Biomedical subjects

J Szívós

Publications and source records attributed to J Szívós.

3 recordsLinked to original sources

PubMed1999

Laparoscopic gastric surgery. Early experiences.

In the Department of General Surgery the authors performed 12 elective laparoscopic gastric operations for gastric pathologies. The indications for the procedures were recurrent or therapy resistant and complicated peptic ulcer in 9 cases, benign gastric tumors in 2 cases and early gastric cancer in 1 case. Operative procedures were the next: posterior truncal vagotomy with anterior lesser curve seromyotomy (5 patients), total truncal vagotomy with gastrojejunostomy (2 patients), total truncal vagotomy with pyloroplasty (1 patient), total truncal vagotomy with antrectomy and Billroth-II reconstruction (1 patient), resection of benign gastric tumor by the transgastric approach (1 patient), Billroth-II resection for benign gastric tumor (1 patient), wedge resection of gastric wall for early gastric cancer (1 patient). Intraoperative gastroscopy was used for location of the lesion in 4 of 12 cases. Apart from delayed gastric emptying (2 cases), patients recovered without any problem. The mean hospital stay was 5.7 days. Early experiences with laparoscopic gastric surgery has shown that there are certain important advantages to the approaches. They hold the promise of less pain, less immobility, quicker alimentation, shorter hospitalization, less wound and respiratory complications and an earlier return to normal activities.

Anastomosis, Surgical↗

PubMed1999

[Laparoscopic truncal vagotomy, antrectomy with Billroth-II reconstruction for complicated duodenal ulcer (Case report and literature review)].

Today surgeons are performing fewer elective ulcer surgeries, as H2 receptor blockers and the eradication of Helicobacter pylori represent a major step in treatment of this disease. Nevertheless, patients with complications and those resistant to medical therapy should be offered surgical options. The laparoscopic management of these complications is an alternative to open surgery, if applied with appropriate patient selection. The authors report a case with repeated bleeding and duodenal narrowing due to a duodenal ulcer. The patient was treated by totally intraabdominal laparoscopic truncal vagotomy, antrectomy and Billroth-II reconstruction--this probably being the first performed and publicized operation in Hungarian literature. The technique this operation and common perioperative problems based on existing literature are reviewed. The benefits of the minimally invasive approach were clearly evident. The authors believe that minimally invasive approaches will renew the interest in definitive surgery for the treatment of ulcer disease.

Adult↗

PubMed1998

Laparoscopic cholecystectomy. Risk of missed pathology of other organs.

BACKGROUND: The wide acceptance of laparoscopic cholecystectomy (LC) has resulted in increased rates of cholecystectomy. However, the increased rate of LC bears the possibility of concomitantly missing other intra-abdominal pathologic states that exist concurrently with this procedure. The purpose of this report was to evaluate data on LC with regard to missed pathologies of other organs in a clinical prospective follow-up. METHODS: The clinical prospective follow-up of 676 patients treated laparoscopically for gallstone disease at our unit since January 1993, was studied. Converted procedures were excluded from the follow-up study. RESULTS: Among 676 patients who underwent LC, 4 patients (0.6%) required readmission for missed pathology of another organ. The diagnostic delay ranged from 2 weeks to 7 months. The readmissions were due to colonic cancer (2 cases), carcinoma of the stomach (1 case), and fibrosis of the mesenterium of small bowel causing ileus (1 case), which are demonstrated in detail. According to retrospective analysis of the symptoms, none of the patients had typical biliary pain at the time of laparoscopic procedure. CONCLUSIONS: The demand for LC from patients and practitioners is becoming increasingly more frequent, as all become aware of its benefits. However, on the basis of data from the literature and this study, the authors would like to emphasize the need for careful history-taking, thorough investigation, and comparison with gallstone symptoms before LC is performed. It is emphasized, however, that surgeons using laparoscopic approaches should learn techniques of full diagnostic laparoscopy, which should be performed at the beginning of every procedure.

Adult↗