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Biomedical subjects

P Piskac

Publications and source records attributed to P Piskac.

At least 19 recordsLinked to original sources
PubMed2005

The laparoscopic ventral and incisional hernia repair.

We retrospectively reviewed the first twenty laparoscopic ventral and incisional hernia repairs performed at the 2nd Department of Surgery, St. Anne's Teaching Hospital, Brno from March 2003 till April 2004. Laparoscopic repairs were performed using Biomesh mesh (Cousin Biotech, France) with a minimum of 3 cm overlap circumferentially with normal fascia and secured with spiraltacks every 3-4 cm and transparietal sutures. All adhesions on the parietal defect are released, using scissors, and whenever possible we attempted to reduce the hernia sac. The mean follow-up period was 7 months with a range of 2 to 13 months. There was no recurrence in the group. There were two hematomas and one seroma in our group, which disappeared without treatment. Two patients experienced transient pain, which was resolved by analgesic treatment over time. By this date, no chronic infection, bowel obstruction, or enterocutaneous fistula have been reported. In conclusion our results are encouraging and suggest that laparoscopic ventral and incisional hernia repair is a safe, feasible, and effective alternative to open techniques. (Ref. 10.)

Abdominal Wall↗
PubMed2005

[Retromuscular mesh repair of a hernia in a scar according to Rives--our first experience].

The authors present a group of 24 patients with hernias in scars operated from February 2004 to January 2005 (12 months) using a retromuscular reconstruction procedure according to Rives. 20 procedure following central laparotomies and 4 procedures following lateral laparotomies were conducted. The defect sizes ranged from 5 to 16 cm. A polypropylene mesh was used which was placed between the rectus abdominis muscle and the posterior leaf of the rectus abdominis sheath. The mesh was covered by the fascia with a minimum overlap of 5 cm in all directions. The mean follow- up period was six months (1-12 months) and no early relapses were recorderd. The complications rate was acceptable--1x secondary wound healing, 2x seroma, 1x non-transmural MI in a patient with a cardiac ischemic disorder. The retromuscular reconstruction procedure according to Rives appears to be an appropriate method for management of large ventral hernias with excellent results and minimum complications.

Abdominal Muscles↗
PubMed2005

20-year experience with operations for popliteal artery aneurysm.

At the 2nd Department of Surgery, St. Anne's University hospital Brno, a total of 76 operations for popliteal artery aneurysm were performed in 67 patients in the last 20 years, in period 1985-2004. 63 operations were elective and 13 urgent. For reconstruction, autologous saphenous vein was used in 53 cases, vascular prosthesis in 15 cases, and a cryopreserved vein allograft in 3 cases. In 5 cases, amputation for advanced lower limb ischaemia was performed without arterial reconstruction. Elective operation is indicated in all patients with popliteal artery aneurysm, and it is associated with a relatively low risk for the patient. In fact, it is a preventive operation. In the acute stage, there is a higher risk of complications and (potential) amputation (Fig. 1, Ref. 8).

Abortion, Legal↗
PubMed2004

[The subclavian steal syndrome].

The aim of this work is to summarize the authors' experience gathered during surgical procedures for the subclavian steal syndrome. The authors put forward the method of anaesthesia with patient's vigility and mobility preserved, favouring the arterial transposition procedures against the prostheses implantation methods. The main common feature of the above approaches is to increase the procedure's safety.

Female↗
PubMed2004

20-year experience in operations for subclavian steal syndrome.

The aim of this article is to summarize our experience in operations for subclavian steal syndrome. We recommend anaesthesia with preservation of patient's consciousness and mobility, and we prefer transposition of arteries to prosthesis implantation. The main characteristic of this approaches is an attempt to increase safety of operation. A feasible procedure is suggested also in the case of reconstruction occlusion: the axillo-axillary bypass. (Fig. 6, Ref. 3.)

Female↗
PubMed2003

[Pseudoaneurysms due to iatrogenic arterial injuries--observations at a vascular surgery worksite].

With advancing care of patients with cardiovascular diseases the number of invasive cardiological operations is increasing. Although effective methods are involved, these procedures are also associated with certain risks for the patient. From the aspect of vascular surgery the most frequent complications include iatrogenic pseudoaneurysms and extensive haematomas. The objective of the present work is to evaluate the development of the number of pseudoaneurysms which occurred after puncture of the femoral artery during coronarography or PTCA, and verification of the hypothesis of the declining trend of the ratio of pseudoaneurysms in the total number of performed invasive cardiological diagnostic and therapeutic operations. The author submits in his paper the retrospectively assessed number of invasive operations performed at the 1st Medical Cardioangiological Clinic of the St. Ann Faculty Hospital Brno in 1996-2001. It summarizes the number of PA dealt with during the same period by physicians of the 2nd Surgical Clinic of the St. Ann Hospital in Brno. It analyzes also the treated complications of cardiological operations in 2001.

