PubMed Health⌕ Search

Biomedical subjects

B Porowska

Publications and source records attributed to B Porowska.

29 records · Page 2Linked to original sources
PubMed1984

Portal stump pressure monitorization in the conscious rat after porta-caval shunt and total liver arterialization with the left gastric artery.

A method for portal stump pressure monitorization following arterialization is presented. Both intra and postoperative pressure determinations were performed and a significant difference between intra and postoperative values was observed. The pressure of the arterialized portal stump either using the left gastric artery or one of its branches, when compared to the free portal pressure did not reveal significant differences. According to these data, the proposed method of arterialization seems to create a "physiologic" arterialized stump pressure. This information while contributing to a better understanding of the complex hemodynamics of the arterialized liver represents essential guidelines for further studies on liver trophism and experimental portal hypertension.

Animals↗
PubMed1984

Occult gallbladder microlithiasis causing acute recurrent pancreatitis. A report of three cases.

Gallbladder microlithiasis may be a cause of acute recurrent pancreatitis. When this process cannot be detected with routine investigative procedures, a precise etiologic diagnosis cannot be formulated. In such circumstances, endoscopic collection of bile followed by microscopic examination for presence of cholesterol crystals constitutes a valid diagnostic tool. Three cases of acute recurrent pancreatitis are presented in which cholesterol crystals were found in the bile. The technique and advantages of the method are described and a useful diagnostic approach is proposed.

Acute Disease↗
PubMed1984

Role of cholesterol and calcium bilirubinate crystals in acute postoperative acalculous cholecystitis.

Acute acalculous cholecystitis is rather unusual, but it is considered an increasing entity. Particularly interesting are the post-traumatic or post-operative forms of acute acalculous cholecystitis. Ischemia of the gallbladder and biliary stasis are the most likely pathogenetic factors. A case of acute acalculous cholecystitis after total gastrectomy for cancer is presented. Particular emphasis is put on the significance of cholesterol and calcium bilirubinate crystals findings in the bile of the gallbladder. The pathogenetic role of this microscopic form of lithiasis in post-operative acalculous cholecystitis is discussed. It is concluded that all surgeons should be aware of this pathology since it is becoming much more common to be faced with elderly patients having life-threatening post-operative gallbladder complications unrelated to macroscopic lithiasis.

Acute Disease↗
PubMedDate not supplied

Surgical management of substernal goitres. When is sternotomy inevitable?

PURPOSE: Aim of this retrospective study is to report personal experience in the surgical management of substernal goitres emphasizing the guidelines for preoperative planning of sternotomy in selected cases. PATIENTS AND METHODS: Medical records of all patients (n=355) submitted to thyroidectomy for struma in our Operative Unit, between 1993-2003, were analysed. A substernal goitre was defined as a goitre having a significant retrosternal extension (>50%) requiring mediastinal dissection. RESULTS: A total of 18 out of 355 patients undergoing thyroidectomy for struma in our Operative Unit had substernal goitres. The most common symptoms, at presentation, were the presence of neck mass and respiratory disorders. Standard cervical incision was adequate to achieve total thyroidectomy in 17 cases while, in one patient with computed tomography images showing the presence of a huge goitre extending below the aortic arch, a sternotomic approach was inevitable to ensure safe removal. No major morbidity or perioperative deaths occurred. One patient with scleroderma experienced bilateral paralysis of laryngeal nerves for two months, with full recovery thereafter. CONCLUSIONS: While removal of the majority of substernal goitres can be achieved by means of cervical incision, this approach is not always safe. In a selected number of cases with an iceberg shaped substernal goiter and with >70% of the volume lying below the thoracic outlet, a sternotomic approach is inevitable. Preoperative diagnostic work-up should, thus, include chest X-ray and computed tomography. Overall results in the present patient population, have been excellent since morbidity has been minimal and mortality absent, and all patients are symptom free.

Adult↗
PubMedDate not supplied

[Nerve sparing total mesorectal excision for rectal cancer. Technical notes and results].

OBJECTIVE: To evaluate the quality of life after nerve sparing total mesorectal excision for rectal cancer. PATIENTS AND METHODS: Crucial technical aspects of the procedure such as the preservation of genitourinary innervation and the achievement of optimal local control of the disease have been emphasized. It is known that local recurrences, sexual and urinary dysfunctions may have a significant impact on postoperative quality of life of the patients. Postoperative evaluation of functional outcomes of nerve sparing total mesorectal excision has been carried out utilizing the QLQ C30 (version 3) (All CR38). RESULTS: At one year follow-up 27.2% of the patients presented sexual activity related dysfunctions, 6.1% complained of urinary dysfunction and 21% of the patients complained of some significant psychologic disturbances. CONCLUSIONS: A correct surgical dissection with preservation of inferior hypogastric plexus and all genitourinary nerve supply yield the best results either in terms of quality of life and of oncologic control of the disease.

Adult↗
PubMedDate not supplied

[Occlusion caused by colo-rectal carcinoma: personal experience].

In the last 12 years 25 patients affected with obstruction from colorectal carcinoma were treated. Mortality following simple colostomy was not different from that of surgical resections (25% vs. 14% in Authors' experience). Major surgery (subtotal colectomy) registered a reasonable mortality rate (5-6%).

Aged↗
PubMedDate not supplied

Severe hemorrhagic complications in pancreatitis.

Severe bleeding may complicate the course of either acute or chronic pancreatitis, the latter being more frequently involved. Pseudocysts, severe inflammation, regional necrosis and infection may cause major vessel erosion with or without pseudoaneurysm formation which eventually may result in severe bleeding into the gastrointestinal tract, retroperitoneum and peritoneal cavity. The AA report their experience on 8 cases and analyze the data of a comprehensive review of 389 cases of massive bleeding reported in the literature during the last 100 years until December 1993. Mortality rate seems to be related to the etiology of the bleeding along with its localization and the underlying anatomo-pathologic findings. In patients with chronic pancreatitis it is 22% while in patients with acute pancreatitis or chronic pancreatitis with acute exacerbation it is 60.4% and 57.1% respectively. Splenic, gastroduodenal and superior pancreaticoduodenal arteries are the most commonly involved vessels being associated respectively with a mortality rate of 20.5%, 27.9% and 46.1%. Massive haemorrhage complicating infected necrosis or abscesses implies a worse prognosis when compared to severe bleeding associated with pseudocyst with or without pseudoaneurysm. The increasing use of diagnostic and interventional radiology appears to be the way forward to improve survival rates. Awareness of high risk predisposing condition, activism in achieving an early identification of the bleeding sources, and eventually its angiographic control are essential guidelines for successful approach to the most unpredictable complication of pancreatitis. When embolization fails or is followed by recurrence of hemorrhage, definitive surgical procedures should be immediately instituted.

Abscess↗
PubMedDate not supplied

Is intraoperative ultrasonography useful in pancreatic cancer surgery?

Preoperative staging of pancreatic cancer represents a major challenge for a suitable surgical management of the disease. In a consistent number of patients laparotomy is still necessary in order to decide whether the tumor is resectable or not. In the present paper the Authors report their experience with intraoperative ultrasonography (IOU) in evaluating pancreatic cancer resectability. Very important data for intraoperative decision making were obtained in 37.9% of the patients, useful information in 31%, while in 31% IOU may be looked forward to as an important aid in decision making and for a safely guided dissection.

Aged↗