PubMed Health⌕ Search

Biomedical subjects

M Dlouhý

Publications and source records attributed to M Dlouhý.

At least 19 recordsLinked to original sources
PubMed2005

[The intraabdominally located mesh in the laparotomy management of major hernias].

AIM: Major hernias in sutures following abdominal surgical procedures make the patients' quality of life significantly worse. Our aim is to prove that, even now, the surgical management of such hernias has its cons and in most cases requires a plastic mesh application. PATIENT SUBJECTS AND RESULTS: The authors operated 82 patients with hernias via the middle laparotomy. The patients had been primarily operated for their colorectal disorders. The incidence rate of the major hernias in sutures was 5.25% (82/1564). The defects of the abdominal wall were corrected using a prolene mesh placed intraperitoneally. Although in 11 patients the authors report postoperative complications in the sutures (1x absces, 6x seroma, a 4x infiltration), the long-term results of the above technique remain very positive. 2 patients had a relaps of the hernia and clinical manifestations of adhesions following the procedure were reported in 7 patients. CONCLUSION: The technique of the intraabdominally located mesh in the major postoperative hernias management enables tension-free procedures of the major defects of the abdominal wall to be conducted with very good long-term results.

Hernia, Ventral↗
PubMed2004

[Surgical treatment of the colorectal carcinoma synchronous with liver metastases].

The authors present their results of the surgical treatment of the synchrone liver metastases in the second stage and following three courses of chemotherapy. Although the trial group is small, counting 25 patients operated between April 2002 and October 2003 (i.e. 18 months), the procedure's clinical benefits may be deducted, based on the immediate postoperative results.

Adenocarcinoma↗
PubMed2002

[Manometry in esophageal achalasia].

OBJECTIVE: Manometric findings in achalasia are pathognomic already in early clinical stages of the disease. The authors evaluate the importance of manometry in the diagnosis and therapy, in particular in early stages of the disease. METHOD: During manometry we obtain data on the function of the lower oesophageal sphincter and the body of the oesophagus. Impaired relaxation of the sphincter is evaluated, as well as increased tonus of the sphincter and tertiary contraction of the body of the oesophagus. In patients with achalasia we implement laparoscopically extramucous myotomy. RESULTS: In 1997 we started a prospective manometric study of dysphagic complaints. We examined 304 patients on account of different diseases of the oesophagus incl. 16(5.2%) where we proved or confirmed achalasia in stage I, II or III according to the radiological classification. These patients were indicated for laparoscopic myotomy. In one instance we had to convert the operation to an open one. In two instances we added partial fundoplasty according to Thal on account of perforation of the oesophageal mucosa. Four patients were subjected after a 5-12-month interval to remyotomy. Twice because of the development of a fibrous stricture at the site of myotomy and twice for an obviously inadequate original myotomy. The history of dysphagia in patients with primary operations was on average 37.3 months. CONCLUSIONS: Manometric examination of patients with functional dysphagia makes it possible to detect achalasia in early stages and to indicate in time surgical treatment. In case of a relapse or persistence of complaints manometry makes it possible to express objectively the cause which is most frequently an atonic oesophagus with inadequate evacuating capacity, stricture at the site of myotomy or inadequate myotomy.

Adult↗
PubMed1999

[Present status of minimally invasive surgery in the Czech Republic].

OBJECTIVE: The authors evaluate the contemporary state of miniinvasive surgery in the Czech Republic. METHOD: The authors made a questionnaire survey in surgical departments of the Czech Republic. Some 58% of the addressed departments (118 departments) replied. They evaluated the prevalence and use of miniinvasive techniques in 1997 in the following areas: flexible endoscopy, sonography, intervention radiology and endoscopic surgery. RESULTS: 40% of the surgical departments possess flexible endoscopes and 14% surgeons use endoscopy. Interdisciplinary collaboration is being enforced. In 54% departments endoscopy is ensured in collaboration by surgeons and gastroenterologists. Single-handed sonography was recorded among 3.2% surgeons, but 80% feel that surgeons should do sonography single-handed. Intervention radiology as an alternative to surgery is indicated by 88% surgeons. However only 1.2% surgeons participate actively in these examinations. The era of endoscopic surgery was started in the Czech Republic in 1991. At present these operations are made at all departments. The number of operations increases steadily. Thoracoscopy is used in 21% departments. In addition to cholecystectomy (100%) most frequently the following operations are made: appendenctomy--81%, inguinal hernia--67%, acute abdomen--55% and in a smaller number of departments (cca 10%) some more pretentious operations are made in the region of the oesophageal hiatus, intestinal resection etc. CONCLUSION: Endoscopic surgery replaced in some areas classical surgery. The importance of flexible endoscopy and sonography induced an ever increasing numbers of surgeons to use these methods actively. Intervention radiology is also of increasing importance and in many cases it is the preferred alternative of classical operations.

