PubMed Health⌕ Search

Biomedical subjects

M Gergely

Publications and source records attributed to M Gergely.

At least 19 recordsLinked to original sources
PubMed2000

[The role of interval surgery and irradiation in the treatment of primarily non-resectable rectal cancers].

The authors review the results of 1181 colorectal operations performed in a 16y period and analyze the last 8y period in which 713 colorectal operations were performed and the irradiation of primarily irresectable rectal cancer was introduced. At the time of the first operation 44% of the rectal cancer cases (69) proved to be irresectable, 14 of them were sent to a proper center as suitable ones for irradiation. 13 patients had got irradiation therapy [in three cases irradiation was combined with chemotherapy (5-fluorouracil)--synchronization chemoradiotherapy) and 11 of them were suitable for resection at the course of the second operation (there were performed 9 abdominoperineal resection and 2 Hartmann's procedures). In this small group (7% of rectal cancer cases) the radiotherapy can change the primarily irresecatable rectal cancer to resectable and for these patients this could be the only chance for cure.

Adult↗
PubMed2000

[Successfully resected carotid glomus tumor].

A 76-years old man with carotid body tumor on the left carotid bifurcation was operated on, in August 1999. The rare tumor of the paraganglionic tissue was detected by ultrasonography and arteriography. Although these tumors have a very low incidence of malignancy, extirpation should be carried out. In this case, the tumor was removable by blunt and sharp dissection without resecting the fork of the carotid artery. The postoperative course was uneventful. They discussed the diagnostic and therapeutic steps of solution of this tumors.

Aged↗
PubMed2000

[Late detection of vascular injuries].

Generally recognizing of traumatical vascular injuries isn't difficult since clinical signs and symptoms show them unambiguously. For some time-mainly in case of blunt and shot wounds-lacking unanimous signs the vascular injuries can't be diagnosed. Later on appearing symptoms as complications raise the chance of existence of an earlier vascular injury. In case of three patients the elapsing time between the vascular injury and its diagnosis was 4 weeks, 3 years and more than 50 years.

Adult↗
PubMed2000

[The use of muscle flaps in the surgical treatment of infected vascular prosthesis].

The solutions for graft infection and its complications in vascular surgery are well known. However, publications dealing with this topic do not, or just occasionally mention muscular flap plast, which is already quite widely used in other fields of surgery. The authors first used pedicled muscular flap plasty in 1996, to cover grafts that had been exposed as a result of infection. Later, this method was also applied in covering subinguinal suturelines and anastomoses respectively, to ward off impending haemorrhage. Between 1996 and 1999, 32 patients presenting with septic complications after vascular surgery were treated. Muscular flap plasty was performed in 12 of these cases. In 7 patients the exposed graftsere covered, while in 5 patients the subinguinal suture-lines and anastomoses were covered respectively with muscle flaps, 5 of the graft covering procedures were successful. In two cases of superinfection and septic progression respectively the graft had to be removed without amputation of the extremity. 3 successful operations were recorded in the cases where the covering of the subinguinal suturelines and anastomoses were the aim. 2 patients presented with erosive haemorrhage, which led to ligation of the femoral artery and consequent amputation, in view of the absence of further possibilities for reconstruction.

Aged↗
PubMed1996

[Biliary fistula, following partial hepatectomy, treated by endoscopic papillotomy (atypical indication for endoscopic sphincterotomy)].

The authors present the case of a 33 y old male patient. The young farmer suffered of a large Echinococcus (hydatid) cyst in the right lobe of his liver. The solution of the problem was a practically atypical right lobectomy. On the 5th postoperative day there was manifested a marked external bile fistula through the drain inserted at laparotomy, and the leakage continued until the 38th postoperative day, when after an endoscopic papillotomy the leak nearly immediately has closed. According to the authors, and some literary data published since, in cases of a postoperative external bile fistula the method of choice seems to be the EST.

Adult↗
PubMed1995

[Evaluation of 3757 cases of open biliary tract surgery before the introduction of the laparoscopic method (basis for comparison)].

