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Biomedical subjects

J Hamzík

Publications and source records attributed to J Hamzík.

7 recordsLinked to original sources

[Bronchopleural fistula after anatomic pulmonary resection].

OBJECTIVE: The authors evaluate in a retrospective study the incidence of bronchopleural fistulae after lung resections implemented in their department in the course of 12 years, and reflect on the causes of their development. METHOD: They compare their experience with mechanical and manual suture of the large bronchi in relation to the incidence of fistulae, with experience assembled by other departments. RESULTS: While preferring mechanical suture of the bronchus, they achieved in a group of 1601 pulmonary resections a 0.87% incidence of bronchopleural fistulae whereby after mechanical suture a fistula was recorded in 0.74% and after manual suture in 2.52%. CONCLUSION: Based on the results of their observations which they compare with work of others, the authors assume that if the department has adequate experience, impaired healing of the bronchus is rare regardless whether the manual or mechanical technique of suture is used.

Adult↗

[Videothorascopic lung biopsy--diagnostic yield of one biopsy sample].

OBJECTIVE: The authors evaluate in a retrospective study the diagnostic yield of videothorascopic (VTS) biopsy of the lungs and evaluate the representativeness of one wedge-shaped bioptic specimen of the lungs collected by an endoscopic device according to HRCT, and the macroscopic finding on operation. METHOD: Based on the indication of a pneumologist in 1993-1999 210 patients were subjected to VTS pulmonary biopsy when all non-invasive diagnostic methods had been exhausted. RESULTS: The bioptic specimens gave diagnostic yields in 202 cases (96.2%), the most frequent histological finding included idiopathic pulmonary fibrosis and sarcoidosis. CONCLUSION: From the results ensues that collection of one sufficiently large and aimed bioptic specimen leads to a correct diagnosis in a high percentage of cases.

Adolescent↗

[Complications after pulmonary resection].

This retrospective study analyses the postoperative complications of the 587 lung resections performed at our department in the period of 1993--1996. Of 587 resections 435 ones were performed for bronchogenic cancer. The mean age of the patient at the time of operation was 53.3 years ranging from 9 to 79. 30 patients were 70 years old and older. In that group there were 452 men and 135 women. The most frequent resection procedure was lobectomy (61.2%) followed by pneumonectomy (19.8%), wedge resection (11%), bilobectomy (6.1%) and segmentectomy (1.9%). Bronchoplastic procedures made up 6.5% of all procedures. 5 patients died within 30 days of the surgery (mortality 0.85%). 3 of them had undergone pneumonectomy (mortality 2.6%) and 2 of them lobectomy and bilobectomy (mortality 0.5%). Postoperative complications occurred in 89 patients (15.2%). In this group the mortality was significantly higher for the patients after pneumonectomy. The morbidity was significantly higher for patients 70 years or older (23.3%). The morbidity after pneumonectomy (9.5%) was not higher than the morbidity after less extensive resections. We conclude, that low incidence of mortality and major morbidity reflects careful preoperative management, selection of appropriate surgical procedure and anesthestesia and postoperative care.

Aged↗

[Combined videothoracoscopy and transhiatal esophagectomy in carcinoma of the middle third of the esophagus].

The authors analyze the problem of resection of the oesophagus without thoracotomy by means of videothoracoscopy and transhiatal technique of oesophagectomy in patients suffering from carcinoma of the middle third of the oesophagus. The authors describe a case with epidermoid carcinoma of the oesophagus which was resected and the oesophagus was replaced by the large intestine. By combination of videothoracoscopy and transhiatal oesophagectomy it is possible to use the advantages of resection of the oesophagus without thoracotomy and at the same time control optically the release of the oesophagus and tumour from surrounding tissues, extirpate, if necessary, paraoesophageal lymph nodes and check haemorrhage by endoscopic clipping of the majority of blood vessels. An asset of videothoracoscopy is prevention of surgical complications of oesophagectomy without thoracotomy.

Carcinoma, Squamous Cell↗

[Spontaneous pneumothorax--modern views on its therapy].

Based on a retrospective study the authors describe their experience with the treatment of spontaneous pneumothorax in 159 patients during a 5-year period/1989-1992/. For the diagnosis they used, in addition to clinical and X-ray examination, in indicated cases also scintigraphy of the lungs, CT examination, thoracoscopy and bronchoscopy. During the period of investigation the basic therapeutic operation was thoracic drainage/one or several drains/, whereby in recent years there were more indications for surgery. Relapses were recorded after simple drainage in 46.5% of the patients, after surgery the authors did not record any relapses of spontaneous pneumothorax. Based on their own experience and data in the literature the authors recommend the radical approach to treatment of spontaneous pneumothorax using the least invasive videothoracoscopic technique which they have been using ever since 1993.

Adult↗

[Surgical treatment of small-cell pulmonary carcinoma].

Based on their longstanding experience of a department with surgical treatment of small-cell carcinoma of the lungs, the authors give an account of their experience. During the five-year period (1988-1992), when also patients in the third stage of the disease were operated, the authors followed up the survival after operation in relation to the presence or absence of N2. During the above period 31 patients were operated on account of small-cell carcinoma. This number comprised 9 patients in stage I and II, 14 patients in stage III, and in 8 patients on account of the advanced stage of the disease explorative thoracotomy was performed. Although the patient groups during the mentioned period were not large, the results are comparable with those of other, larger investigations. Patients operated in stages without tumourous affection of the mediastinal lymph nodes survived resection of the lungs supplemented by adjuvant chemotherapy significantly longer than patients with N2 affections and a similar therapeutic procedure. Based on the achieved results the authors do not recommend resection of the lungs in the IIIrd stage of the disease as the primary or as an adjuvant therapeutic modality.

Adult↗