Biomedical subjects

P Stádler

Publications and source records attributed to P Stádler.

14 recordsLinked to original sources

PubMed2006

A modified technique of transperitoneal direct approach for totally laparoscopic aortoiliac surgery.

OBJECTIVE: To present our modification of the transperitoneal direct approach (TDA) for totally laparoscopic aortoiliac surgery. METHODS AND RESULTS: From September 2003 to August 2005 a total of 52 patients underwent laparoscopic operations for aortoiliac disease (50 aortoiliac occlusive disease; two abdominal aortic aneurysm). The modified TDA was used in 20 patients. CONCLUSION: The main advantage of TDA is reduced dissection of the aorta and pelvic arteries resulting in lowered blood loss and lymphatic injury.

Aorta↗

PubMed2006

[Postoperative re-stenosis of the carotid--A case for reoperation or endovascular management?].

The aim of this work was to assess frequency rates of re-stenoses following surgical or endovasular treatment of re-stenoses after primary endarterectomies of the carotid artery, taking into consideration concomitant disorders and the contralateral findings. Another objective was to assess differences in peroperative and postoperative complications frequency rates. The retrospective study included patients undergoing vascular surgery during a seven-year period. The study revealed that repetitive restenoses were statistically significantly (3x) more frequent in cases of the endovascular management compared to that in re-operations (p = 0.015). In the repetitive re-stenoses patients, the rate of the contralateral carotid affection was significantly higher (93.8%, p = 0.05) and also the rate of the contralateral artery obliteration was higher (43.8%, p = 0.05). The highest frequency rates of the repetitive carotid re-stenosis was in patients with a concomitant affection of the contralateral artery. Surgical management of the repetitive re-stenosis of the carotid artery following its primary surgical management showed better results than the endovascular management.

Aged↗

PubMed2006

[Initial experience with da Vinci robotic system in vascular surgery].

Robotic operational systems improve accuracy, control of and skilful management of surgical procedures up to levels unachievable by a human factor itself. A surgeon is also allowed to conduct the types of miniinvasive procedures, which cannot be conducted using contemporary technologies. High degree of the procedure's safety can be achieved. Currently, the robotic surgical systems are used in top clinics worldwide and the concept of the robotic operating theatre is considered to become standard for some procedures in future. In October 2005, a multispecialist robotic centre was opened in the Hospital Na Homolce, which then created a new qualitative standard in the miniinvasive surgical management. The authors present the initial group of patients, who were operated from November 2005 to January 2006 with employement of the da Vinci robotic system, listing its pros and cons.

Aged↗

PubMed2005

[Allografts in the vascular surgery].

The use of allografts represents one of the therapeutic options in the treatment of vascular prosthetic infection. Close cooperation with a transplant center is unconditional for successful graft harvest and storage. Although the transplantation programme in the Czech Republic is handled in several centers across the country the use of vascular allografts is still exceptional. During multiorgan harvest procedures arterial or venous grafts have been removed and stored in antibiotic solution at 4 degrees C till implantation. Cardioplegic and short-term organ preserving solution Custodiol was used in our cohort. At the Department of Vascular Surgery of the Na Homolce Hospital in Prague fresh arterial allografts were used in 14 patients in the years 2001-2004. In all, absence of usable autologous graft was the common denominator. In ten cases previous synthetic vascular grafts were infected. Of these, critical limb ischaemia and imminent amputation due to the poor outflow tract occurred in three patients. Once, false femoral artery aneurysm infected with methicilin-resistant Staphylococcus aureus (MRSA) led to several hemorrhagic episodes. There was no early mortality but one early occlusion with subsequent major amputation. In 11 patients (79%) the procedure was uneventful at the short-term follow-up. All patients were treated with cyclosporine.

Aged↗

PubMed2005

[Laparoscopic resection of the abdominal aortic aneurysm].

Some 500 aortoiliac aneurysms are mostly electively operated in the Czech Republic each year. Miniinvasive approaches already widely accepted in general surgery are gradually becoming more routine in vascular surgery as well. Better patient comfort hand in hand with reduced hospital stay represent the major advantages of these procedures. The authors present their initial experience with laparoscopic AAA resection with the use of their own modification of the transperitoneal-retroperitoneal approach. Ischemic preconditionning's techniques with regard to the expected prolonged aortic clamping time were used during surgery.

Aorta, Abdominal↗

PubMed2004

[Comprehensive therapeutic approach to a symptomatic pseudoaneurysm in the distal aorto-aortic replacement anastomosis and carcinoma of the right kidney].

The authors present a case of a complex approach to treatment of a symptomatic pseudoaneurysm of the distal anastomosis of the aorta-aortic replacement in concurrence with a carcinoma of the right kidney. The patient was acutely hospitalized in August 2003 for a two-day-history of a stomach ache. In March 1996, the patient underwent a surgical resection and the aorta-aortic replacement of the abdominal aorta aneurysm. On admission, the CT-AG scan showed a large pseudoaneurysm (5 x 4 x 8 cm) localized in the area of the distal anastomosis with a suspected leak of the contrast matter to the surrounding tissues. Furthermore, an extrarnally bulging expansion in the superior part of the right kidney with a central necrosis measuring 31 mm and the sigmoid diverticulosis were reported as accidental findings.

