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Biomedical subjects

J Vrastyák

Publications and source records attributed to J Vrastyák.

14 recordsLinked to original sources
PubMed2001

[Carcinoma of the lower half of the rectum].

Authors analyze the group of patients surgically treated for rectal carcinoma during ten-years long period. While the surgical tactic in upper part of the rectum is solved by the resection with straight anastomosis, in carcinomas of lower part of the rectum there is an open question there, to use the deep pelvic anastomosis after radical resection or to perform the rectal extirpation with saving of sphincters and using the coloanal anastomosis. The necessary requirement is complex preoperative examination of the tumor and of pelvic fundus physiology. For application of coloanal anastomosis the rigid indications are determined. Authors used this method in 107 patients of the monitored group. Early and delayed complications of these interventions are analysed, indication for temporary stomy and application of pouchs. In the group of patients with coloanal anastomosis no local recurrence was noted, in the group with deep pelvic anastomosis the locoregional anastomosis was found in 8% of patients.

Anastomosis, Surgical↗
PubMed2000

[Injuries of the small intestine in polytrauma].

The authors inform on the increasing number of penetrating abdominal injuries during the last five years, especially in the criminal injuries. Diagnostic methods in a stabilised patient are analysed, diagnostic and therapeutic laparoscopy is preferred to lavage of the abdominal cavity in indicated cases. Urgent surgical revision is recommended in patients in a critical state on account of quickly increasing compartment syndrome, although staged laparotomy is needed. The timing of surgical methods is emphasised in serious associated injuries. Conclusions are illustrated with surgical results.

Adolescent↗
PubMed2000

[Does a pelvic compartment exist? Personal experience].

The authors analyze a group of 7 patients transferred to their hospital for instable fractures of the pelvic circle and lumbar spine. The pelvic compartment was manifested 24-48 hours after injury. Early diagnostics are based on the use of new imaging techniques, spiral CT examination is preferred, and angiography in stabilized patients. Early surgical intervention is aimed at evacuation of haematomas, revision of vessels, release of the ureters and temporary nephrostomy.

Compartment Syndromes↗
PubMed1999

[Central rupture of the liver in multiple injuries].

Authors evaluate clinical material of polytraumatized patients operated on account of liver injury during the last 15 years. The contribution of new imaging techniques is analyzed, especially of spiral computed tomography, for the diagnosis of liver injuries and associated injuries of the abdomen and retroperitoneum. These techniques enable in stabilized patients with the trauma I, II injuries and in some cases of grade III injuries to prefer conservative treatment. During the last 3 years the authors treated 5 polytraumatized patients with central liver rupture. Consistent with experience of major trauma centres in USA and Switzerland, criteria for conservative treatment are outlined, especially in patients of younger age groups.

Humans↗
PubMed1999

[Changes in acid-base equilibrium, ventilation parameters and immunologic reactions in thoracoscopic operations].

In the thoracoscopic operations it is usually necessary to deflate completely the ipsilateral lung. The aim of this study was to determine changes of blood gases and alterations of immune response mediators during thoracoscopic surgery with one-lung ventilation OLV. In the study 38 patients were included undergoing thoracoscopic or video-assisted thoracic surgery. Arterial blood gases, respiratory parameters, heart rate, blood pressure were determined before one-lung ventilation, at the peak of operation and after finishing OLV. The circulatory cytokines IL-1 beta, IL-2, IL-6, IL-8, TNF-alpha, and reactive oxygen species (ROS) were measured before and after operation, 3 h, 24 h and 48 h after operation. The obtained variables were statistically evaluated. One-lung ventilation caused a significant increase of PaCO2 (from 4.69 +/- 0.67 to 5.91 +/- 0.87 kPa) which was accompanied by an adequate decrease of pH (7.455 +/- 0.033-7.368 +/- 0.037) and a number of patients developed respiratory acidosis (34%). There were no significant changes in levels of the investigated cytokines, only a mild increase of IL-6, IL-8 and TNF during first 24 h after operation was observed. The activity of ROS was highest at the end of the operation, but did not differ significantly from the start, but then decreased significantly for a period of 24 h. The authors conclude that the observed increase of carbon dioxide levels and decrease of pH had no impact on the fate of the patients. Thoracoscopic or VATS procedures were a minimal load for patients causing no significant changes of proinflammatory cytokines. The operations did not significantly elevate the activity of ROS.

Acid-Base Equilibrium↗
PubMed1999

[Loss injuries of the biliary tract in laparoscopic cholecystectomy-- possibilities of reconstruction].

Authors analyze occurrence of injuries of external biliary tract relating to the increasing number of laparoscopic cholecystectomies, especially of loss injuries, very demanding for its reconstruction. The early diagnosis of these injuries is emphasized and the necessity of their surgical revision as soon as possible, best still during the primary intervention. Authors present the own reconstruction method by high intrahepatic anastomoses in loss injuries of the common hepaticus and its branches.

