Biomedical subjects

J Olejník

Publications and source records attributed to J Olejník.

17 recordsLinked to original sources

PubMed2002

[Surgical risk in treatment of a bleeding gastroduodenal ulcer in the era of invasive endoscopy].

OBJECTIVE: Objectivization of the asset of the present therapeutic algorithm in patients with haemorrhage from peptic gastroduodenal ulcers using invasive endoscopic and surgical haemostasis. METHOD: Comparison of quantitatively and qualitatively equivalent groups of 341/318 patients, the first group without application of invasive endoscopy, the second one with its application. RESULTS: Surgical haemostasis was called for in 12.3/11.6% cases. 92.9/59.5% operations were resections and bionomic operations, the mortality of the patients was 14.3/21.6%, re-operation was necessary in 7.1/13.5% cases. At the time of operation 57.1/78.3% patients were a high risk, the length of the "critical" interval of haemorrhage in the second group increased by 48.3%. CONCLUSIONS: The present accepted procedure of haemostasis is associated with risks of limited selection of the optimal method of invasive endoscopy, the protraction of the interval of haemorrhage with an adverse rise of the index of the patient's risk, inadequate stabilization of the patient during the interval of haemorrhage and controversial indication of surgery in case of intractable haemorrhage.

Adult↗

PubMed2001

[Diverticulosis of the small intestine and massive digestive tract hemorrhage].

The authors present the case-record of a female patient with serious haemorrhage from the digestive tract. A surprising finding of the acute surgical diagnosis and treatment in the stage of compensated hypovolaemic shock were multiple diverticula of the small intestine aborally from the lig. Tretz on the mesenterial side of the intestine. Massive haemorrhage originated in the diverticula of the terminal ileum, haemostasis was achieved by hemicolectomy with resection of the bleeding part of the ileum. The selected surgical treatment is successful on a long-term basis.

Aged↗

PubMed2001

[Acute cholecystitis during the time of minimally invasive abdominal surgery] ].

OBJECTIVE: To define optimal rules for the treatment of acute cholecystitis taking into account possible laparoscopic surgery. METHOD: Critical analysis of the authors' group of 90 patients with acute cholecystitis. RESULTS: Optimal results were achieved with surgical treatment within 72 hours after the first clinical symptoms of the disease without the need of conversion of the laparoscopic operation in the authors' group. Surgery between the third and tenth day of hospitalization is unfavourable with a conversion rate of 18%. CONCLUSION: Acute cholecystitis with complications calls for urgent classical surgery, acute cholecystitis without complications laparoscopic operation within 72 hours after the first clinical symptoms. In critically ill patients alternative cholecystostomy or puncture of the gallbladder may be used.

Acute Disease↗

PubMed2000

[Extensive defect in the inguinal region and damaged femoral arteries. Single stage reconstruction of the arterial supply and skin coverage. Case Report].

The authors present an account on a patient with extensive damage of the tissue in the area of the right groin with complete severing of the artery and vein. After control of the infections they reconstructed the arterial supply and skin cover in one stage. They used a PTFE prosthesis with an extraanatomical localization and a muculocutaneous flap formed from the musculus rectus abdominis on a caudal stalk.

Adult↗

PubMed1999

[Quo vadis the azygo-portal disconnection].

Based on experience at their department since 1983 the authors analyze the position of the azygoportal disconnection in the treatment of complications of portal hypertension. During the observation period the number of operations declined due to extensive use of endoscopic diagnosis and treatment. However the azygoportal disconnection still remains part of surgical intervention in indicated cases, in particular in secondary hypersplenism and profuse haemorrhage.

Adult↗

PubMed1999

[Laparostomy in the treatment of severe intra-abdominal infections].

The objective of the work was to evaluate the results of comprehensive treatment of protracted primary and secondary intraabdominal infection. Retrospective analysis of a group of patients in 1994-1998 using laparostomy, peritoneal lavage, thorough repeated cleansing of the peritoneal cavity, microbiological monitoring with subsequent aimed antibiosis and comprehensive intensive care provide evidence of the rescue of almost 40% liminally curable patients. The results justify the use of comprehensive therapeutic procedures in late stages of serious peritonitis.