Adenocarcinoma↗

PubMed2004

[Laparoscopic ilio-femoral by-pass. A case-review].

The authors introduce a laparoscopically conducted ilio-femoral by-pass operation for the external iliac artery occlusion. The common pelvic artery preparation, the clips application, the arteriotomy and the central anastomosis, all were conducted laparoscopically, the peripheral anastomosis was then carried out through a standard inguinal incision. The laparoscopic approach represents, together with angioplasties and stentgraft implantations, yet another technical variation in vascular surgery.

Femoral Artery↗

PubMed2004

[Minilaparotomy as an access route to vascular reconstruction procedures in the aortoiliac region].

Following the example of general surgical procedures, also vascular surgery gradually minimizes the size of its surgical entrances. Miniinvasive surgical procedures significantly reduce postoperative complaints and shorten the patients recovery rates. Minilaparotomy, either a hand-assisted or a laparoscopy-assisted procedure, a procedure conducted fully via laparoscopy or thoracoscopy and a robot-assisted procedure, all of the above are contemporary options for miniinvasive procedures in the vascular surgery. The authors introduce their initial experience with the use of minilaparotomy in the aortoiliac region. From November 2002 to April 2004, 29 procedures were performed for the abdominal aortic aneurysm repair or for aortoiliac occlusive disease. In 15 cases the abdominal aortic aneurysm was managed and in 14 cases the aortoiliac occlusive disease was managed.

Aged↗

PubMed2004

[Laparoscopic vascular reconstructions--initial experience].

Laparoscopic techniques, which have been found useful in the general surgical procedures, have influenced the vascular surgical procedures with a certain delay. The main reason for the delay were technical difficulties of the vascular anastomosis, which resulted in a reluctant acceptance of the laparoscopic procedures by vascular surgeons. However, with respect to clear benefits of the miniinvasive procedures, including reduction of the postoperative pain, faster recovery rates and reduction of the total treatment costs, the laparoscopic procedures are finally being applied in the vascular surgery as well. The authors introduce operative results and outcome of ten laparoscopic vascular procedures for aortoiliac occlusive disease, which were conducted from September 2003 to April 2004. In five cases, iliofemoral bypasses were conducted, fourtimes unilateral aortofemoral bypasses (AF) and once an aortobifemoral bypass (ABF). All the IF and AF reconstructions were conducted via laparoscopy and the ABF reconstruction was conducted as laparoscopy-assisted.

Aged↗

PubMed2001

[Thoracoscopic thoracic sympathectomy--personal experience].

The authors present a group of 48 thoracoscopic thoracic sympathectomies they performed in 35 patients between November 1997 and March 2000. A favourable effect was recorded in all operated patients where the defect healed or the blood supply of the upper extremities improved. Twice thoracoscopic resympathectomy was performed in a patient 15 years after classical upper thoracic sympathectomy [2] from the supraclavicular space. Twice a relapse was recorded one year after the operation. The complaints are substantially smaller than before operation. The authors emphasize the advantages of thoracoscopic thoracic sympathectomy which is associated with a minimal risk of complications.

Adult↗

PubMed2001

[An unusual extensive thrombus in the abdominal aorta of a young female patient after recurrent embolisms in the pelvis and lower extremity].

The authors present a case of an uncommon based thrombus of the abdominal aorta, which partly obturated its lumen and caused repeated embolization of the left pelvic circulation and left lower extremity. Even detailed modern diagnostic methods (angiography, CT, NMR) were unable to rule out before surgery anotheretiology of the obturating process in the aorta. Only removal of the thrombus from the abdominal aorta and subsequent histological examination elucidated the diagnosis and led to final cure.

Adult↗

PubMed1999

[Upper thoracic thoracoscopic sympathectomy as the method of choice for reoperation of the thoracic sympathetic nerve].

The authors present in their paper the possibility of thoracoscopic thoracic sympathectomy as the method of choice for reoperation of the thoracic sympathetic nerve 14 years after classical surgical upper chest sympathectomy, as the original effect had receded. They mention the possibility of reoperation of the sympathetic nerve with a subsequent favourable effect by the endoscopic method which reduces the risk of complications to a minimum.

Female↗

PubMed1998

[Comprehensive surgical treatment of mixed crural ulcers with femoropopliteal distal bypass and endoscopic elimination of Cockett's perforating veins].

The authors present an account on a successful cure of a mixed crural ulcer using combined therapy by a classical vascular surgical method and endoscopic surgery of the venous perforators of the leg. In the described case this combined treatment is the method of choice because it was not possible to use the classical Linton operation and also to protect a vascular prosthesis from infection.

Humans↗

PubMed1997

[Allogenic vein transplantation in vascular surgery].

The authors evaluate retrospectively a group of 159 applications of venous transplants for arterial reconstruction in 54 patients and for preparation of a haemodialyzation approach in the remaining 105 patients. As allograft they used the stem of the saphena magna from patients with varices kept in saline with addition of an antibiotic at a temperature of 4 degrees C. Twelve-month patency rate was in vascular reconstructions 84%, in secondary arteriovenous fistulae 45.8%. Based on data in the literature and their own experience the authors draw attention of vascular surgeons to this cheap and available material and recommend its wider use as a second choice replacement.

Arteriovenous Shunt, Surgical↗