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Biomedical subjects

P Holeczy

Publications and source records attributed to P Holeczy.

6 recordsLinked to original sources

[Prevention of venous thromboembolism in general and laparoscopic surgery].

Pulmonary embolism and thromboembolic attacks remain the most frequent cause of mortality in patients after general surgery or laparoscopy. The authors review the risk factors, indication of prophylaxis of thromboembolism and the currently used modes of prophylaxis. The so-called low-molecular-weight heparins (LMWH) are the most frequently used modes of prophylaxis. The algorithm of prevention and doses of LMWH used in general surgery and laparoscopy are presented. (Tab. 5, Ref. 17.)

Heparin, Low-Molecular-Weight↗

Complications in the first year of laparoscopic gastric banding: is it acceptable?

BACKGROUND: From December 1997 to December 1998, 25 laparoscopic adjustable silicone gastric banding (LASGB) procedures were done without previous experience in bariatric surgery. Body mass index (BMI) ranged from 37 to 57 kg/m2 (average 45.5 kg/m2). METHODS: Retrospective analysis of the 1-year experience was done. Operating time was measured, and BMI and complications were reviewed. RESULTS: Five complications were observed. There was a complication rate of 20%. On two occasions, it was gastric wall slippage, and both were corrected laparoscopically. In one patient, the intususception of the gastric wall through the band resulted after profuse vomiting. Removal of the band was necessary, with conversion to an open procedure. On two occasions, the infection of the port-site was observed, in one of these patients, port removal was necessary. No antibiotic prophylaxis was used. CONCLUSION: Despite lack of experience in bariatric surgery in these laparoscopic surgeons, the complications with LASGB appear to be acceptable. Although prior bariatric surgical experience is preferable.

Adult↗

[Laparoscopic appendectomy in acute appendicitis].

Laparoscopic appendectomy has not yet become a stable part of surgical armamentary as has laparoscopic cholecystectomy. The authors on the basis of their own experience show its benefit for the surgeon and for the patient. The conversion rate (7.7%) in the study group is comparable with literature data. The indication for operation was always periappendical mass, in combination with retroceocal position of the appendix. Minimum complication rate in the study group (one case of subfebrile fever in 5 days), very good overview in operation field with the possibility to treat also another pathologic findings concern the authors together with short hospital stay a clear advantages of laparoscopic appendectomy. On the basis of this experience their advocate the routine use of this operation. (Ref. 19.)

Acute Disease↗

[Fibronectin and the human spleen].

Fibronectins are glycoproteins with a function of molecular glue. The aim of the study is to encourage interest in processes in extracellular matrix of the spleen. Undigested cryostat or formol-paraffin sections and commercially available antibodies were used. We were mostly successful in extracellular localization of fibronectin in trabeculae, vessel walls and lamellae of circumferent reticulum of periarterial lymphatic sheaths and in the ring fibres of the sinuses. Changes in the amount of fibronectin occurred, for example, in circulation disturbances. In hereditary spherocytosis the ring fibres were reduced. Increase of fibronectin can suggest the development of fibrosis.

Extracellular Matrix↗

[Traumatic rupture of the spleen. Histopathologic findings].

The most common causes of splenic rupture are blunt injury and surgical intervention in abdominal cavity. Morphological investigation of the spleen often shows but a small capsular laceration as well as haemorrhage and granulocytic infiltration in microscopy of its margins. The laceration may be sometimes difficult to find. There are two types of microscopical haemorrhage. One in sinus-lacking subcapsular tissue zone, the other in deeper layers. In this case the tissue haemorrhage is diffuse, sometimes within or around the marginal zone. The sinuses are neither collapsed nor obturated by any material even close to margins of the wound.

Humans↗

Laparoscopic transgastric pancreatic pseudocystogastrostomy--first experience with extraluminal approach.

BACKGROUND/AIMS: Transgastric cystogastrostomy (Jurasz procedure) became a standard procedure in the treatment of mature pancreatic pseudocysts contacting the stomach. The first experience with laparoscopically performed transgastric cystogastrostomy under performing anterior gastrostomy is discussed. METHODOLOGY: Five ports were used. The anterior stomach wall was opened 2 cm in length. The communication channel with the pseudocyst was created by means of precise coagulation of the posterior stomach as well as the pseudocyst wall. The pseudocyst was evacuated and the stoma was completed by stapling with the EndoGIA lineal stapler 3 cm in length. The anterior stomach wall was also closed with EndoGIA stapler. RESULTS: Excellent results could be achieved. The pseudocyst resoluted within 1 month after the operation, and the anastomosis healed completely. The patient was discharged on the 8th post-operative day. The follow-up for 1 year was free of complications. CONCLUSIONS: Laparoscopic pseudocystogastrostomy appears to be a reliable method for treatment of large size mature pancreas pseudocysts because it is a minimally invasive procedure with standardized stapler-performed anastomosis. However, this initial experience has to be confirmed with a large number of patients.

Anastomosis, Surgical↗