Biomedical subjects

S Czudek

Publications and source records attributed to S Czudek.

12 recordsLinked to original sources

PubMed2006

[Prevention of venous thromboembolism in surgery, in laparoscopic surgery, in venous surgery and in urology].

The article summarizes published data regarding the prophylaxis of venous thromboembolism in surgery, in laparoscopic surgery, in venous surgery and in urology. In surgical patients with low risk, no specific thromboprophylaxis is needed. Patients with moderate risk levels are the candidates for administration of subcutaneous low molecular weight heparin (LMWH) at doses under 3 400 anti-Xa units a day and patients with increased risk at doses higher than 3 400 anti-Xa units a day during the period of higher risk. In order to decrease the risk of bleeding, a half dose 2 hours prior or 4-6 hours after the operation can be administered. Under the highest risk conditions, there is a recommendation to combine LMWH over 3 400 anti-Xa units with elastic panty-hose or, alternatively, with intermittent pneumatic compression (IPC). At moderate risk levels, subcutaneous administration of unfractionated heparin at the doses of 5 000 units twice a day is also possible and at increased risk levels, a TID administration (LDUH) over the increased risk period. In patients with a significant bleeding risk, the physical method of thromboprophylaxis can be used and pharmacological prophylaxis can set in after the risk of bleeding has passed. Fondaparinux is the alternative to LMWH in people with a history of heparin induced thrombocytopenia over the past three months. The sole use of acetylsalycilic acid is not recommended. While undertaking epidural anaesthesia or analgesia, it is necessary to follow strictly the guidelines of the use of pharmacological thromboprophylaxis. Thromboprophylaxis with LMWH, LDUH, elastic panty-hose or IPC is indicated only in those patients who undergo laparoscopic surgeries and who moreover display the additional thrombosis factors. Patients with additional risk thrombosis factors undergoing major venous reconstructions require prophylaxis with LMWH (or LDUH). Uncomplicated patients undergoing transurethral or other low risk urologic surgery require no specific thromboprophylaxis. If they undergo a major intervention and/or they display additional risk thrombosis factors, they require the administration of LMWH or LDUH. Elastic panty-hose and/or intermittent pneumatic compression have the same indication as in abdominal surgeries.

Anticoagulants↗

PubMed2006

[Laparoscopy-assisted exenteration of the pelvis in a locally advanced rectal carcinoma].

INTRODUCTION: In this pilot study, based on three case-reviews, the authors report on their initial experience with the laparoscopy-assisted total exenteration of the pelvis, conducted in patients with locally advanced rectal carcinomas. METHODS: In two patients with histologically confirmed rectal carcinomas, the neoadjuvant radiochemotherapy was initiated, due to the locally advanced tumor finding, aiming to downstage and locally control the disorder. The pelvic exenteration was indicated, based on the control findings of the imagining methods. In one patient, due to repetitive enterorrhagies, the primary surgical management was indicated. RESULTS: The surgical procedures were multidisciplinary, assisted by urologists. In all three cases, the laparoscopic resections, followed by planned conversions and constructions of the ileouretheral conduit and the terminal sigmoidostomies (resp. with their maintenance), were completed. Prior to the procedures, in all the three patients, the presence of distant metastases was excluded. No peroperative complications were recorded in the case-reviews. In one case, postoperative re-suturing of the wound was inevitable, due to its dehiscence. In this patient, the enzymatic acute MI, without the ECG correlate, was diagnosed. CONCLUSION: The laparoscopy-assisted pelvic exenteration may be a suitable modification of the classical surgical procedure in selected patient groups with locally advanced colorectal carcinomas. Good visualisation and exact orientation in the region of the small pelvis, as well as other generally accepted advantages of miniinvasive procedures, are the pros of the method.

History, 17th Century↗

PubMed2006

[Colorectal cancer--short time results of laparoscopic resection in 350 patients].

