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I Rozsos

Publications and source records attributed to I Rozsos.

At least 19 recordsLinked to original sources
PubMed1996

[Micro- and modern minilaparotomy in biliary tract surgery. (Remembering János Balassa)].

The author remembering "János Balassa" points out how his legacy can be used as a moulding energy for surgery in our present time. After analysing the personality and values of Balassa the results of 1357 consecutive unselected cholecyatectomies and choledocholithotomies performed in micro- and modern minilaparotomy are analyzed. The issue of mini laparotomy has not been defined yet, so that abdominal incisions from 3 to 10 cm are also called mini laparotomy. The author suggested in 1992 that the term microlaparotomy be applied to incisions less than 4 cm, modern mini laparotomy from 4 to 6 cm, and conventional mini laparotomy from 6 to 10 cm. In contrast to other mini laparotomies he uses a vertical incision in the infrasternal triangle. From the functional anatomical point of view this approach is advantageous because it is situated above Calot's Triangle and Moosman's area and results in reduced postoperative pain. Special lighting retractors have been developed for excellent exposure and illumination of the surgical field to make the operation safe. Micro and mini laparotomies can be used for both early and late reoperations on the biliary system and also for the conversion of laparoscopic cholecystectomy. At our department conventional, laparoscopic and micro laparotomy cholecystectomy are used. Considering both surgical and economic factors, the author has found that micro laparotomy cholecystectomy offers better results than conventional and laparoscopic cholecystectomy.

Biliary Tract Diseases↗
PubMed1995

[Special complications of cholecystectomy performed by micro- and modern mini-laparotomy].

There is no data on the special complications of micro (less than 4 cm incision) and modern mini laparotomy cholecystectomies (4.1-6 cm incision). Out of 710 non selected patients, 643 micro laparotomy cholecystectomies were performed and 61 modern mini laparotomies due to choledocholithiasis. On three occasions, conventional mini (6.1-10 cm) laparotomy was performed and in another three, conventional laparotomy (over 10 cm incision) was executed. Intraoperative bleeding was encountered in 15 cases (2.1%) while accidental hepatic duct clipping occurred in one case (0.1%). Damage to the bile duct did not occur in any case reported. Postoperative bleeding was reported in 8 cases (1.1%) and delayed bile leakage was reported in 10 cases (1.4%). Special complications reported as a result of pathological alteration in the bile tract as follows: Intraoperative bleeding encountered during simple cholecystectomy-1% but cholecystectomy due to obstructive cholecystitis 3.8%, also caused by intraoperative bleeding. Delayed bile leakage in simple cholecystectomy was not observed, but after cholecystectomy for obstructive cholecystitis it encountered in 3.4%. Special complications resulted in four early reoperations (0.5%). Two other patients were re-operated within three weeks, independent of special complications. The percentage of both intra and postoperative complication was significantly higher in obstructive cholecystitis with an operative delay of 11 or more days.

Adolescent↗
PubMed1995

[Cholecystectomy performed by macro- and modern mini-laparotomy].

The conventional and laparoscopic cholecystectomy is as already every day utilized method, the operation procedure is well developed and the instruments used allow a reliable operation. The cholecystectomy performed by minilaparotomy is not yet a widespread procedure, since there is no established method and the instruments needed are not readily available, as well as the fact that special complications' rates is not yet well known. In order to further elaborate on the procedure and to demonstrate it's true value, 710 micro- and modern minilaparotomies, without exclusion or selection, were analyzed and the operation procedures were then summarized. The operations were completed with microlaparotomy (smaller than 4 cm incisions) in 643 cases (90.6%) with modern minilaparotomies (4.1-6 cm) in 61 cases (8.6%), with conventional mini (6.1-10 cm), and the incisions longer than 10 cm with conventional laparotomies in 3-3 instances (0.4-0.4%). We performed a complete cholecystectomy in 97.2%, a longer cystic stumps was left in 1.7%, subtotal and partial cholecystectomies in 0.7% and 0.3% respectively. In 69 of the cases (9.7%) simultaneous choledocholithiasis was discovered and resolved. 21.2% of the operations were termed as difficult. 2/3 of the intra and postoperative complications as well as early reoperations occured in cases where they followed a delayed operation of obstructive cholecystitis. One patient was lost (0.14%) due to non-surgical complication. These experiences show that cholecystectomy performed by micro and modern minilaparotomy is a realistic alternatives to the conventional and laparoscopic cholecystectomies.

