Biomedical subjects

K Smejkal

Publications and source records attributed to K Smejkal.

18 recordsLinked to original sources

PubMed2001

Immunoscintigraphy and intra-operative radioimmunodetection in the treatment of colorectal carcinoma.

PURPOSE: Intra-operative radioimmunodetection of malignant involved lymph nodes follows the pre-operative immunoscintigraphy in the treatment of patients with colorectal carcinoma. The aims of this clinical study were to determine the sensitivity of the method, to compare the results in study when using Oncoscint and CEA-Scan and to evaluate the importance of the method of surgery and postoperative adjuvant therapy. PATIENTS AND METHODS: 121 patients with colorectal tumours (106 primary and 15 recurrent) were operated on using radioimmunoguided surgery (RIGS). The study compared results of pre-operative immunoscintigraphy, intra-operative radioimmunodetection and postoperative histological examination. Histological investigation used classical H&E staining. In histologically negative and RIGS positive cases the immunohistochemical investigation was supplemented. Two radiopharmaceuticals were used Oncoscint CR 103 (MAb B72.3, Satumomab Pendetide), labelled with 111In in 56 patients and CEA-Scan (IMMU 4-Fab' fragments MAb against CEA, Arcitumomab), labelled with 99mTc in 65 patients. RESULTS: The relationship between RIGS positive results and histological examination was statistically assessed after 38 operations and the most acceptable RIGS evaluating index was determined. All subsequent results were evaluated by this index. Immunoscintigraphy of tumour was positive in 112 cases (92.6%). Fifty-five RIGS positive cases of malignant infiltrated lymph nodes were confirmed by 43 histologically positive examinations (78%). In this group 9 cases were discovered only by immunohistochemistry. Sixty-six remaining RIGS negative results were confirmed in 62 (94%) cases by negative histology. CONCLUSIONS: Both immunoscintigraphy and RIGS enable one to make a more accurate diagnosis. While treating the primary disease the use of RIGS may help in assessment of necessary extent of operation performance and in staging of the disease by revealing occult lymph nodes involved. Pre-operative immunoscintigraphy seems to be a useful diagnostic method for detection of tumour recurrence. When comparing two radiopharmaceuticals used, CEA-Scan seems to be more suitable for diagnostic studies, but using the Oncoscint for tumour recurrence detection had some specific benefit, too.

Journal Article↗

PubMed2001

[Role of peroperative coloscopy].

The authors focus attention on the method of preoperative endoscopy which is useful in some operations of the digestive tract and evaluate retrospectively its contribution in their own department. They compare data on this method in the professional literature and consistent with them they recommend preoperative endoscopic examination in indicated cases as a safe, rapid and effective method for improving the standard of surgical care of patients and recommend this method in the algorithm of treatment.

Colonoscopy↗

PubMed2001

Importance of the anorectal manometry in chronic anal fissure.

This publication presents the results of postoperative manometric investigations of 77 patients with anal fissure treated within the time span 1985-1997 by lateral sphincterotomy (LS). Results of manometric investigations are compared with digital anal examinations and subjective complaints of patients. Digital anal examination correlated with manometry results in 52 cases (68%). The correspondence between these two results was proved in 48 cases when normal finding was present. An increased sphincter tonus was found in 3 patients, all of them having the anal fissure recurrences. A marked sphincters insufficiency, which had been manifested by stool and gas incontinence was found in one case. When searching for the reason of this complication we found out that this operation procedure had been performed by an unexperienced team of surgeons. In 25 cases (32%) the digital anal assessment and manometric measurement were different. Nevertheless, the clinical symptoms in this group of patients were rather poor. To conclude we may state that manometry provides important data for preoperative evaluation of anal sphincter function and should be performed prior to lateral sphincterotomy operation at least in women.

Adolescent↗

PubMed2000

Assessment of sphincterotomy results in patients treated for anal fissure.

OBJECTIVE: This paper summarizes results of a study of 90 patients operated on for chronic anal fissure with lateral sphincterotomy (LS) between 1985 and 1997. METHODS: Preoperative and postoperative complaints, anal examination and continence were evaluated. All patients were asked to rate the results of LS as very good, good, satisfactory or unsatisfactory. RESULTS: Sixty-six patients (73.3%) judged the results of LS to be very good. Only 4 (4.4%) judged the results unsatisfactory and 1 patient (1.1%) considered the results satisfactory. Recurrent anal fissure was found in 4 cases (4.4%). Two patients developed a fistula in connection with the procedure. CONCLUSIONS: Lateral sphincterotomy is a safe and simple operation that yields good results. However, LS should be diagnosed and performed by a surgeon skilled in proctologic surgery.

Chronic Disease↗

PubMed1999

[Treatment of chronic anal fissure with lateral sphincterotomy].

This paper presents a group of 134 patients, who underwent treatment of chronic anal fissure by internal lateral sphincterotomy (ILS) within the period of 12 years (1985-1996). This number of patients where those in whom conservative treatment (anal divulsion) was not successful. From the total number of 134 patients 110 were treated successfully by surgery (82.08%). In 19 patients even after fissure healing slight discomfort persisted. Moderate and more severe complaints were reported in 5 patients. In 4 cases the chronic anal fissure failed to heal, in 1 patient due to ILS perianal fistula developed. No other complications, like incontinency etc., were found within the short time interval of follow-up. ILS is a simple and safe surgical procedure performed under general anaesthesia after precise differentitation of the internal sphincter. The results of surgical treatment are very satisfactory, marked painfulness relieves immediately after operation, the fissure heals rapidly after relaxation of the internal sphincter spasm. Postoperative treatment is simple, the percentage of complications is low. None of the patients operated on in the authors department developed incontinence. (Tab. 3, Ref. 25.)

