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Biomedical subjects

I Penka

Publications and source records attributed to I Penka.

At least 19 recordsLinked to original sources
PubMed2001

[Effect of carbon dioxide pneumoperitoneum on selected parameters of the acid-base equilibrium in laparoscopic cholecystectomy].

The authors focused attention on a hitherto less well known area of the effect of capnoperitoneum during laparoscopic cholecystectomy on homeostasis of the internal environment, i.e. values of the acid-base balance and its changes during surgery and the early postoperative period. From a randomized perspective study ensued that intraabdominal pressure and the reduction of the intraabdominal CO2 pressure from 15 mmHg to 10 mmHg did not have a significant effect on parameters of the acid-base balance in the investigated group of patients as compared with a control group. From the results it is apparent that possible danger of acidosis as a result of CO2 absorption from the abdominal cavity, deterioration of the splanchnic blood supply or a negative impact of the intraabdominal overpressure on the cardiovascular apparatus is sufficiently compensated by the respiratory system during artificial pulmonary ventilation. There is however a certain danger of acidosis during the immediate postoperative period after extubation when the patients are not yet able to compensate possible fluctuations of the acid-base balance and are according to the authors' measurements in a state of mixed or respiratory acidosis. But even in this respect no statistically significant difference was observed between the two groups. These assessments were made in relatively healthy patients, i.e. group I and II according to the ASA classification, therefore these results will apply even mor in groups of risk patients of higher ASA categories. In particular in these patients it is useful to adjust the insufflation pressure individually to lower values in order to reduce to a minimum possible negative impacts of the capnoperitoneum.

Acid-Base Imbalance↗
PubMed2000

[Compression anastomosis in acute resection of the colon].

The authors draw attention to the possible use of a biofragmentable anastomotic ring (BAR) for anastomosis of the gut, used by the authors for construction of an anastomosis after acute resection of the colon under particularly risky conditions with infection and advanced deterioration of the intestinal wall. In both instances when this alternative method was used the postoperative course was uneventful and the patients were discharged without complications into domiciliary treatment.

Adult↗
PubMed2000

[Carcinoma of the colon invading the duodenum and pancreas].

In the submitted case-history the authors present the case of a 60-year-old woman with an extensive tumour of the transverse colon penetrating into the duodenum and head of the pancreas with an intimate relation to the upper mesenteric vein. An extensive curative en bloc resection included right-sided hemicolectomy, hemi-pancreatoduodenectomy and partial parietal resection of the upper mesenteric vein. The pathologist identified in the resected tissue a medium differentiated adenocarcinoma of the large intestine damaging the head of the pancreas and infiltrating the duodenal wall. The lymph nodes were negative and no metastatic affections were revealed. The postoperative course was without serious complications. The few cases of this type reported in the literature illustrate the possibility of successful resection and thus a substantially improved prognosis of the affected patient.

Adenocarcinoma↗
PubMed2000

[Late postoperative colonic stenosis caused by the biofragmentable anastomosis ring (BAR)].

The authors focused their attention on the prevalence of late postoperative stenoses of anastomoses following resection of the colon. In 42 patients the anastomosis was implemented by means of a Valtrac ring--i.e. by compressive biofragmentable seamless technique. Within an interval of 6 months after surgery the majority of these patients were subjected to colonoscopic examination with direct visualization of the intestinal anastomosis. The authors did not record any late postoperative stenoses of the BAR anastomosis of the colon. Moreover on colonoscopic examination in the majority of patients the original intestinal anastomosis was only difficult to detect.

Adult↗
PubMed2000

[Adenocarcinoma of the appendix--case report].

The authors describe a case with a rare diagnosis of adenocarcinoma of the appendix in an adult female patient. The patient was indicated for surgical revision on account of acute appendicitis with a peroperative finding suspect of malignity of the vermiform appendix. A radical resection of the ileocoecal area was performed along with part of the ascendant colon and appropriate mesocolon as a primary operation. According to the postoperative histological evaluation of the resected portion the diagnosis of adenocarcinoma of the appendix was confirmed.

Adenocarcinoma↗
PubMed1999

[Continuous loop stitch in single-layer laparotomy suturing].

The authors evaluate their favourable experience with the use of a new absorbable loop suture for one-layer closure laparotomy. The percentage of dehiscences of surgical wounds was lower in the group of patients where Safil Loop suture was used than in the control group. The speed of completing the suture was also greater and the safety of closure of laparotomy was more favourable.

Absorption↗
PubMed1999

[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↗
PubMed1999

[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↗
PubMed1999

[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↗
PubMed1999

[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↗
PubMed1999

[Endoscopic visualization of BAR (biofragmentable anastomotic ring)].

The authors present information on the use of a modern sutureless anastomotic connection by means of a biofragmentable ring--BAR (Biofragmentable Anastomotic Ring) which was used in patients to restore the continuity of the GIT after resections in the upper portions of the digestive tract. The authors present their initial clinical experience and emphasize the importance of visualization of biofragmentable anastomoses by gastroscopic examination in case of postoperative complications with the possibility of therapeutic provisions, if necessary.

Adult↗
PubMed1998

[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↗
PubMed1997

[Repeat laparoscopy in the management of biliary leaks after laparoscopic cholecystectomy].

The incidence of bile leaks increased with the introduction of laparoscopic cholecystectomy in surgery. The present paper is focused on biliary leaks-their diagnosis and treatment in a large group of patients, with special emphasis on a miniinvasive approach. Nine biliary leaks were found (i.e. 0.72%). Four leaks resolved spontaneously, five were treated surgically with good results.

Bile↗
PubMed1991

[Emergency endoscopy in the diagnosis and treatment of hemorrhage in the upper part of the gastrointestinal system].

The authors describe, based on an analysis of 2970 patients subjected to endoscopy, the advantages of urgent endoscopy performed within six hours after admission to the surgical department. They refute former statements that urgent endoscopy is endoscopy performed within 24 or 48 hours. They discuss the different approach of endoscopists to different types of haemorrhage and to the time factor and emphasize the prognostic considerations of the endoscopist.

Emergencies↗
PubMed1990

[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↗
PubMedDate not supplied

The role of relaparoscopy in the management of bile leaks after laparoscopic cholecystectomy.

The incidence of bile leaks has increased with the advent of laparoscopic cholecystectomy. The present paper is focused on bile leaks--their diagnosis and management approaches with special consideration to relaparoscopy. From February 1992 to May 1995 a total of 1223 laparoscopic cholecystectomies were performed in two hospitals. Eight biliary leaks were found in the series under study (i.e. 0.65%). The diagnosis was confirmed by means of ultrasound, CT scans and ERCP. Three leaks resolved spontaneously on external drains placed during the operation. Two and three patients underwent laparotomy and relaparoscopy, respectively. The etiology of the leakage included three cases of ducts of Luschka, one cystic duct leak, and one retained CBD stone. the source of the remaining leaks was not determined. In all cases the management approaches comprised relaparoscopy and laparotomy. It may be concluded that an early diagnosis and management of bile leaks after laparoscopic cholecystectomies would prevent further complications.

Bile↗