Biliary Tract Surgical Procedures↗
PubMed1998

[Laparoscopy in abdominal injuries].

Application of laparoscopy in trauma was studied in Traumatological Hospital in Brno, within a more widely concipated project of grant IGA, Ministry of Health in Czech Republic. In the series of 28 patients there was detected neither a single complication, nor a reoperation nor any significant damage to the patient in connection with the use of the endoscopic method detected. Results of the research and author's observations act as a guide for use of more precise indication criteria and adequate selection of patients and for the proper evaluation of the method. Provided that basic principles and priorities of the urgencies management are kept, the application of this minimally invasive method in the management of patients with selected both the blunt and the penetrating abdominal trauma is justified, including associated extraabdominal injuries and polytrauma. It's diagnostic contribution exceeds the therapeutic one.

Abdominal Injuries↗
PubMed1997

[Laparoscopic inguinal hernioplasty--results in the initial group 2 years after surgery].

The authors evaluate retrospectively after a two-year interval the results of laparoscopic inguinal hernioplasty (L.I.H.) in an initial group of 49 patients (52 hernias) operated by three surgeons using the method of transabdominal preperitoneal plastic operation (TAPP) in 1993, 1994 and 1995. They confirmed the expected favourable results, except for the very high incidence of relapses (6.7%). In view of the small number of patients other conclusions cannot be drawn except analyse the three early failures of L.I.H., indicate technical mistakes made when introducing the new operation and emphasize the necessity to adhere to the known basic technical details when performing this relatively pretentious laparoscopic operation.

Adolescent↗
PubMed1997

[Acute surgical diseases in spinal injuries with spinal cord lesions].

Authors analyse the group of 22 operated patients admitted to the Spinal Centre of the Traumatological Hospital Brno for instable spinal fracture with the transversal lesion of the spinal cord, in whom the acutely affected abdomen and acute surgical disease manifested. The anamnestic and clinic examination of the abdomen is not reliable in patients with the transversal lesion of spinal cord for valid laws of the spinal cord. Authors evaluate the contribution of new diagnostic imaging techniques and endoscopic methods to determinate the early indication for surgical treatment.

Abdomen↗
PubMed1996

[Injuries of organs in the abdominal and retroperitoneal cavities].

In the Traumatological Hospital Brno approx. 100 polytraumatised patients yearly are admitted with involvement of 2, 3 or 4 systems. During the period of years 1982-1991 authors operated 308 injured patients with increasing haemoperitoneum, 254 patients with profuse bleeding into retroperitoneum, 77 patients with traumatic perforative peritonitis and 61 patients with severe thoracoabdominal trauma. Mortality in this group was 26%. Authors evaluate the contribution of new diagnostic methods for the indication of early surgical treatment, and results of operations, complications and problems.

Abdominal Injuries↗
PubMed1996

[Thoracoscopic major pulmonary resection--pro and con].

The first reports of thoracoscopic video-assisted procedures are from 1993. The main reason for this new techniques was that they allow the performance of standard thoracic surgical procedures in a less invasive ways. The operation trauma is minimalised that could be a cause not only of postoperative pain but often also of chronic future problems. The other advantages are the shortened hospitalisation time and earlier end of disablement. On the other hand there are many objective arguments against here. Firstly, the operative technique is not standardised and thoracoscopic lobectomy and pneumonectomy are performed by many modified methods. No regular randomised studies are available that could confirm the positive contribution of thoracoscopy in these cases. It is possible to perform classic thoracotomy by very careful way saving muscles and contemporary observing the requirement of safe operation and to attain the maximally possible result. Resuming information from written and verbal reports in last 3 years we have necessary the impression that the main reason for thoracoscopic reactions was to demonstrate the technical feasibility of this operation which is entirely insufficient reason for acceptance of this technique. Authors suggest that thoracoscopy is in experienced hands and adequately equipped workplaces an accurate and safe method for the diagnosis and in some cases also for therapy of hemodynamic stabile patients with thoracic trauma.

Endoscopy↗
PubMed1996

[Trauma and emergency thoracoscopy].

Authors present their first experience with urgent videothoracoscopy in polytraumatism and in isolated thoracic trauma patients. During the prospective study in 1993-1995 thoracoscopically was treated 41 (18%) from 229 multiple trauma patients including thorax trauma, hospitalised in our Institute. Thoracoscopy underwent 62 (4%) from 1452 patients with simple thoracic trauma. Thoracoscopy has been indicated above all for continued bleeding into peritoneal cavity, for suspected diafragmatic injury and for the diagnosis and treatment of posttraumatic complications. Authors suggest that thoracoscopy is in experienced hands and adequatelly equipped workplaces an accurate and safe method for the diagnosis and in some cases also for therapy of hemodynamic stabile patients with thoracic trauma.

Adult↗