Adolescent↗

PubMed1999

[Gastrointestinal stromal tumor--GIST--case report].

Authors describe a newly introduced oncological entity that represents different views on some already well known mesenchymal and neuroectodermal tumours of gastrointestinal tract. These submucosal GIT tumours, showing only few differences in both the clinical and histological pictures, are generally called gastrointestinal stromal tumours. This paper presents a case of 37 year old patient with this disease.

Adult↗

PubMed1997

The chronic anal fissure treatment by internal partial lateral sphincterotomy and following anal manometry.

Anal fissure remains one of the most common proctologic problems. A number of reports have advocated the use of partial internal sphincterotomy as a treatment of chronic anal fissure. Our study shows the results of a retrospective analysis of our patients who underwent lateral internal sphincterotomy for the treatment of chronic anal fissure. To determine long time results we examined random sample of 75 operated patients. Apart from taking careful history and patient's assessment of the operation effect, the patients were investigated "per rectum", and even possibly rectoscopically. To asscertain suitability and also security of properly done internal sphincterotomy, we performed anorectal manometric examinations in 53 patients controlled. To conclude our results, we can state that in 9 (12%) patients controlled some subjective complaints or certain pathologic findings connected with anal fissure or sphincterotomy were found. None of the people from the set of ours suffered from any complaints, which can be taken as stool incontinency. In no patients any change in pressure measured by anorectal manometry indicating incontinency was proved.

Anal Canal↗

PubMed1992

[Recurrent Crohn's disease].

In 1973-1990, i.e. in the course of 18 years, at the Surgical Clinic in Hradec Králové 148 patients with Crohn's disease were operated. The author gives an account of the localization of the disease and surgical interventions performed. Thirty-four patients were operated on account of relapses, i.e. 23%. One re-operation was performed in 22 patients (64%), two re-operations in 6 patients (17.6%) and three and more re-operations also in 6 patients (17.6%). The authors mention the types and total number of re-operations which amounted to 56 operations. They evaluate some causes such as the patients age, sex, site of relapse, duration of disease before the primary operation and some other factors which could have an impact on relapses and re-operations of Crohn's disease.

Adolescent↗

PubMed1991

Gastrointestinal endoscopy and endoscopic polypectomy as a contribution to prevention and treatment of malignancies.

In the retrospective study the author shows the survey of 4,468 gastro and colonofiberscopies performed at the Endoscopic Unit of the Clinic of Surgery in Hradec Králové during the time span 1981-1990. Indications and contraindications, as well as the conditions for performing these endoscopies are being considered. Experiences with the optimum preparation of such patients are also described. Furthermore, the question of the occurrence and importance of gastrointestinal polyps is being discussed. In the second part of this study mainly the problematics of the endoscopical polypectomy is revealed. This set includes 612 patients with polyps in both the upper and lower parts of the gastrointestinal tract. The group of polyps has been divided and studied in greater detail from several points of view, such as their histological character, morphology, localization, clinical symptomatology and others. The endoscopic treatment of polyps is further compared with the alternative way of treatment. The survey of complications is also given. In the discussion and conclusion the follow-up policy, which differs from that of some other authors, is being supported and further ways of diagnosis in this field are outlined, too.

Adult↗

PubMed1990

Contribution to the technique and tactics of the surgical treatment of Crohn's disease.

On the basis of their own long time experience with the surgical treatment of the Crohn's disease the authors refer to the correct course and ways in surgical treatment, whose influence on the frequency of recurrences and thus on the destiny of patients are evaluated. They especially stress the effort to prolong the symptom-free interval between the remissions of this grave general disease.

Crohn Disease↗

PubMed1990

[Colonoscopy in the diagnosis of hemorrhage in the colorectal area].

The authors submit a retrospective study based on their own material, pertaining to experience with coloscopies in acute and chronic haemorrhage from the colorectal region. They analyze the causes of haemorrhage, and give a detailed histological classification in particular of polyps as possible precancerous conditions. They also compare the clinical value of coloscopy with other examination methods according to their own experience and data in the literature.

Colonic Diseases↗

PubMed1990

[Post-resection states after surgery for gastroduodenal ulcer disease].

A total of 115 patients with gastroduodenal ulcers submitted to surgery at the Department of Surgery in Hradec Králové between 1975 and 1979 had been reported on retrospectively. Authors emphasized the long term postgastrectomy results providing minimally 10-year-lasted intervals since. After a detailed clinical examination of patients, postgastrectomy results may be evaluated as good ones and comparable to a number of literary experiences. Therefore, they estimate this surgical modality of treatment to be justified and appropriate in respect with contemporary indicatory criteria as well as other therapeutic modalities known to exert influence on gastroduodenal ulcers.

Adult↗

PubMed1989

[Endoscopic sclerotization as a method of treatment of esophageal varices].

In the retrospective study of 23 patients the authors are rendering and evaluating their experiences in treating oesophageal varices by endoscopy sclerotization. On the basis of both proper experience and literature sources, they compare the efficiency of their approach with other conservative and surgical procedures. Their own modest experience is collated with the latest literature data. Far from estimating this method as an exclusive one in treating the portal hypertension complications, the authors believe it to be a considerable contribution to improve further destiny of the patients so treated.

Endoscopy↗

PubMed1988