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Biomedical subjects

F Jagos

Publications and source records attributed to F Jagos.

11 recordsLinked to original sources

Randomized trial of different intraabdominal pressures and acid-base balance alterations during laparoscopic cholecystectomy.

BACKGROUND: Experimental and clinical studies document risks of acid-base balance alterations toward acidosis and hypercapnia during intraperitoneal carbon dioxide insufflation. The aim of this study was to assess the influence of different insufflation pressures on arterial blood gas changes and acid-base alterations during laparoscopic cholecystectomy and immediately postoperatively. METHODS: Thirty patients were randomized to receive either 10 or 15 mmHg insufflation pressure. Anesthesia was standardized for both groups. The following parameters of acid-base balance were recorded: pH, pCO2, pO2, base excess (BE), HCO3. Suitable data were analyzed by the Mann-Whitney U-test. RESULTS: Pneumoperitoneum with carbon dioxide caused a decrease in pH toward acidosis that was either respiratory or mixed in origin. There were no statistically significant differences in acid-base balance alterations between the two groups of patients. CONCLUSIONS: Carbon dioxide pneumoperitoneum causes alterations of the acid-base balance, mostly of respiratory or mixed type. Lowering of the insufflation pressure from 15 to 10 mmHg does not contribute to the elimination of acid-base balance alterations during laparoscopic cholecystectomy.

Abdominal Cavity↗

[Bar-Valtrac--a modern alternative to conventional intestinal anastomosis?].

The authors describe a modern method of intestinal anastomoses without suture after resections of the gastrointestinal tract, by means of a biofragmentable ring used in 62 patients where the continuity of the digestive tract was restored by means of BAR-Valtrac (Davis Geck Co, USA). The perspective alternative of the common manual and stapler technique BAR anastomosis is evaluated on the basis of data from the literature and the authors own clinical exoerience with regard to the main parameters of healing of the anastomosis and immediate postoperative complications, among which dehiscence of the anastomosis is, no doubt, most important.

Adult↗

[Pitfalls of biofragmentable anastomotic ring construction].

The authors describe the main problems of the technical implementation and construction of biofragmentable anastomoses by means of the Valtrac ring, used for anastomosis after resections in the area of the gastrointestinal tract in a total of 72 patients. The authors evaluate postoperative technical difficulties and the main aspects of the implementation proper which may be the cause of serious complications during the immediate postoperative period.

Anastomosis, Surgical↗

[Incidental laparoscopic orchiectomy of intra-abdominal testis].

The authors present an incidental finding of intraabdominal testicle during laparoscopic operation for another diagnosis in an adult man. The surprising finding was managed by laparoscopy without conversion to an open procedure, adhering to rules of oncologic prevention because possible testicular cancer. Had an open approach been chosen in this patient, the intraabdominal testicle would have remained undetected.

Adult↗

[The BAR-Valtrac for the colon].

The authors present their experience with biofragmentable anastomosis in the area of the colon in 42 patients where they used a biofragmentable ring Valtrac, Davis-Geck Co. to restores continuity after resection. The authors focus their attention on the peroperative technical difficulty of construction of the anastomosis proper and on complications encountered during the immediate postoperative course. The most serious among them is, no doubt, dehiscence of the anastomosis. Based on this experience, the authors express their opinion on the simplicity of the implementation proper of a BAR anastomosis and problems of postoperative complications.

Adult↗

[Laparoscopy in oncology patients].

In a group of 23 patients with suspected malignant disease in the abdominal cavity laparoscopy was indicated and 11 times positive findings were obtained--six time a primary tumourous process and five times secondaries. The authors demonstrate on case-histories the advantages of laparoscopy when other examination fail or give dubious results. In their group of patients it always helped to establish a definite diagnosis.

Abdominal Neoplasms↗

[Necrotizing pancreatitis and its complications managed by surgery].

The authors have summed up their 10-years experiences (1978-1987) with the therapy of acute necrotizing pancreatitis and of some serious surgical complications. While in 252 patients operated early for biliary pancreatitis mortality rate did not exceed 8.7% in 65 patients operated for necrotizing abscessing pancreatitis and its complication it was as many as 63%. The stress has been laid both on early operations of biliary tract diseases and the prevention of developing severe forms of pancreatitis. Even in the cases of advanced necrotizing pancreatitis, priority has been given to radical necrectomy as early as in the second week of the disease duration supplemented with lavage and profuse drainage. The maintenance of therapeutical laparostomy is suitable.

Humans↗

[Reoperation in colorectal surgery].

Because of unsatisfactory results of surgical therapy in rectal carcinoma the authors have re-evaluated their attitudes and elaborated resection methods of the rectum with retaining the system of sphincters trough atypical approaches: abdominotransvaginal in female and anterior abdominoperineal in male patients. They have also worked out the methods of coloanal anastomosis with passing through by trans-sphincter approach from posterior colpotomy or transperineally. These new access ways have been used in reconstructive operations after rectal resections performed previously according to Hartmann with terminal sigmoideostomy. Physiological passage through the rectum was restored till 3 weeks. 55 patients underwent the reoperation, 47 of them with excellent and good results (i.e. 85.5%) and the patients have returned to the normal social and working process.

Colorectal Neoplasms↗

The impact of laparoendoscopic surgery on the training of surgical residents.

Laparoscopic cholecystectomy is an accepted part of the training of surgical residents at present. Further procedures performed by residents include laparoscopic appendectomy, herniorrhaphy and others. This report analyzes the first 22 months of operative laparoscopy in Bakes Surgical Hospital and the impact on the training of residents. From September 1993 through May 1995 four residents performed 179 laparoscopic operations. Their operative experience has been shifted especially towards laparoscopic cholecystectomy but education in open cholecystectomy and open biliary tract procedures has not been jeopardized. It may be concluded that surgical residents can master essential laparoscopic operations without additional complications in a manner standard for training of other procedures.

Acute Disease↗