Aged↗
PubMed2003

Patient with percutaneous endoscopic gastrostomy.

INTRODUCTION: Since 1980, when percutaneous endoscopic gastrostomy was described and performed for the first time, the number of patients with this way of nutrition has been growing. At present, however, these patients are treated not only in intensive care units, but also in follow-up care institutions or in home care. AIM: We want to explain the problems of nutrition via endoscopic gastrostomy to those physicians who take long-term care of these patients. METHODS: In our department we introduced percutaneous endoscopic gastrostomy in 1994. A total of 78 PEGs were performed. In all cases the pull technique was used. A condition for percutaneous endoscopic gastrostomy insertion was an unaffected gastrointestinal tract from the stomach in aboral direction. The most frequent indications were: necessity of long-term enteral nutrition in patients during artificial ventilation, neurological patients with lost swallowing reflex, and patients with a tumor in the ENT area with preserved patency for the endoscope. RESULTS: In all cases, the intervention itself was without major complications and no death occurred relating to the intervention. Subsequently, mainly local complications such as decubitus ulcers or maceration around the tube and its accidental removal by a restless patient were noticed. CONCLUSION: In cases of more than 6-week inability to ingest food per os with otherwise unaffected gastrointestinal tract, it is appropriate to consider the nutrition via PEG. Using this method, it is possible to ensure an adequate access for enteral nutrition for a longer time without risk of complications associated with the nasoenteric tube, with minimum trouble to the patient. (Fig. 1, Ref. 9.).

Enteral Nutrition↗
PubMed2002

[Endoscopic gastric polypectomy--personal experience].

In the time period from August 1986 to August 2001, a total of 10,260 gastrofibroscopic examinations were performed in our department. Gastric polyps were found in 28 patients--in 15 men and 13 women. Polypoid foveolar hyperplasia was present in 67.8% patients, hyperplasiogenic polyps in 21.5%, and adenomatous polyps in 10.7% of patients. Multiple gastric polyposis was found in 3 patients: in two of them all polyps were removed and one patient has regular gastrofibroscopic checkups. We did not encounter complications after endoscopic polypectomy of the stomach in our study group. Polypectomy via gastrotomy was not performed in any of our patients.

Female↗
PubMed2000

[Ischemic disease of the lower extremity and lumbar sympathectomy].

We consider lumbar sympathectomy (LSE) to be the last attempt to improve the condition of the limb. Though being aware of inconsistent opinions on LSE, we are not opponents of this method, particularly if it is carried out in a selected group of patients, that is in case of: 1) treatment of frostbites, 2) treatment of patients at an early stage of advanced ischemia whose main symptom is moderate night pain at rest, 3) desiccation of chronically moist ulcerations between the toes, 4) treatment of patients with reflex symptomatic dystrophy (causalgia), 5) Buerger's disease.

Female↗
PubMed1999

[Emergency ERCP and acute biliary pancreatitis].

In the period from 1992 to 1997, a total of 130 urgent therapeutic ERCPs were performed at the 2nd Department of Surgery of the Faculty of Medicine in Brno. The examination was indicated because of acute pancreatitis, acute septic cholangitis, and papillary ileus. Fifty nine patients with proven acute biliary pancreatitis and successful endoscopic papillosphincterotomy were followed up subsequently. Information on 44 patients could be retrieved (75%). The results were evaluated and compared with a group of patients treated for acute biliary pancreatitis at the 2nd Department of Surgery in Brno before introduction of urgent therapeutic ERCPs. In addition to lower mortality, in the group of patients who underwent endoscopy a decrease in the percentage of surgical revisions needed was reached, and in the group with conservative treatment, statistically significant reduction of hospitalization was duration achieved. (Tab. 3, Fig. 1, Ref. 14.)

Acute Disease↗
PubMed1997

[100 emergency ERCPs performed at a surgery department].

