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M Lovecek

Publications and source records attributed to M Lovecek.

8 recordsLinked to original sources
PubMed2003

[Peroperative diagnostic methods during esophageal achalasia surgery. Initial experience].

AIM OF THE STUDY: The authors present their first experience with the application of esophageal manometry during the operation on achalasia of esophagus. The completeness of performed myotomy is evaluated on the basis of decreased pressure in the region of lower esophageal sphincter (LES). METHODS: Stationary pull-through four-channel manometry was performed twice during the operation: before the application of capnoperitoneum to localize LES with evaluation of its length and tonus and after the myotomy was performed after capnoperitoneum was abolished to verify sufficient extent of myotomy. The subsequent endoscopic control was used to exclude damage of esophagus mucous membrane. RESULTS: In the period of one year during 2002/2003 the authors operated on four patients with achalasia, when manometry was used for peroperative localization of LES and evaluation of the extent of myotomy. The peroperation manometry demonstrated decreased tonus of LES (the mean 42.06 mmHg before myotomia and the mean 20.03 mmHg after myotomia) and in one case the finding resulted in necessary extension of myotomia. CONCLUSIONS: Based on our preliminary experience with peroperation manometry in operations on achalasia of esophagus it may be stated that it is a useful method for objectivization of the completeness of myotomy, which does not significantly prolong the period of operation. It contrast, it makes it possible to respond to lasting hypertonic area in LES subjected to myotomy, which may be the cause of lasting complaints of patients after the operation.

Esophageal Achalasia↗
PubMed2003

[Complications after laparoscopic surgery of inguinal hernias].

AIMS: The authors describe the occurrence of complications in laparoscopic approach to treat inguinal hernias in patients operated on at 2nd Surgical Clinic in Olomouc from May 1991 to the end of the year 2002. METHODS: The occurrence of preoperation and postoperation complications and relapses in inguinal hernias treated with laparoscopy in the period of May 1991 to the end of 2002. The TAPP method was used for operation on 98% of inguinal hernias, the IPOM method for 0.9% of inguinal hernias, TEP method in 0.4% and a simple suture in operation on 0.7% of inguinal hernias. RESULTS: Five hundred and thirty four (56% of all surgically treated inguinal hernias) were treated with laparoscopy in adult patients in the period of May 1991 to the end of 2002. Eight preoperation and postoperation complications (1.4%) were encountered. These included two cases of hematoma in the wound after port (0.3%), one hematoma of scrotum (0.2%), two artificial perforations of intestine (0.3%), one case of neuralgia of n. genitofemoralis, one artificial perforation of urinary bladder (0.2%), and one postoperation hydrocele (0.2%). There were 14 relapses (2.6%) in the 534 inguinal hernias operated on with laparoscopy. CONCLUSION: Based on our experience in the solution of inguinal hernias with laparoscopy the method of transabdominally-preperitoneally localized grid (TAPP). In this method we have used three-point fixation--by a screw to pected ossis pubis and the upper margins of the grip with two transparietal stitches fixed permanently in subcutaneous tissue.

Adult↗
PubMed2003

[CHS 100P surgical mesh in inguinal hernioplasty in adults using the Lichtenstein tension-free method].

AIMS: The authors present their initial experience with surgical grid CHS 100 P with strengthened middle strip for the intestinal hernioplasty by the method without tension according to Lichtenstein. METHODS: In the inguinal hernioplasty by anterior transinguinal way in adult patients the authors use prolene grid and a surgical grid CHS 100 P with strengthened middle strip having been developed in collaboration with the Research Knitting Institute in Brno. RESULTS: From November 2001 to May 2003 56 adult patients were operated on inguinal hernia by the tensionless plasty according to Lichtenstein using a surgical grid CHS 100 P. No preoperation of postoperation complication or relapse were encountered. The patients were subject to load in the first postoperation day. CONCLUSION: Based on our first experience with flexible surgical grid with strengthened middle band CHS 100 P used for tensionless inguinal hernioplasty in adult patients according to Lichtenstein it may be concluded that the grid is well tolerated by the patients. Flexibility of the grid makes it possible to fully load inguinal area during the first postoperation day.

Hernia, Inguinal↗
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↗
PubMed2002

Limited versus total stripping of vena saphena magna.

BACKGROUND: There are two different ways to operate on patients with varicose veins. OBJECTIVES: Prospective evaluation of two groups of patients operated on in two different ways to find out more convenient procedure for varicose veins surgery. METHODS: The results of 577 patients operated on for lower limbs varicose veins were evaluated. The patients were divided into two groups. The first group comprised of 125 patients in whom limited stripping of vena saphena magna was performed. The second group comprised of 397 patients in whom total stripping of vena saphena magna was applied. In the remaining 55 patients an operation other than VSM was performed in the venous system of lower limbs. During the follow-up three months after the operation the main attention was paid to a possible neurological disturbance. RESULTS: Much better results were observed in the group of patients treated with the method of limited stripping. Neurological disturbances occurred in two patients only (i.e. 1.6%). Within the other group disturbances were encountered in 28 patients (i.e. 7%). CONCLUSIONS: Limited stripping of vena saphena magna results in lower number of neurological disturbances. (Tab. 1, Ref. 10.).

Adult↗
PubMed2001

Primary malignant melanoma of the esophagus treated by endoscopic ablation and interferon therapy.

Primary malignant melanoma of the esophagus is a rare illness accounting for 0.1-0.2% of malignant diseases of the esophagus; however, the incidence of the disease appears to be rising. The average survival time is between 10 and 15 months. The authors describe the 25 month follow up of a patient with primary malignant melanoma of the esophagus which was treated with endoscopic ablation followed by interferon therapy. No other focus was found and the patient is undergoing regular endoscopic check-ups, currently without any problems.

Biopsy, Needle↗
PubMedDate not supplied

Open versus laparoscopic appendectomy.

BACKGROUND/AIMS: To asses the role of laparoscopic appendectomy in the treatment of acute as well as chronic appendicitis on the basis of our own experiences. METHODOLOGY: From the set of 849 patients treated with appendectomy (from January 1993 to December 2000) 331 were singled out, i.e.; those unable to work for some time and thus being on sickness benefit who asked for a medical certificate. They were operated on for either acute or chronic appendicitis. RESULTS: In our set of 331 patients (158 males, 173 females, the average age 29.4) open appendectomy was performed on 179 patients and laparoscopic appendectomy on 152. Laparoscopic appendectomy was performed in 43 males (28%) and 109 females (72%); open appendectomy in 115 males (64%) and 64 females (36%). Laparoscopic appendectomy took 53.7 +/- 18.1 minutes, open appendectomy took 43.6 +/- 8.99 minutes. The time of work disablement is longer in open appendectomy (open appendectomy: 41.2 +/- 9.91 days; laparoscopic appendectomy; 29.1 +/- 15.11 days). A significant difference (p < 0.00001) can be seen in the length of hospitalization (laparoscopic appendectomy: 5.0 +/- 2.75 days, open appendectomy: 8.3 +/- 2.83 days). CONCLUSIONS: Patients who undergo laparoscopic appendectomy spent less time in hospital, and they can return to work rather earlier. On the other hand the time of surgery is longer. Higher cost is compensated for with shorter hospitalization and early return to work.

Acute Disease↗