Biomedical subjects

M Brocki

Publications and source records attributed to M Brocki.

15 recordsLinked to original sources

PubMed1999

Long-term observation in 68 patients operated on for pectus excavatum: surgical repair of funnel chest.

BACKGROUND: Recurrence after correction of pectus excavatum may sometimes occur, but its origin is not clear. The type of deformity, surgical technique, and patient lifestyle after operation can all affect the final shape of the thorax. The purpose of the present study was to compare the short-, medium-, and long-term cosmetic results of funnel chest repair. METHODS: Sixty-eight patients (mean age, 12.1+/-5.4 years; 48 male) were operated on for pectus excavatum using the same surgical technique: subperichondrial resection of the abnormal costal cartilages and stabilization of the elevated anterior chest wall with Kirschner's wires. The patients were followed up every year (1 to 10 years) after operation, and the anterior chest wall contour was checked by physical examination and x-ray film. RESULTS: Excellent to good cosmetic results 1 year after operation were achieved in 66 patients (97.1%). During the later follow-up period, a mild or moderate degree of recurrent sternal depression was noted in 6 patients (8.8%), teenagers only, 3 to 9 years after primary repair. CONCLUSIONS: Our technique for correction of pectus excavatum yields good short-term cosmetic results. Late recurrence of the deformity occurs during pubertal growth and does not appear to depend on surgical technique or length of follow-up.

Adolescent↗

PubMed1999

Pectus excavatum: increase of right ventricular systolic, diastolic, and stroke volumes after surgical repair.

OBJECTIVE: The study was undertaken to assess how a surgical correction of funnel chest modifies right ventricular structure and function. METHODS: Before and 6 months after surgery in 42 patients (27 male and 15 female patients, aged 5-31 years), a pectus index was calculated and echocardiographic examinations of the right ventricle were performed, with calculation of systolic, diastolic, and stroke volume indices. Right ventricular volume was estimated by subtracting the left ventricular volume from that of the entire heart. The values of the right ventricular volumes and the pectus index before and after the operation, as well as the changes in the indices, were compared. RESULTS: Statistically significant changes in the pectus index and the right ventricular volume indices after surgery were noted. No correlation was observed between the changes in the pectus index and the changes in any right ventricular volume indices. CONCLUSION: Surgical treatment of funnel chest causes an increase in right ventricular systolic, diastolic, and stroke volumes, although there is no correlation between these changes and the degree of sternocostal elevation.

Adolescent↗

PubMed1999

Right ventricular morphology and function after pulmonary resection.

OBJECTIVE: To identify the effect of pulmonary resection on right ventricular performance and its possible contribution to mortality and morbidity. METHODS: Before and 2 days after pulmonary resection for primary lung cancer in 31 patients (21 males; ages 32-69 years), echocardiographic examinations of the right ventricle were performed. Systolic, diastolic and stroke volumes as well as right ventricular ejection fraction were estimated. Right ventricular volumes were calculated using the subtracting method. RESULTS: Right ventricular end-diastolic volume index increased significantly in patients after pneumonectomy: 80.4+/-7.2 ml/m2 versus preoperative evaluation: 66.1+/-5.2 ml/m2 (P = 0.031). In patients who underwent pneumonectomy right ventricular ejection fraction significantly decreased from 48+/-5.0% preoperatively to 39%+/-4.1% after surgery (P = 0.027). Fourteen patients after pneumonectomy had development of supraventricular arrhythmias postoperatively. These patients had much higher right ventricular end-diastolic volume index (76.3+/-6.4/82.1+/-7.4; P = 0.032) and lower right ventricular ejection fraction (42+/-4.3/37+/-3.9; P = 0.021) after surgery in comparison with patients who had normal sinus rhythm postoperatively. CONCLUSION: Pulmonary resection caused a significant dilatation and dysfunction of right ventricle in the early postoperative period. Early detection of deterioration in right ventricular function after pneumonectomy may provide the opportunity for interventional therapy.

Diastole↗

PubMed1999

Videothoracoscopy and muscle flaps in the treatment of bronchial stump fistula.