Czech Republic↗
PubMed1999

[Laparoscopic gastrostomy: report on 20 cases].

Establishment of a permanent gastrostomy for feeding the patient is even at the end of the 20th century a task for a surgeon, the operation being in the majority laparoscopic. This mutilating operation is however highly selective and unique and is used only after other possible ways to restore food intake by the natural route was exhausted. The most expedient way of recanalization of the oesophagus in inoperable tumours is nowadays insertion of an autoexpansive stent.

Enteral Nutrition↗
PubMed1999

Miniinvasive approach to the treatment of liver cysts.

During the period from 1995 to 1997 we followed and treated six patients for liver cysts. Diagnostics was based not only on clinical examination but also on ultrasonography and computational tomography (CT). Surgery is applied in solving larger cysts damaging liver parenchyma and causing pressure symptomatology. Nowadays most cysts can be solved by means of laparoscopy.

Adult↗
PubMed1998

Selective isolation of Pseudomonas stutzeri from vertebrate faeces on Rambach agar.

Faecal samples collected from 308 wild birds of 25 species and 19 rodents of 3 species in South Moravia (Czechland) were pre-incubated in Müller-Kauffmann tetrathionate broth at 42 degrees C for 24 h and then streaked onto Rambach agar plates which were incubated at 37 degrees C for 48 h. Seventeen out of 22 isolates forming orange-red colonies on Rambach agar were identified as Pseudomonas stutzeri, the rest as Pseudomonas sp. and Alcaligenes sp. The colonies of P. stutzeri were either dry, wrinkled and adherent to the agar (resembling Bacillus) or smooth, less adherent (mimicking Salmonella). P. stutzeri was recovered from five species of vertebrates caught in farmland habitats: the house sparrow (Passer domesticus), the tree sparrow (P. montanus), the great warbler (Acrocephalus arundinaceus), the wood mouse (Apodemus sylvaticus) and the common vole (Microtus arvalis). The overall isolation rate was 4.5% in birds (12.6% in house sparrows) and 15.8% in rodents. The procedure can be useful for the isolation of P. stutzeri in clinical and environmental studies.

Agar↗
PubMed1998

[Identification of Pseudomonas stutzeri with the NEFERMtest, NEFERM test 24 and API 20NE commercial test kits].

A total of 35 strains of Pseudomonas stutzeri were tested by commercial diagnostic kits NEFERMtest, NEFERMtest 24 (both Lachema Co., Brno, Czech Republic) and API 20NE (bioMérieus sa, RCS Lyon, France). The best identification efficacy was achieved by means of the commercial API 20NE (97.1%). Only 60% strains were correctly identified by means of NEFERMtest. NEFERMtest 24 improved successful identification (80%). Most misidentified strains were identified as Alcaligenes denitrificans and Al. xylosoxidans.

Bacterial Typing Techniques↗
PubMed1998

[Palliative treatment of inoperable esophageal stenoses using stents: long-term results, complications].

The authors evaluate the effectiveness of palliative treatment of inoperable oesophageal stenoses by means of self-expandable stents in a group of 102 patients and discuss complications. In all patients after implantation of the stent dysphagia improved by at least two degrees. Eighty nine patients of the group died, the mean period of survival was 107 days. At the time of evaluation 13 patients survive, the mean survival period being 175 days. As to complications the authors recorded incomplete expansion of the stent (n = 1), fissuring of the tumour (n = 1), migration of the stent (n = 8), oesophagorespiratory decubital fistula (n = 4), ingrowth of the tumour into the stent (n = 4), obstruction of the stent by food (n = 7) and arterial haemorrhage (n = 1). The effectiveness of palliative treatment of inoperable oesophageal stenoses by self-expanding stents is high and prompt. The total number of complications is 22%, the mortality after surgery is zero. The majority of complications is easily resolved by methods of interventional radiology.

Esophageal Neoplasms↗
PubMed1997

[Surgery of gastroduodenal ulcers in the Czech Republic].

