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M Schnorrer

Publications and source records attributed to M Schnorrer.

At least 19 recordsLinked to original sources
PubMed2004

[Surgical treatment of pulmonary metastases--long-term results].

A group of 103 patients operated for lung metastases in the Surgical clinic of the FNsP of L. Dérer and in the II Surgical clinic of L. Pasteur is assessed in this work. Minor operations of atypical resection prevailed among the resections. The postoperative mortality in the whole group was 1.9%. The best long-term survival rates were reached in tumors primarily treated by chemotherapy and followed by the lung metastasectomy. All patients in this group suffered from testical tumors and their long-term survival rate was 69%. In tumor cases, where the metastasis was primarily removed by surgery, the long-term survival rate correlated with the literature data of 30%. When the prognostic factors were considered, the number of removed metachrone metastases being less than 3, appeared statistically significant from the point of view of the patient survival. Based on the evaluated results, it can be concluded that surgical treatment of the lung metastases performed within the interdisciplinary oncological concept, currently remains a generally accepted therapeutic procedure.

Adolescent↗
PubMed2001

Delayed orchiectomy after chemotherapy in patients with advanced testicular cancer.

INTRODUCTION: The therapeutic procedures in the management of testicular cancer are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis. However, all advanced tumors could be treated by primary chemotherapy regardless of the histological findings. The current imaging techniques (ultrasound of the testis, abdominal and chest CT examination) and laboratory tests (determination of serum tumor markers AFP and hCG) provide sufficient evidence for the presence of cancer. When the diagnosis of advanced tumor is evident, it is possible to start the treatment without orchiectomy. The aim of this study was to evaluate the advantages of neo-adjuvant chemotherapy with delayed orchiectomy in the management of advanced testicular cancer. MATERIAL AND METHODS: A total of 36 patients with advanced germ cell testicular cancer underwent primary PVB or BEP chemotherapy without previous orchiectomy. Mean age of patients was 32 years. Detailed medical, surgical and urological examination showed pulmonary metastases and/or extensive abdominal tumorous masses imitating acute abdominal crisis and impaired drainage of the kidney due to ureteral obstruction. Searching for the origin, testicular tumor was detected. Eleven patients had a bulky disease in the retroperitoneum (Stage IIC), two had enlarged retroperitoneal lymph nodes (Stage IIB), two had enlarged mediastinal lymph nodes (Stage III) and other 16 patients had also pulmonary metastases, and 5 pts had pulmonary metastases only. The patients were treated with cisplatin-containing combination chemotherapy. Following completion of chemotherapy, orchiectomy was performed alone or simultaneously with retroperitoneal lymph node dissection (RPLND) and/or lung metastasectomy in cases with persistent residual mass. Following orchiectomy the patients were regularly checked and in cases with viable malignant tumor found in the testis sequential chemotherapy was administered. Similarly when the relapse of the disease was detected, the patients were treated with sequential chemotherapy. RESULTS: Complete disappearance of metastases was observed in 12 patients following chemotherapy alone. The residual mass persisted in 24 patients (in 22 out of them in the retroperitoneum and in two patients also in the lungs) and was removed surgically. The viable tumor in the removed tissue was found in one patient. Delayed orchiectomy was performed simultaneously with surgical removal of residual mass in the retroperitoneum in 24 patients and as a separate procedure in 12 patients who have been considered to be complete responders following chemotherapy alone. Residual viable tumor in testicular specimen was found in three patients, necrotic or fibrotic tissue in 18, and mature teratoma in 15 patients. Overall survival of the patients was 26/36 (72.7%) at mean of 56.9 months (range 7-145 months, median 50 months) since the start of the treatment. CONCLUSIONS: In patients with advanced germ cell testicular cancer preference must be given to the early beginning of intensive chemotherapy without the need of tissue diagnosis of primary tumor that should be obtained by orchiectomy. Benefit of this therapeutic approach is the timely management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases.

Adult↗
PubMed2001

[Delayed orchiectomy and surgery of metastases after primary chemotherapy in the treatment of advanced testicular tumors].