Abdomen↗

PubMed1999

[Causes of rupture in laparotomy incisions].

The objective of the presented work was a quantitative analysis of causes of ruptures of laparotomic wounds with emphasis on risk factors, and thus a contribution to the prevention of the mentioned complication. Complete rupture of laparotomic wounds such as eventration are encountered most frequently in interaction of high intraabdominal pressure and weakness of the suture. Continuous loop stitch is the optimal closure of laparotomy. The authors evaluated in a retrospective study a group of 21 patients with eventration and found a coincidence of causes increasing the risk of rupture of the laparotomic wound. From the quantitative aspect serious causal factors include the length and urgency of primary surgery, infection of the wound, a combination of pathogenetic factors such as malignancy, diabetes, anaemia, obesity and hypoproteinaemia. The interaction of different causes increases the risk of wound rupture in all four stages of healing of the surgical wound.

Adult↗

PubMed1999

[Methods of hemostasis in upper digestive tract hemorrhage].

The authors describe methods of haemostasis used nowadays in haemorrhage from the upper digestive tract. Based on evaluation of their own group of 91 patients with haemorrhage of this type they found that 13.2% of the patients with haemorrhage required surgery, when the haemorrhage was localized, 16.4%. Comprehensive treatment and endoscopic methods of haemostasis predominate while surgical treatment is used when non-surgical methods fail. The results are in favour of revision of the surgeon's position in the treatment of patients with haemorrhage from the GI tract.

Adult↗

PubMed1998

[All-in-one parenteral nutrition and enteral nutrition--experience and risks in surgical clinical practice].

The author presents an account on total parenteral nutrition "all-in-one" used in his department in a group of 479 patients, and enteral nutrition in a group of 98 patients in 1995-1997. When the two methods were used, the patients' nutritional status was maintained or improved, while the risk of remediable complications is small. The optimal strategy of postoperative nutritional support is a combination of the two methods. Enteral nutrition makes physiological rereplations during administration possible and reduces the risk of septic complications.

Adolescent↗

PubMed1990

[Technics in the treatment of gastroesophageal varices].

In a prospective study based on contemporary knowledge of the problem of gastrooesophageal varices the authors submit the algorithm of the therapeutic procedure. Sclerotization treatment holds a dominant position, as it can be used in all stages of the disease and in all three groups of patients classified according to Child. In case of gastric varicosities which cannot be treated by sclerotization the method of choice in patients of groups Child A, B are ablative operations and selective portosystemic anastomoses, in concurrent hypersplein: azygo-portal separation.

Adolescent↗

PubMed1990

[Changes and risks in gastroduodenal surgery].

By retrospective analysis of clinical material changes and risks of gastroduodenal surgery were evaluated. The number of elective operations declined and the number of urgent surgical operations on account of peptic ulceration in conjunction with the development of medicamentous antiulcerous treatment increased. The number of patients with gastric cancer is rising. The range of surgical operations is preserved, none of the operations is ideal treatment. The risk of reoperation involves long-term morbidity and a high mortality.

Adult↗

PubMed1988

Endoscopic sclerotherapy of oesophageal varices.

The authors present their experience with the outcome of gastrofibroscopic sclerotherapy of oesophageal varices, performed in a total of 70 patients with portal hypertension. All patients were classified in classes B and C according to Child's criteria, and 68 of them had variceal bleeding before receiving sclerotherapy. Acute bleeding was successfully arrested in seven cases, and elective sclerotherapy in between bleeding episodes was carried out in 60 cases. To date, complete obliteration has been noted in 34 patients. An effect of previous sclerotherapy was observed during the next therapeutic session in 18, and eight patients died from progressive hepatic insufficiency. In the discussion section, the authors analyse current concepts on the technique of sclerotherapy related to complications, on instrumentarium and sclerosing solutions, and on the significance of prophylactic, acute and elective sclerotherapy, with the importance of endoscopic sclerotherapy of oesophageal varices perceived mainly in comparison with the results of surgery from the point of view of long-term patient survival.

Adolescent↗

PubMed1987