complications included anastomotic leaks and respiratory distress syndrome. The authors emphasize that frequency of post-operative complications and mortality are related with the patient general condition and extent of the surgery.

Adolescent↗
PubMed1999

[Postop complication of pancreatic resection].

Early complications after partial pancreatic resections and benign pancreatic tumours were analysed. 276 patients with pancreatic tumours were treated in the years 1979-1997. In 77 cases radical operation was performed. 65 patients underwent Whipple and 12--Traverso-Longmire pancreatoduodenectomy. Malignant tumour was found in 55 cases and 22 were benign. In 4 patients tumour's resection along with invaded portal vessels and portal confluence reconstruction was performed. These were the first cases with vessels resection operated in Poland. There were 2 post-operative deaths observed in that group. Complications in our material were as follows: pancreatico-jejunal anastomosis fistulae, haemorrhage from ulcers in gastro-jejunal anastomosis, diffuse peritonitis, haemorrhage from pancreatic stump vessels, ileus, acute renal insufficiency, pneumonia and myocardial infarct. Mortality in whole group was 11%. In the last 5 years due to our growing experience and some technical modifications mortality fell to 4.4%.

Female↗
PubMed1997

[Intraoperative portography in operations for resection of pancreas neoplasms].

Since 1993 during pancreatic resection routine intraoperative portography has been employed. Thus we are able to establish infiltration engaging portal vein and its branches. Facilitating decision making about resectability of the tumor. 29 portographies were performed. In eight cases malignant infiltration on portal vein was established. Because of that in seven cases no radical resection was undertaken.

Aged↗
PubMed1997

[Iatrogenic injuries of the cardia antireflux system].

Among presented 18 patients with iatrogenic injury of the cardia antireflux system, 5 were females and 13 males aged 35-62 years of life. 13 cases were operated before for cardiospasmus, 5 had gastric resection B2 for duodenal ulcer. In consequence all the patients presented stricture of the thoracic lower and abdomen part of oesophagus. 16 patients required reoperations, 2 had dilatation. In 2 cases stricture were located in middle and lower part of oesophagus. In 4 cases in abdominal and supradiaphragmatic part of oesophagus, in 5 cases in abdominal part of oesophagus, and in 7 cases in the cardia. 11 patients required one corrective surgery, 4-two operations, and 1-three operations. As a final procedure: in 2 cases artificial oesophagus was formed with intestinal graft, in 8 cases the cicatrical part of the oesophagus was excised and replaced by a pedunculated graft by Merendino method, in 3 cases esophagogastric anastomosis were done using Heyrowsky method, in 2 cases bypass was made from pedunculated part of jejunum which connect the part of oesophagus above the narrowing with the prepyloric part of the stomach by the own method, in 1 case intrathoracic esophagogastric anastomosis was performed. The best results were obtained by oesophagogastric bypass.

Adult↗
PubMed1997

[Pleural hernia of an esophageal graft--late postoperative complication].

Pleural hernia of the oesophageal substitute from pedicled intestinal segment is one of the late postoperative complications. 13 cases of patients with oesophagus reconstructed because of lye ingestion stenosis are presented. Problems concerning diagnosis and treatment of pleural hernia are analysed. Eight patients with minor symptoms were treated conservatively. Five patients were operated, two of them from acute necrosis of the substitute. Necrosis was caused by incarceration of the bowel and torsion of the mesentery. Elective operative treatment consisted of reduction of hernia sac contents, closing of the hernia orifice, chest drainage and temporary gastronomy. In patient operated as an emergency cases necrotic part of substitute was removed. This resulted in oesophageal exclusion in the neck, creating gastronomy. Chest drainage was also performed.

Anastomosis, Surgical↗
PubMed1995

[Difficulties in diagnosis of esophageal achalasia].

The authors present the case of 36 years old patient with dysphagia. This symptom appeared three years ago and became more severe for six month. The endoscopic and radiologic examinations revealed achalasia of the cardia. The surgical treatment was performed. Two weeks after surgery all symptoms disappeared. We present this case because achalasia of the cardia is comparatively rare disease which diagnostic is not easy.

Adult↗
PubMed1994

[The pseudo-pacemaker syndrome].

We describe three cases of the pseudo-pacemaker syndrome. One of them due to selective fast pathway fulguration of atrioventricular nodal reentrant tachycardia and two others have occurred in spontaneous form. All cases were related with the presence of first-degree atrioventricular block and sinus node tachycardia. The treatment was done with complete atrioventricular block induction catheter ablation and permanent pacemaker implantation in two patients. In conclusion, the procedure of radiofrequency ablation to control AV nodal reentry tachycardia must preserve the fast nodal pathway in order to avoid the pseudo-pacemaker syndrome and this syndrome can spontaneously occur and must be considered during investigation of etiology of syncope.

Adult↗
PubMed1994

[Radiofrequency catheter ablation of type I atrial flutter].

PURPOSE: To verify the efficacy and safety of the creation of a barrier with radiofrequency (RF) in the tricuspid annulus and the vena cava ostium (TA-IVC). METHODS: Nine consecutive patients, 7 males, with age ranging from 36 to 76 years, with paroxysmal (7 patients) or permanent (2) type I atrial flutter (negative P wave in lead II, III and F) were submitted to RF ablation of TA-IVC istmo. One deflectable catheter with 4mm size tip was introduced into the right ventricle apex and pulled back to the inferior vena cava. When the atrial electrogram was detected the RF application was started. The RF was applied (20 watts during 60s) up to the proximity of inferior vena cava ostium. The end point was to stop atrial flutter. Then a vigorous atrial stimulation protocol, including isoproterenol infusion was used. In the next day, patients were submitted to transesophageal stimulation with the same protocol. RESULTS: Atrial flutter was interrupted in all patients (100%) with 4 to 28 (mean 16.7 +/- 7.7) applications. Eight patients (88.8%) with one session and 1 (11.1%) with two sessions. The mean time spent to stop the atrial flutter with one application was 30.5 +/- 18.5s. There were no complications. After a mean follow up of 3 +/- 1.6 month all patients (100%) are asymptomatic. Two of them are taking propranolol to control symptomatic atrial and ventricular ectopic beats. CONCLUSION: RF ablation of the TA-IVC istmo is efficient and safe in a short term follow up to interrupt and prevent re-induction and recurrence of type I atrial flutter.

Adult↗
PubMed1986

Kidney function of pyelonephritis patients with impaired renal function treated with mezlocillin.

Ten patients with pyelonephritis and impaired renal function were treated with 2.0 g mezlocillin (Baypen) 8-hourly. They all recovered from urinary tract infection and showed a distinct improvement of their kidney function measured by blood urea nitrogen, serum creatinine and creatinine clearance. No side effects were seen and the blood coagulation remained within normal limits. An overview of the literature on urinary tract infections treated in patients with impaired kidney function is given.

Adult↗