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Biomedical subjects

K Grabowski

Publications and source records attributed to K Grabowski.

At least 19 recordsLinked to original sources
PubMed2000

[The second reconstructive operation of the esophagus].

What we need in order to obtain good results in oesophageal reconstructive surgery is long enough segment of intestine with sufficient blood supply. Evaluation of the blood flow is very difficult and often only after completion of the mobilization and transposition of the intestine into the neck final evaluation can be made. In the cases with poor blood flow one must resign from the already mobilized intestine. In such situation the second operation with the use of different alimentary tract segment must be performed. In our practice we encountered 7 cases where it was necessary to mobilize the second intestinal segment in order to achieve success in the reconstruction of the oesophagus. In 3 cases during the first operation jejunum was used. In 3 cases the necrosis of mobilized jejunal segment forced us to perform the second operation. In two patients during the second operation right colon segment along with terminal ileum was used. The third was operated with the use of right colon. In 2 others right colon was used in the first operation. One of them was operated for the second time with the use of left colon. The other were operated with the use of ileum. 2 patients with the substitute from right colon along with the terminal ileum when operated for the second time had the jejunum and left colon segment used to bridge the gap. Mortality in our reconstructive operations was 28.57% (2/7).

Adolescent↗
PubMed2000

[Esophageal substitute corrective operations].

In the Clinic of Gastrointestinal Surgery at the Medical University in Wrocław in 402 cases substernal oesophageal reconstruction was performed using different pedunculated oesophageal substitutes. 63 patients had to be operated on for the second time because of disorders in the oesophageal substitute. In 13 cases stenosis in the upper anastomosis and in 3 patients stenosis in the anastomosis with stomach were corrected. In 7 cases oesophageal ulcer was excised. 6 patients were operated because of substitute herniation into pleural cavity. In 3 cases huge diverticula in the neck were removed. 5 patients were operated because of stomach outlet stenosis. In 15 cases operation was necessary to correct the sequel of reflux oesophagitis. In 8 cases the surgery was performed to remove stenosis of the substitute. In 2 cases there was torsion of substitute and in the other 2 cases postoperative stenosis was caused by adhesions. One patient was operated because of the dumping syndrome. In 2 patients with the colon substitute polyps from the segment used for the oesophagus were removed endoscopically. The mortality after corrective surgery on the oesophageal substitute was less than 10% (6/63).

Anastomosis, Surgical↗
PubMed1997

[Iatrogenic esophageal injuries].

Own experience regarding treatment of 25 iatrogenic oesophageal lesion are discussed. Diagnosis was established mainly by x-ray examination with the water soluble contrast and plain chest x-ray. One patient was treated conservatively. 24 were operated. All patients received antibiotics intravenously and for local mouth rinse. Operations consists of chest drainage and exclusion of oesophagus from food passage by gastrostomy. Treatment in all cases resulted in healing of oesophageal lesion.

Anti-Bacterial Agents↗
PubMed1997

[Gastroesophageal reflux after reconstruction of the esophagus with colon interposition].

In this study 113 cases were analysed; in which colon interposition was used for the reconstruction od the esophagus. The function od the esophageal grafts was evaluated 2 to 36 years after the reconstruction. Massive reflux was observed mainly when the anastomosis had been made to the gastric fundus. Reflux to isoperistaltic grafts was found in 21% of cases in children and in 27% od cases in adults, whereas for antiperistaltic grafts is was found in 33% od cases in children and in 61% od cases in adults. 4 children and 7 adult patients required a a reoperation.

Adolescent↗
PubMed1997

[Surgical methods of protecting grafts from the colon against gastric reflux].

The authors presented their methods of protecting esophageal grafts made of colon intestine from the gastric reflux to the graft; the methods were invented in their Department and verified in clinical practice. 51 patients had anti-reflux interpositions of jejunal or ileo-cecal segments made during the initial reconstruction or as a reoperation. Despite this, reflux was found on control examination in 12 cases, 8 of which had esophagitis confirmed by histology.

Adult↗
PubMed1997

[Pleural hernia of an esophageal graft--late postoperative complication].

Pleural hernia of the oesophageal substitute from pedicled intestinal segment is one of the late postoperative complications. 13 cases of patients with oesophagus reconstructed because of lye ingestion stenosis are presented. Problems concerning diagnosis and treatment of pleural hernia are analysed. Eight patients with minor symptoms were treated conservatively. Five patients were operated, two of them from acute necrosis of the substitute. Necrosis was caused by incarceration of the bowel and torsion of the mesentery. Elective operative treatment consisted of reduction of hernia sac contents, closing of the hernia orifice, chest drainage and temporary gastronomy. In patient operated as an emergency cases necrotic part of substitute was removed. This resulted in oesophageal exclusion in the neck, creating gastronomy. Chest drainage was also performed.

Anastomosis, Surgical↗
PubMed1992

Surgical treatment of cardiospasm and megaoesophagus.

Long-term results of operative treatment of cardiospasm and megaoesophagus in 111 patients are presented. There were 67 women and 44 men treated, age 4 to 65. The authors have for several years used their own, in this Department developed method of operation for cardiospasm, which joins Heller's operation with the reconstruction of the cardia to prevent reflux. In very advanced stages of the disease as megaoesophagus they use an original surgical procedure, which consists in connecting the thoracic segment of the oesophagus with the prepyloric part of the stomach by means of a pedicle jejunal graft. Clinical follow-up supported by x-ray examination and endoscopy has shown very good results of such treatment.

Adolescent↗
PubMed1990

[Late results of esophageal prostheses created from intestinal grafts].

During the last 30 years, 280 retrosternal esophageal replacements from stem intestinal grafts were performed at GIT Surgery Clinic AM in Wroclav. Both clinical and auxiliary investigations showed the small intestine grafts have been of the best function as to the food passage. In esophagi made from the large intestine, the following and mostly frequent changes occur: the dilatations of their lumina, the stop of food passage and inflammatory changes varying in both the degree and extent. Inflammatory changes as well as ulcers are rather difficult to detect by radiology. Through the last years, the Second Clinic of General Surgery AM in Wroclav provides endoscopy of artificial esophagi. Being sophisticated, this approach is of benefit in early determining pathologic changes in the esophageal wall, the collection of contents for biochemical tests, tissue biopsies for histology and the initiation of appropriate therapy.

Adolescent↗