Since the year 1989 the authors, surgeons, performed more then 1600 ERCP. In the period of 1992 to 1995 urgent ERCP was indicated in one hundred cases when block of papila Vateri, cholangitis or acute pancreatitis were suspected. Our results in ERCP were: cholangitis with common bile duct stones 14, pancreatitis acuta biliaris 53, pancreatitis acuta nonbiliiaris 28, other diagnosis 1. In 4 cases, ERCP was unsuccessful. Endoscopic papillosphincterotomy (EPS) was indicated in all patients after the successful ERCP with pancreatitis or cholagitis. We achieved success in urgent EPS in 92%. No patient died owing to ERCP or EPS. From our point of view urgent ERCP and EPS are important diagnostical and therapeutical methods in patients with cholangitis and pancreatitis biliaris which may be performed as soon as possible. (in our cases all patients undergo ERCP and EPS no later than six hours after their admission to the hospital). In case of nonbiliaris pancreatitis we prefer and have good results with EPS too, but our number of these patients is too small to be generalized. (Tab. 5, Ref. 13.).

Adult↗
PubMed1997

Our experience in the surgical treatment of liver tumors in the years 1994-1996.

The study is based on the evaluation of a study group consisting of 61 patients who underwent surgery for liver tumors in the 2nd Surgical Clinic in Brno between 1994 and 1996. Liver resections were carried out in 39 patients, port-systems for regional chemotherapy were implanted in 29 patients. In recent years, port-systems have been inserted even in liver resections in indicated cases. The median survival after liver resection for hepatocellular carcinoma was 43 months, for colorectal carcinoma metastases it was 32 months. The in-hospital mortality was 3.4%.

Antineoplastic Agents↗
PubMed1996

[Emergency endoscopic papillosphincterotomy in a department of surgery].

During 1992-1994 at the Second Surgical Clinic of the Faculty Hospital (St. Ann) in Brno a total o 66 urgent ERCP were performed on account of acute pancreatis, cholangitis and rapidly progressing jaundice of the obstructive type. After the diagnostic part of the examination endoscopic papillosphincterotomy followed in 58 patients. A 92% success was achieved in endoscopic papillosphincterotomy and 77% success as regards sanation of the biliary pathways during the first session. The authors emphasize the advantages of these endoscopic method in surgical departments.

Acute Disease↗
PubMed1996

[Juxtapapillary diverticulum--the effect on endoscopic interventions and diagnosis].

Juxtapapillary diverticula are found in the contemporary population according to various sources in 10-20%. Their importance in the pathogenesis of some diseases and symptoms is beyond doubt, while in other cases, such as pancreatic diseases, it is doubtful. In the submitted material the authors evaluate experience assembled during endoscopic examinations and interventions on the papilla Vateri implemented in 1988. The authors confirm the more frequent prevalence of choledocholithiasis in patients with juxtapapillary diverticula. Juxtapapillary diverticula make endoscopic examination as well as possible subsequent interventions more difficult. It is necessary to use more complicated procedures, specially those with guides. Diverticula may even be the cause of failure or complications such as haemorrhage or perforation. For the experienced endoscopist there are, however, no decisive impediment.

Adolescent↗
PubMed1995

[Experience with 1000 ERCPs in a surgery department].

In 1988-1994 at the Second Surgical Clinic of the Masaryk University in Brno and at the Surgical Department of the Hospital of the Merciful Brethren in Valtice a total of 1037 diagnostic and therapeutic operations of the papilla of Vater were performed. Eventually after practice was assembled, the rate of successful operations was 94-99%. The authors emphasize the necessity to introduce endoscopic methods into the common practice of surgical departments; they emphasize the necessity of high-standard training of doctors and nurses. As compared with data from the literature and from other departments, the morbidity and mortality rate recorded by the authors was substantially lower.

Adolescent↗
PubMed1994

[Surgical experience with endoscopy in upper gastrointestinal tract hemorrhage].

During 1988-1994 at the Second Surgical Clinic in Brno and in the surgical department of the Hospital of Merciful Brethren in Valtice a total of 5200 fibroscopic examinations were made incl. 560 on account of haemorrhage into the upper gastrointestinal tract. The purpose of fibroscopy was to detect sites of haemorrhage and treat them, or to establish at least the level of the haemorrhage. Visualization of the source was achieved in 90%, the level was assessed in 7.5% and failure was recorded in 2.5%. By treatment of the source of haemorrhage primary haemostasis was achieved in 83.32%, definitive haemostasis in 77.01%. Endoscopy of acute haemorrhage into the GIT is at present the method of choice when resolving these conditions. Classical procedures involving supplementation of the blood volume and waiting for spontaneous haemostasis should be considered as "non lege artis" procedures.

Adult↗