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Marcin Strzałka

Publications and source records attributed to Marcin Strzałka.

6 recordsLinked to original sources

Is the Lichtenstein operation of strangulated groin hernia a safe procedure?

BACKGROUND: In spite of many published articles describing the hernia repairs, there are only a few original reports concerning the polymer mesh application during emergency procedures for strangulated inguinal hernias. The aim of our study was to evaluate the results of the Lichtenstein and Bassini operations for strangulated groin hernias and to show the changing number of the tension-free repairs. METHODS: From 1997 to 2004, the Bassini procedure was performed in 21 patients, 6 of whom underwent small intestine resection and 2 others required resection of the necrotic omentum. The strangulated intestinal loop or omentum were released in 13 cases. After the repair 1 patient died of shock caused by intestinal necrosis. Of 56 patients who underwent an emergency Lichtenstein procedure, 55 were followed-up. A small intestine resection was performed in 2 cases to correct segmental necrosis. The gangrenous omental appendix of the sigmoid colon was excised in 1 patient, and necrotic omental fragments were resected in 2 cases. The strangulated intestinal loop or omentum was released in 51 patients. All patients were given wide-spectrum antibiotics intravenously. RESULTS: Between 1997 and 2000 tension-free procedures were performed in half of the patients undergoing emergency operation for strangulated hernia; between 2001 and 2004 such procedures were employed in more than 90% of the cases. In 2 patients we observed a small inflammatory infiltration of the wound that resolved within several days after Lichtenstein repair. A serous fluid collection was present in 2 cases. The treatment consisted of puncture and was successful in both cases. CONCLUSIONS: The use of monofilament polypropylene mesh for strangulated inguinal hernia repair is safe, and the risk of the local infectious complications is low.

Aged↗

[The decade of laparoscopic cholecystectomy].

The role of laparoscopy in the treatment of gallbladder stones has been discussed. Operative technique, intraoperative difficulties, complications and its treatment were presented. Indications, postoperative course, advantages and drawbacks of minimally invasive techniques in the treatment of cholelithiasis were discussed.

Cholecystectomy, Laparoscopic↗

[Acute appendicitis--open or laparoscopic surgery?].

UNLABELLED: Laparoscopy is used more and more frequently in the treatment of abdominal emergencies including acute appendicitis. This technique has a lot of advantages especially in the group of the young female patients, where the differential diagnosis between gynecological diseases and appendicitis is difficult. AIM OF THE STUDY: The study is designed to compare the results of open and laparoscopic exploration in patients with suspected appendicitis. MATERIAL AND METHODS: From 1998-2001 we performed 278 operations for suspicion of appendicitis in the 2nd Dept. of Surgery of the Jagiellonian University. There were 127 laparoscopic procedures performed in 46 men and 81 women (mean age 28.6 years) and 151 classical exploration in 99 men and 52 women (mean age 37.9 years). We reviewed retrospectively the patients' data analysing age, sex, duration of the procedure, length of the hospital stay, intraoperative and postoperative complication rate. RESULTS: The patients operated classically were older than patients operated laparoscopically. The proportion of male and female patients was reversed in both types of exploration. The female patients composed a majority (2/3) in the case of laparoscopic procedures and minority (1/3) in the case of open operations. The average duration of open appendectomy was 43 min. as compared with 49 min. of laparoscopic procedure, which was however getting shorter in the analysed period. The mean length of the hospital stay was twice shorter after laparoscopic appendectomy (4.8 days vs 8.4 days). There were only 4 (3.15%) complications connected with laparoscopic technique and 34 (22.52%) complications after open appendectomy. There were 12 (9.45%) conversions, most of them in patients with the retrocoecal position of the appendix. The diagnosis of acute appendicitis was confirmed in similar percentage in both operation types (laparoscopy--78.74%, open technique--79.47%). There were also similar proportions of the patients with no macroscopical changes in the appendix and with other abdominal diseases. CONCLUSIONS: Laparoscopy allows for the precise diagnosis and final treatment in most patients with the suspected acute appendicitis. Some patients also avoid laparotomy. Hospital stay is significantly shorter and complication rate is markedly lower among patients operated laparoscopically.

Acute Disease↗

[Maffucci's syndrome with giant tumor of the thoracic wall].

Maffucci's syndrome is a rare nonhereditary malformation of mesodremal dysplasia origin which consists of multiple hemangiomas of the soft tissue and multiple enchondromas. Only approximately 170 cases of this disease have been reported in the literature. Maffucci's syndrome is known to be associated with tumors of mesodermal origin. Chondrosarcoma, osteosarcoma and angiosarcoma are the most common malignant neoplasms and the benign tumors consist of pituitary adenoma, adrenal cortical adenoma, parathyroid adenoma, thyroid adenoma and breast fibroadenoma. We present a case report of a 26-year old female patient with Maffucci's syndrome and a giant thorax tumor composed of fibroadenoma and canalicular adenoma.

Adenoma↗

[Type 1 carcinoids and ECL-cell hyperplasia of the gastric mucosa].

Carcinoids develop from neuroendocrine cells. These cells share the same origin from ancestor stem cells in the regenerative zone of the gut. There are a few types of neuroendocrine cells in the stomach, mainly: G cells (antrum), D cells (corpus and antrum), ECL cells (corpus and fundus), D1 cells, EC cells, P cells and X cells. Each type of the endocrine cell is able to a tumor formation, but the gastric carcinoids are most likely to derive from ECL cells. The dominant type of cells of the corpus and fundus mucosa are the ECL cells. They constitute up to 30-40% of the neuroendocrine cells of the stomach and release histamine which is responsible for parietal cells stimulation. Hypergastrinemia predisposes ECL cells to proliferation. There is a continuity of changes ranging from simple hyperplasia to ECL cells carcinoids (often multiple). Among three types of gastric carcinoids, type three is aggressive and highly malignant, while type one is the most common but of low malignant potential. This publication presents 7 patients with extensive ECL cells hyperplasia and type 1 gastric carcinoids. The endocrine cells and carcinoids were visualized with the immunohistochemical reaction to chromogranin A. Prolonged, lasting several years observations of some of the patients under study confirm the indolent character of the disease. Individual, type-adapted, conservative treatment is sufficient.

Aged↗

[Laparoscopy in abdominal emergencies].

Up-to-dated concepts about the use of laparoscopy in the "acute abdomen" have been discussed. Most frequently performed procedures in abdominal emergencies and trauma were presented. Indications, contraindications, advantages and drawbacks with regard to own experience and literature were discussed.

Abdomen, Acute↗