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F Necas

Publications and source records attributed to F Necas.

14 recordsLinked to original sources

[Recurrent peptic ulcer--surgical complications].

Recurrent ulcer is serious complication of surgical treatment. Resection, reconstructive operations under conditions of severe adhesions, inflammatory infiltrates and abscesses are exacting and often connected with complication. In the period of 1978-1987 the authors carried out 64 reoperations for recurrent peptic ulcer, incl. 39 cases, whom they had to operate urgently. 19 patients were reoperated on account of penetration and peroperation of the ulcer, 11 because of massive haemorrhage, and 9 patients because of gastrocolic fistulae. In reoperations, subtotal resection of the stomach with vagotomy was carried out in 66%. In 4 patients reoperated repeatedly, Zollinger-Ellison's syndrome was found and resection of the pancreas was performed simultaneously. The mortality rate in the group, including patients reoperated urgently, was 21.9% (i.e. 14). The authors emphasize that the main aim of reoperation must be long-term therapeutic results without recurrences of ulcers and without serious functional disturbances.

Adult

[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

[Primary sclerosing cholangitis].

Authors report about 3 cases of primary sclerosing cholangitis type I of the total 3,043 patients operated for benign disease of biliary ducts in the course of 10 year's period (1978-1987). Diagnosis was determined not only on the base of clinical symptoms but mainly on the base of ERCP, PTC and histological examination. Two cases of obstructive icterus were treated by hepato-jejuno-anastomosis after Rouxe and one patient by high-hilar anastomosis with jejunum and diahepatal drainage left for 3 months. During the postoperative period patients were treated with hepatoprotectives and corticosteroids.

Cholangitis, Sclerosing

[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

[Multiple injuries involving the retroperitoneal space].

From 1971-1982, 598 polytraumatized patients had concomitant injuries of the retroperitoneal space. The mortality rate came up to 33.4%. Diagnostically abdominal lavage, laparoscopy, selective angiography and CT were carried out. Often life saving laparotomy had to be practised without further delay.

Abdominal Injuries

[Severe liver injuries].

This is a retrospective study of all post-mortem reports made by the Institute of Forensic Medicine at the University of Brno between 1972 and 1981, where a hepatic trauma was present (495 cases). Only 73 patients, suffering from a liver injury mostly in combination with concomitant injuries were admitted in time. All others came to death during transportation or before surgical help could be established. Diagnostically the authors emphasise urgent laparoscopy and in special cases selective arteriography, sonography and CT. Partial resection of the liver segments should be preferred to tamponade of liver wounds which is no longer recommended.

Abdominal Injuries