OBJECTIVE: The therapeutic procedures in the management of testicular germ cell tumors (TGCT) are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis. However, all advanced TGCT could be treated by primary chemotherapy (CHT) regardless of histological findings. The current imaging techniques (ultrasonography of the testis, abdominal and thoracic CT examination) and laboratory tests (determination of serum tumor markers AFP and hCG) provide sufficient evidence for the presence of TGCT. In cases of acute abdominal and/or pulmonary symptoms because of life-threatening distant metastases, when the diagnosis of advanced TGCT is evident, it is possible to start the treatment without primary orchiectomy (OE). The aim of this study was to evaluate the advantages of neo-adjuvant CHT with delayed OE in the management of advanced TGCT. MATERIAL AND METHODS: During last 12 years a total of 40 patients with advanced TGCT were treated by neo-adjuvant cisplatin-based combination CHT without previous OE. Eleven patients had bulky mass in the retroperitoneum (Stage IIC), three patients had enlarged retroperitoneal lymph nodes (Stage IIB), two patients had enlarged mediastinal lymph nodes (Stage III). Another 24 patients had pulmonary metastases (Stage IV), 15 of them had also bulky mass in the retroperitoneum and 6 of them in the mediastinum. Following the completion of CHT, OE was performed alone or simultaneously with retroperitoneal lymph node dissection (RPLND) and subsequent lung metastasectomy in cases with persistent residual mass. RESULTS: Complete disappearance of metastases was observed in 13 (32.5%) patients following PVB or BEP CHT alone. The residual mass in the retroperitoneum was removed surgically in 27 patients. In three of them residual tumorous mass was removed also from the lungs without finding of viable tumor. Viable malignant tumor in the removed retroperitoneal tissue was identified in two patients (7.4%). Residual viable malignant tumor in the testis was found in 5 patients (12.5%). Overall survival was 29/40 patients--72.5% (by mean of 55.2 months since the start of the therapy). CONCLUSIONS: The benefit of this therapeutic approach in the immediate management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases. Another advantage is the like hood of surgical treatment of residual metastatic masses simultaneously with delayed OE on the same day, under one anaesthesia.

Adult↗
PubMed2000

[Simultaneous occurrence of acute myasthenia gravis and acute polymyositis in 3 patients and in 2 patients also associated with a thymoma].

In the Slovak Centre for Neuromuscular Diseases 768 patients with myasthenia gravis are on the records. 112 myasthenics (14.5%) have another associated autoimmune disease. Most frequently a combination with an autoimmune disease of the thyroid gland or rheumatoid arthritis is involved. Extremely rare is the concurrent manifestation of the acute form of mysthenia gravis and acute polymyositis, observed by the authors in three patients,incl. two associated with a thymoma. In all three patients the disease had a serious clinical picture which called for controlled ventilation and a nasogastric tube. From the prognostic aspect rapid and correct diagnosis and early adequate treatment--combined immunosuppressive treatment (prednisone, azathioprin) is most important, incl. large i.v. doses of methylprednisone, repeated plasmaphereses, i.v. administration of human immunoglobulin, 0.4 g/kg body weight for a period of five days and optimally timed thymectomy with removal of the thymoma.

Female↗
PubMed1999

[Determination of prognostic factors in surgical treatment of myasthenia gravis].

The authors evaluated, using statistical analysis, the importance of prognostic factors in patients subjected to thymectomy on account of myasthenia gravis. The results revealed a better prognosis of the disease, if the history was less than 6 months, preoperative treatment less than 1.5 years, a histological finding of thymus hyperplasia, second clinical stage according to Ossermann and the patients age below 30 years. From the statistical analysis ensues that the prognosis of myasthenia gravis is more favourable when the case-history is shorter as a result of rapid diagnosis and when preoperative treatment is reduced to a minimum.

Adult↗
PubMed1999

[Thymectomy at the 2nd Surgical Clinic of the Comenius University Medical School Hospital].

Based on comparison of two groups of thymectomies (46 in 1955-1975 and 158 in 1990-1998) the authors found a marked improvement of the results of thymectomy. During the former period thymectomies had a severe postoperative course with a high lethality and low percentage of remissions. Due to the introduction of immunosuppressive treatment the lethality of thymectomies declined to almost zero and clinical and pharmacological remission resp. was recorded in 70% patients.

Adolescent↗
PubMed1998

[Hernias in scars].

The authors evaluated a group of patients operated at the Surgical Clinic in 1992-1996 on account of a hernia in a scar by the Mayo plastic operation. During a mean follow-up period of 33 months 44% patients were re-operated or had a relapse. The results confirmed data reported in the literature of 30-50% relapses of hernias in scars when synthetic nets are not used. With regard to the unfavourable results the authors use since November 1997 synthetic nets in plastic operations of hernias.

Abdominal Muscles↗
PubMed1996

[The effect of age and risk factors on postoperative complications and mortality in patients with surgery for colorectal carcinoma].

The authors analyzed the risk factors and their impact on perioperative complications and mortality in aged patients electively operated due to colorectal cancer at the II. Surgical Clinic LFUK in Bratislava during the period from January 1, 1986 to October 31, 1994. The patients were divided into three groups according to WHO criteria, those younger than 65, from 65 to 75, and older than 75 years of age. The results are in correlation with the data published in literature. According to the accomplished results the age per se does not represent contraindication to surgical intervention. However, the lethality in the aged patients with two or more risk factors significantly increases. In regard to the latter the authors recommend a strictly individual consideration as to whether these patients would benefit more from palliative therapy procedures as to life prolongation and its quality improvement. (Tab. 5, Ref. 25.)

Age Factors↗
PubMed1996

[Results of long-term follow-up of surgical treatment of pulmonary metastases of testicular germ cell tumors].

The authors analyse 34 cases of surgeries performed due to residual pulmonary metastases with germinative testicular tumours. Good results in the length of survival are ascribed to thoracotomy, or sternotomy with the resection of metastatic foci, i.e. the only method which reliably ascertains the biological nature of residual pulmonary lesion after chemotherapy. (Tab. 1, Fig. 2, Ref. 17.)