3757 elective nonmalignant biliary tract operations are evaluated retrospectively in the 17-year period from January 1, 1974 to December 31, 1990. The operations were divided into four periods according to development and frequency of intraoperative diagnostics: I. period without examinations of common bile duct (511 operations), II. selective period (848 operations), III. routine period (906 operations), IV. restricted routine period (1492 operations). The authors experienced improvement in their results if they carried out intravenous cholangiography routinely. Comparing eight characteristic factors they believe that their results are favourable if they performed intraoperative common bile duct examinations (manometry, cholangiography, flow rate measurement) in 39.6% rate and if they employed praeoperatively EST if necessary. They propose the selective intraoperative cholangiography. In the period of 39.6% intraoperative cholangiography (restricted routine period) they found common bile duct stones in 10.7%, unsuspected stones in 0.4%, retained stones in 1.6%, unnecessary choledochotomies in 2.7% and intraoperative common bile duct injuries in 0.2%. The overall mortality rate was 0.4%. They deal with the intraoperative differential diagnostics of Vater papilla stenosis and spasm.

Ampulla of Vater↗
PubMed1993

[Quo vadis, Chirurgia?].

After an overview of the last one and a half century of the golden age of classic surgery the author discusses the problem of specialization in general surgery. Due to the basic change of the nature of some diseases and to the development of medical and endoscopic treatment some of the routine surgical procedures have nearly disappeared: for example the partial gastrectomy in ulcer disease, the proximal gastric vagotomy itself, the transduodenal sphincterotomy, etc. This fact raises the question of education and post-graduation of young surgeons. Now the unlimited use of laparoscopic methods in abdominal surgery opens up new vistas. The recent state of art and the future is discussed, emphasizing the need of high ethical standard on the field of this entirely new surgery.

Forecasting↗
PubMed1992

[Pancreatic cystic tumor misdiagnosed as pseudocyst: lessons from an intraoperative error].

A 62-year old woman presented a fistula due to a previously made cystojejunostomy performed because of a small pancreatic lesion considered as a pseudocyst. This intervention was performed in another institute. In the course of the exploration the authors resected the whole mass with the Roux-en-Y loop, and with the spleen. The histological examination proved a cystadenocarcinoma of the pancreas. There are discussed the problems of the intraoperative diagnosis of pancreatic lesions, and the possibilities of the reduction of mistakes. The authors emphasize the experience of the surgeon--which is the most important factor of the cure--and the importance of the fine needle biopsy.

Cystadenocarcinoma↗
PubMed1991

[Surgical aspects of space-occupying lesions in the pancreas].

A mass in the head of the pancreas is always a challenge, and the differentiation between malignancy and the chronic inflammation even in the course of the operation is nearly impossible. The number of these type of pancreatic lesions is increasing. The basic diagnostic tools are the sonography and the endoscopic pancreatography, and a useful possibility is the percutaneous or intraoperative fine needle biopsy. In the case of a space-reducing tendency of the lesion the surgical intervention is mandatory--in some cases (jaundice, etc.) the solution can be performed in two-stages. These patients should be treated in departments with special interest and practice concerning these lesions, at least at the stage of definitive surgery. In the author's modest practice in the course of a 13 year period on two hospital departments there were operated upon 176 patients with 211 surgical interventions. There were made 48 radical pancreatic resections (Whipple-procedures 28, body-tail resections 17 and 3 total pancreatectomies) with an acceptable mortality--there was only one death among the 28 duodenopancreatectomies. It is emphasized, that the best palliation is the resection, the Whipple-procedure can be performed without any pancreatodigestiv anastomosis, and the usual complication of this method, the pancreatic fistula can be prevented by a simple pancreatogastrostomy. The patients underwent these types of surgery need a long-term postoperative care. The nihilism of pancreatic malignancies is obsolete.

Diagnosis, Differential↗
PubMed1991

[Diagnostic and therapeutic problems in a severe case of bacterial contamination of the small intestine].

Five years case record of a 18 year old man is reported. Because of sustained diarrhea he was treated several times on departments for infectious diseases. The patient was operated on three times in various surgical departments because of vigorous abdominal pain, cachexia and CT scan finding. In addition extraintestinal complications and symptoms delayed the diagnosis. The diagnosis was verified by the H2 breath test and microbiological examination of intestinal juice. Complaints of patient ceaset after sustained Ciprobay therapy. The severe deficiency symptoms were relieved by complex substitution.

Adolescent↗