Adolescent↗
PubMed1994

[Treatment of recurrence and complications following non-surgical management of cholelithiasis].

The authors performed cholecystectomy on 9 patients either while on oral BAT, or after the termination of oral BAT. Five cases of the operation were due to hydrops, 3 cases due to obstructive cholecystitis, and one case due to contraction of the gallbladder in the absence of gallstones. Two patients underwent operation after PTCL, while one patient was operated on after ESWL. In all 12 cases serious adhesions were noticed around the gallbladder. Cholecystectomy was made complicated by the fact that in 11 cases there was cicatrized thickening of the wall of the gallbladder: one of the cases was even coupled with Mirizzi syndrome. After ESWL, the wall of the gallbladder did not thicken, however the adhesions left impressions on the hepatic duct which caused diagnostic problems. In ten cases, micro-, and in two cases mini-laparotomy was employed. The patients were discharged from hospital 24-72 hours after cholecystectomy. It is obvious that after the non operative treatment of cholelithiasis, with the preservation of the gallbladder, the reoccurrence of the gallstones is always coupled with complications which then render cholecystectomy more difficult to perform. In such cases the gallbladder is much more safely removed by employing micro- and modern mini-laparotomy.

Adult↗
PubMed1994

[Ileal intussusception, caused by fibroma, after cholecystectomy performed under microlaparotomy].

The development of minimally invasive surgery for the management of cholelithiasis has been based on the premise that abdominal exploration during cholecystectomy is unnecessary. In the current study, 575 patients undergoing micro- and modern mini-laparotomy cholecystectomy were evaluated to assess the incidence and significance of undetected intra-abdominal pathology. In one instance an intussusception occurred from an ileal fibroma. This patient required a reoperation on the 20th postoperative day, after the removal of the porcellaneous gallbladder. After the primary resection of the tumor and affected bowel area, the patient recovered completely. During 575 cholecystectomy, performed with the micro- and modern minilaparotomy method, only in one patient (0.17%) was significant pathology not detected.

Adult↗
PubMed1994

Micro- and modern minilaparotomy cholecystectomy.

The issue minilaparotomy cholecystectomy has not been clearly defined. For the purpose of discussion, microlaparotomy cholecystectomy (MLC) is less than 4 cm coeliotomic incision, modern minilaparotomy cholecystectomy (MMLC) from 4.1 to 6 cm and the conventional minilaparotomy cholecystectomy (CMLC) from 6.1 to 8 or 10 cm long abdominal incisions. The object of our paper is a presentation of our experiences during 607 MLC and MMLC developed as alternatives to laparoscopic cholecystectomy (LC) as well as conventional cholecystectomy (CC). There were 435 women and 172 men. The youngest patient was 15 years old, and the oldest 87 years old. (Death rate: 0.16, early reoperation: 0.49%, conversion rate: 0.49.) Only 156 of the 607 patients were designated as simple cases. The most complicated patients were encountered in the obstructive cholecystitis group. The 9 significant complications of the 11 encountered during 607 MLC and MMLC belonged to the delayed group. MLC and MMLC did not require sophisticated expensive technology or specialized skill, and therefore it could be available in any general hospital. The MLC and MMLC are designated as safe, less expensive alternatives to LC as well as CC.

Adolescent↗
PubMed1994

The applicability of micro- and minilaparotomy in the management of obstructive cholecystitis.

There are conflicting opinions concerning the management of acute cholecystitis, with particular reference to the optimal time for surgical intervention in the course of minimally access surgery. The present study was undertaken to elucidate the applicability of micro- and modern minilaparotomy in the management of obstructive cholecystitis and to ascertain the optimum time for surgical intervention. A total of 607 consecutive cholecystectomies were performed by micro- and modern minilaparotomy between 11 December, 1990 and 11 December, 1993 at our department: 202 (33.3%) with obstructive cholecystitis. The patients were divided into five groups on the basis of time passing from the onset of the acute symptoms to surgery. Comparing the data of the first 3 groups to the 4th and 5th groups, data demonstrate that those operations which were done up to 10 days following the onset of acute cholecystitis were technically difficult in 16% of the patients. However, the technical difficulties increased up to 56% (group 4) and 59% (group 5) by the delay of surgical intervention to more than ten days or six weeks after the onset of the acute symptoms of obstructive cholecystitis.