The aim of the paper is to report our surgical technique applied for treatment of broncho-pleural fistula (BPF) as well as the results of the treatment. From 1992 to 1998 we performed 127 pneumonectomies for lung cancer. In 5 cases (3.9%) bronchial stump insufficiency developed postoperatively. Three patients were treated by means of videothoracoscopy (the Multifire Endo Hernia Stapler was used to clipped the fistula). Rethoracotomy with myoplasty was performed four times in 3 patients. In one patient both the methods were employed. In 2 out of 3 cases videothoracoscopic treatment was successful and the patients were discharged without signs of BPF and pleural empyema. In one case the recurrence of the fistula occurred and the stump of the bronchus was successfully covered with the pectoral musce flap 3 days later. In two cases after rethoracotomy and myoplasty (one of them was reoperated twice) the recurrence of BPF occurred and both the patients died due to cardiopulmonary failure. Despite the limited experience, we think videothoracoscopy is worth considering as a tool for treatment of BPF.

Aged↗

PubMed1998

Cardiorespiratory function before and after operation for pectus excavatum: medium-term results.

OBJECTIVE: The study was undertaken in order to assess the degree of impairment of the cardiovascular system in patients with funnel chest and to investigate any changes caused by surgical correction. METHODS: Echocardiographic examinations with systolic, diastolic and ejection volume indices calculation as well as pulmonary function tests were performed before surgery and at medium-term follow-up on 34 patients who were operated on for pectus excavatum between 1987 and 1992. RESULTS: The mean age was 13.4 years. There were 70.6% males. Pulmonary function was found to be restricted preoperatively in 18 patients. Inspiratory vital capacity and forced expiratory volume were increased or did not change at follow-up (5 years) in these patients. In cases with normal or moderately restricted pulmonary function (inspiratory vital capacity, forced expiratory volume more than 75% predicted) the reduction of lung function was noted after surgery. Marked haemodynamic improvement was found with the increase of diastolic and ejection volume of both heart ventricles (mainly right one). The improvement was more evident in patients with severe deformations. CONCLUSION: Only in case of severe reduction of lung function in a patient with funnel chest can one expect improvement after surgery. Sternocostal elevation improves function of both heart ventricles at rest.

Adolescent↗

PubMed1997

[Gunshot injuries of the thoracic and abdominal cavities in peace time].

Authors present gunshot damage of the chest and abdominal organs. The large number of wounded people particularly young men in the period of 12 years proves to have a widespread problem. They present an important of diagnostic examination, methods of surgical treatment complications and morbidity and mortality in the group of 627 patients.

Abdominal Injuries↗

PubMed1997

[Pathophysiologic aspects of extracorporeal shock wave lithotripsy].

The function of the gallbladder in 48 patients with cholecystolithiasis who were subjected Extracorporeal Shock Wave Lithotripsy (ESWL) is reported in the paper. The measurements were obtained basing on ultrasonography before and after the treatment. The following parameters were estimated: maximal and minimal gallbladder volume, ejection time, ejection fraction and gallbladder ejection rate. It was concluded, basing on the obtained results, that the initial gallbladder function had no influence on the outcome of the treatment. The function of the gallbladder maintained weakened over the following six weeks after ESWL only in the patients in whom the treatment was unsuccessful.

Adult↗

PubMed1997

[The value of endoluminal multiplane ultrasonography in evaluation of rectal cancer progression].

The authors present the value of transrectal endosonography in estimating infiltration of each layer of the rectum wall and neighboring organs and metastases into rectal lymphatic glands. The sensitivity of the examination in authors hands was about 83.7%. Authors prove the usefulness of endosonography in the proper assessment of the rectal cancer staging.

Endosonography↗

PubMed1997

[Taking advantage of thoracoscopic techniques for diagnosis and treatment of thoracic diseases].

The authors report their experience in VATS technique employed in the diagnosis and treatment of pleural and mediastinal diseases and lung tumors. Between 1992 and 1996, 50 thoracoscopic procedures were carried out in 48 patients. The following operations were performed: six thoracic sympathectomies, two cases of closing bronchial stump fistulas, six cases of successfully treated spontaneous pneumothorax. In eight cases (16.3%) it was necessary to convert this procedure into thoracotomy because of pleural adhesions. The diagnostic thoracoscopies (35 cases) included: mediastinal and lung tumor biopsies, taking up samples of pleural exudate. There were no complications connected with these procedures. We consider thoracoscopic technique to be a suitable method for the diagnosis and treatment of mediastinal and pleural lesions.

Adult↗

PubMed1979