OBJECTIVE: Evaluation of surgical treatment of gastroduodenal ulcers during the past 20 years and its importance at the present time. METHOD: During the past 20 years three questionnaire surveys were implemented in surgical departments in the Czechoslovak Republic (1975-57 departments, 1989-80 departments) and in the Czech Republic (1994-80 departments) focused on surgery of gastroduodenal ulcers. The authors analysed also a group of patients from their own department covering a five-year period (1990-89 operations and 1995-27 operations). RESULTS: In surgical departments of the Czechoslovak and Czech Republic the ratios of different operations during the mentioned years were as follows: 1975: resections 85%, vagotomy 9%, suture of perforation 6%. 1989: 71%, 10%, 19% and 1995: 48%, 8%, 31% and other operations 13%. In the authors department the ratio of these operations in 1990 was as follows: 23%, 23%, 10% and in 1995: 59%, 7%, 23%, 11%. The surgical approach declined in the course of five years by 70%. During the last two years in the Czech Republic and in the authors department first experience was assembled with laparoscopic suture of perforated ulcers and with superselective vagotomy. The initial results are very encouraging. CONCLUSION: The basis of treatment of gastroduodenal ulcers is modern medicamentous treatment, surgery is indicated most frequently if conservative treatment fails or in case of haemorrhage (78% of haemorrhages are controlled endoscopically). In gastric ulcers resection is indicated most frequently, similarly as in complications of duodenal ulcers. In non-complicated duodenal ulcers superselective vagotomy is an equivalent alternative of long-term conservative treatment.

Czech Republic↗
PubMed1996

[Treatment of perforating mediastinitis].

In 1986-1994 at the Second Surgical Clinic in Olomouc Faculty Hospital and Medical Faculty 23 patients with perforating mediastinitis were treated. The treatment of this serious disease is associated with a 30% lethality. The cause of its development are complications after surgery of the oesophagus, more frequently operations in the area of the cardia but also damage during instrumental treatment of the upper digestive tract. The analysis draws attention to the risk of perforation of the oesophagus in different types of operations. The author emphasize the importance of early comprehensive intensive treatment, incl. support of respiratory functions.

Esophageal Perforation↗
PubMed1996

[Retroperitoneoscopic lumbar symathectomy].

During the period between August 1995 and February 1996 at the Second Surgical Clinic of the Faculty Hospital in Olomouc 12 retroperitonescopic lumbar sympathectomies were performed on account of different indications. The authors present an elaborate technique of access into the retroperitoneum and their own technique of lumboscopic sympathectomy. The success of the method was evaluated clinically and by histological evidence of sympathetic ganglia in the collected material. Retroperitoneoscopic lumbar sympathectomy is considered a gentle and safe method which can be used also in other patients where the risk of open surgery would be excessive.

Adult↗
PubMed1994

New possibilities of miniinvasive treatment of esophageal stenoses.

We report our first very good experiences with the treatment of inoperable, especially malignant stenoses of the esophagus, with perorally inserted metallic self-expanding stents. During the period since August 1993 up to now, we have introduced 17 stents in 15 patients. We have compared the introduction of stents with other modalities of palliative treatment of esophageal stenoses, as actinotherapy, contact or focused laser, palliative by-pass surgery, classic surgical or endoscopical stenose-pertubation. In the last place for the patient stands the dismal nutrition-gastrostomy. From this point of view, the miniinvasive treatment with metallic stents is very successful, easy, well tolerated by the patients, and practically without complications. The therapeutical effect, elimination of severe swallowing-discomfort, allows especially to patient with malignancies to live terminal months of life with a relatively maximum quality of deglutition.

Catheterization↗
PubMed1994

Mediastinitis due to perforation.

The oesophageal perforation is a begining of tragedy. We present a group of patients with serious complication-mediastinitis after operations of the oesophagus or after instrumental diagnostics and instrumental treatment.

Catheterization↗
PubMed1991

[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].

In 1948-1990 the authors operated 112 patients with paraoesophageal and mixed hiatus hernias. 100 patients operated in 1988 were followed up on a long-term basis. Gastroesophageal reflux was recorded before operation in 52%, haemorrhage in 18%, an ulcer in the neck in 7% an incarceration and obstruction in 9%. Before the onset of the seventies hiatorrhaphy and gastropexy were performed. During check-up examinations in these patients relapses were recorded in 47%, reflux in 43%, subjective complaints in 26%. This made the authors change the surgical procedure and in subsequent years they performed hiatorrhaphy, fundoplication, fundophrenopexy and anterior gastropexy. The incidence of relapses of hernia during check-up examinations declined to 21%, of gastroesophageal reflux to 9% and subjective complaints to 10%. The follow-up period varied between 1 and 19 years. The surgical lethality was 2%.

Adult↗