Acute Disease↗
PubMed1993

[Antibiotic prophylaxis in cholecystectomy performed by micro- and modern mini-laparotomy].

The authors review the results of the use of antibiotic prophylaxis (AP) during 412 cases of micro (MLC) and modern mini-laparotomy cholecystectomy (MMLC). 2 gr of Mandokef (M) or 1.5 gr of Zinacef (Z) were the employed antibiotics, administered intravenously 30 minutes before the commencement of the operations. In the case of patients above the age of 50 AP was given on routine basis. Apart from cases of obstructive cholecystitis (OC), a single shot of Mandokef or Zinacef proved effective; there was no occurrence of suppuration. Out of 94 under fifty patients--where in accordance with the accepted standpoint applied to traditional cholecystectomy AP would not have been necessary--AP was administered in 43 cases: no suppuration occurred. 51 patients did not receive AP; here 2 cases of suppuration occurred (4%). In 99 patients suffering from obstructive cholecystitis (OC), the single-shot AP was supplemented and continued with cover therapy where necessary. On the basis of the time elapsed between the presentation of the OC and the operation, the cases were classified in the following groups: 1.27 patients operated on within 10 days: no cases of suppuration or other complications II. 34 patients operated on between 10 days and 6 weeks: 2 cases (5.9%) III. 38 patients operated on after 6 weeks: 3 cases (7.9%) of suppuration or other complications were encountered. After MLC and MMLC the patients are emitted form hospital within 24-72 hours. However, 80% of the bacteria resoiling in the gallbladder can cause wound suppuration 4-10 days post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Alternatives to minimally invasive cholecystectomy].

Open endoscopic minimally invasive cholecystectomy procedures were developed as alternatives to laparoscopic as well as conventional cholecystectomy. The procedures: 1. Open endoscopic microsurgical removal of gallbladder (with or without laser) a 2-2.5 centimeters verticular median incision between the xiphoid and umbilicus. 118 operations with this technique has been performed. 2. Open endoscopic minimally invasive removal of gallbladder with 2.6-4 cms verticular median incision (63 patients) and 4.1-6 cms verticular median incision. Eighteen operations with this technique have been performed (7 choledocholithiasis, 4 accessory bile duct to the right liver lobe etc). Since 1990 we performed 200 consecutive open endoscopic minimally invasive cholecystectomy with no death and a morbidity rate of 1%. There were 161 women and 39 men (19 to 82 years). All gallbladder diseased patients are candidates for this procedures including patients with acute cholecystitis, empyema of the gallbladder, choledocholithiasis, large gallstones or previous abdominal surgery. These procedures are designed as safe, less expensive alternatives to laparoscopic or conventional cholecystectomy.

Adult↗
PubMed1991

[Data on possibilities of rehabilitation of lower limb amputees].

The authors investigated ways to improve the results of rehabilitation during the course of their clinical practice. During the last 2 years, amputation was performed on 136 patients and 50 patients were supplied with temporary protheses. 38 patients out of 50 answered the question form supplied. After analysis of the question form, the authors summarized the possibilities to improve the results of prolonged mobilisation and rehabilitation. This programme stresses the need for 1. early mobilisation-teaching to walk and 2. care of body and soul.

Amputees↗
PubMed1991

[The use of an isolated jejunum segment in gastric surgery].

The author summarizes the possibilities of the employment of isolated jejunum segment in gastric surgery. After a short historical review, the author tries to indicate the site of the surgical method in the treatment of gastroduodenal peptic ulcers, corrosive internal injuries of the stomach and gastric cancers, and surgical correction of the operated stomach. In gastric surgery today, besides the use of the "traditional" Billroth-type resections, vagotomies, and the Roux-type surgical methods, gastric resection performed with jejunum interposition has practically sank into oblivion. However, with the implementation of selective surgical principles this method can stand its place in gastrointestinal surgery. With proper judgement of its employment, the attained level of success could probably be improved.

Gastrectomy↗
PubMed1990

[The role of autotransfusion in vascular surgery].

Use of autotransfusion has recently come into the limelight of clinical practice especially because of the AIDS-risk and financial considerations. Authors have analysed data of 20 patients with peripheral arterial disease at whom hemodilution were carried out before the operation with the aim of using autotransfusion. Attention is called to the importance of autotransfusion and its applicability in the practice of other sorts of surgery.

Acquired Immunodeficiency Syndrome↗