Adolescent↗
PubMed1996

[Sclerotherapy of varicosities of the lower extremities].

The authors used ambulatory sclerotherapeutic treatment in 910 patients whom they also followed up. All these patients suffered from primary and relapsing varicosities of the lower extremities. A favourable effect was recorded in 82% of the patients. A relapse was recorded in 13.2% of patients, where subsequent operation was recommended. Complications after sclerotherapy were recorded in 4.5% patients.

Adolescent↗
PubMed1996

Management of germ cell testicular cancer with pulmonary metastases.

Twenty eight patients with germ cell testicular cancer pulmonary metastases received primary chemotherapy including bleomycin, etoposide, and cisplatin (BEP). Complete response was achieved in 21 (75%) patients, in 11 of them CR was achieved following chemotherapy alone. Postchemotherapy surgery of residual mass was performed in 12 (42.9%) patients with normalized serum tumor markers. Retroperitoneal lymph node dissection was performed in one patient, pulmonary surgery in four, and both postchemotherapy treatments in 7 patients. Overall cure rate was 89.3%, 26 (92.9%) patients are still alive at a mean follow-up of 19.7+ months (range, 3-34+ months) after the treatment start. Two (7.1%) patients died: one of them due to disease progression during chemotherapy, and the second one due to postoperative complication (acute respiratory failure). Relapse of disease was observed in one patient 21 months following CR achievement, and sequential chemotherapy was introduced. Authors recommend surgical remove of all radiologically detected residual deposits, because the available imaging methods are not adequate for determining the histologic composition of residual mass, which is decisive for further therapy and has prognostic value.

Adolescent↗
PubMed1996

[Amputation of the lower extremities for non-traumatic causes in Slovakia in 1995].

The authors submit a questionnaire-based epidemiological study from 61 surgical departments in Slovakia, focused on the problem of amputation of the lower extremities. The objective of the study was to evaluate indirectly the standard of care of diabetic feet in Slovakia. In the study 61 surgical departments participated with a catchment area comprising 4,814,000 insured persons, i.e. 85% of the Slovak population. In these patients a total of 2116 amputations on account of non-traumatic causes were performed (44/100000 population). This number included 1578 diabetic patients (74.6%). Minor amputations were performed 1044 times, incl. 92.2% in diabetic subjects. Major amputations were made 1072 times, incl. 57.3% in diabetics. The prevalence of major amputations in 1995 was 21.8/100000 population. The authors recorded a 2.65 fold increase of the total number of amputations since 1985. They recorded dissatisfaction with the small number of revascularization operations-total 294 (13.9%) which is only one quarter of the desirable number. The authors submit their study as the basis for a systemic solution of care of the diabetic foot in Slovakia and as a challenge for its improvement.

Amputation, Surgical↗
PubMed1996

[Atypical abdominal abscesses].

In case-histories of four patients the authors present an account on atypical abdominal abscesses which are late symptoms of advanced malignity of the large bowel or inflammatory intestinal disease. They discuss whether it is suitable to use percutaneous drainage or surgery. The latter holds despite the higher mortality a permanent place in the solution of serious intraabdominal infections, in particular if combined with malignity.

Abdominal Abscess↗
PubMed1995

[Myasthenia gravis and 93 thymectomies. Therapeutic strategies and results 1990-1994].

The authors evaluate 93 thymectomies they performed in the course of five years. Indication for surgery was in all instances myasthenia gravis. Surgery was used only after conservative treatment, the patients had to be asymptomatic or have only minimal myasthenic manifestations. Thymectomy was associated with a 6.4% morbidity and zero mortality. On long-term follow-up the results were excellent or very good in 66.7% of patients and marked improvement was recorded in 30.1%. Thymectomy is part of comprehensive treatment of patients with myasthenia gravis.

Adolescent↗
PubMed1995

[Splenectomy and sparing surgery of the spleen].

In 1958-1993 the authors made at the Second Surgical Clinic in Bratislava 357 splenectomies on account of haematological diseases and four conservative operations of the spleen. They consider it inevitable to seek accessory spleens and to drain the left subphrenic space. Analysis of long-term results revealed that clinical and laboratory remission was achieved in particular in lienal types of destruction. The authors draw attention to the possibility of preserving the spleen or its part in some lienal diseases such as pseudocysts and cysts of non-parasitic origin. In conservative operations of the spleen the use of the fibrin glue. Tissuecol, is of basic importance. It was shown that 25-30% of the original tissue suffices to preserve complete function of the spleen.

Adolescent↗
PubMed1995

[Carcinoids of the appendix].

Based on a group of six patients with carcinoid of the appendix treated at the Surgical Clinic of Dérer's Hospital in Bratislava in 1988/93, the authors discuss the diagnosis and treatment of clinically silent carcinoids (< 2 cm). Appendectomy was performed and the mesoappendix was removed. The prognosis of these patients is good, after five years 100% of the patients survive. The carcinoid syndrome is a symptom of an advanced tumour or secondaries in the liver where comprehensive treatment (surgery + metastasectomy + chemotherapy) is indicated. One third of the patients survive after five years.

Adult↗