BACKGROUND: Laparoscopic resection of the colon with its results is fully acceptable method of choice in patients with colorectal cancer. Authors present their own experiences. METHODS AND RESULTS: A retrospective study of 350 patients who undergone laparoscopic resection because of colorectal carcinoma (curative or palliative) from January 1, 2002 to December 31, 2005. From these patients 50.8 % were operated in the 1. and II. grade of the disease, it means without detectable metastases of the lymphatic nodes. Patients with the carcinoma localised in rectosigma and rectum - 61.1 % dominate in our study. The conversion of the laparoscopic operation was necessary in 9.1%, in 13.1% there were surgery postoperative complications and postoperative mortality was 1.4%. Normal eating was allowed to patients in average 4.1 days after the operation and the average hospitalisation time was 8.3 days. We mentioned also the time of operation in various types of resection, size of resection express by the number of detectable lymph nodes and necessity of the postoperative analgesic therapy. CONCLUSIONS: Laparoscopic resection of the colorectal cancer is today method of choice, which is safe for patient and with the same morbidity and mortality as in open surgery, provides advantages of mini-invasive approach.

Adult↗

PubMed2005

[Laparoscopy in the colorectal carcinoma treatment].

AIM: The authors present their experience and results with laparoscopic surgery in the colorectal carcinoma treatment in the Centre of Miniinvasive Surgery of the Podlesí-Trinec hospital. METHODOLOGY: In this retrospective study, the authors present a group of 148 patients with colorectal carcinomas operated by their team from 1st January, 2002 to 30th June, 2004. RESULTS: The authors completed resection procedures in 133 patients. In 15 patients, with respect to the extent of their disorder, the authors had to apply derivation colostomies, to construct by-pass ileotranversal anastomoses or to complete the procedures with exploration laparoscopies. CONCLUSION: Thank to miniinvasive techniques, laparoscopy has found its place also among the colorectal carcinoma treatment methods. The presented results, in accordance with other studies published in literature worldwide, present this method as a suitable one for a patient and fulfilling all criteria of the onco-surgical radicality.

Adult↗

PubMed2005

[Surgical complications of laparoscopic colectomy in patients with colorectal carcinomas].

INTRODUCTION: The authors present their experience with laparoscopic resections of the large intestine in patients with colorectal carcinomas. The aim is to discuss and assess peroperative and early postoperative surgical complications. METHODOLOGY: From 1st January to 30th June, the team of authors operated over 350 patients with colorectal carcinomas. In 264 patients the team completed laparoscopic resections (laparoscopy-assisted) of the colo-rectum. Patients who, following an initial laparoscopic exploration, underwent a classical procedure and patients who underwent derivation stomies, eventually by- pass procedures, were excluded from the study group. RESULTS: In 16 patients (out of the total 264 laparoscopic colectomies) the laparoscopic procedure was converted. The rate of peroperative complications was 3.4% and the rate of postoperative surgical complications was 14.4%. Five patients in our study group exited before the postoperative day 30. Two of these cases were directly related to surgical postoperative complications. CONCLUSION: Laparoscopic colectomy is a method of choice in patients with colorectal carcinomas. The more experienced the surgeon and the whole team, the lower the total lethality rate. The rate is similar to that of classical colectomies, however some indicators prefer the laparoscopic procedure.

Adult↗

PubMed2004

[Laparoscopic therapy of inguinal hernia--transabdominal onlay mesh (TOM)].

AIM: A presentation of the authors experience and results with the TOM (Transabdominal Onlay Mesh) when using the laparoscopic method for the inguinal hernia treatment. MATERIAL AND METHOD: The laparoscopic treatment method of the inguinal hernia has been used in the Centre of the miniinvasive surgery in Podlesí since October 1992. Until September 2003, we had operated 4910 patients, who were treated for 5399 inguinal hernias. From January 1999 to October 2003 we operated 3550 inguinal hernias in 3183 patients using the TOM method (367 hernia cases were bilateral). RESULTS: The average operation time in cases of uncomplicated hernias during unilateral surgical procedures is 21.4 minutes and during bilateral procedures is 31.5 minutes. Complications totaled 1.268% (peroperative 0.282% and postoperative 0.986%) The average patients age was 51.3 years (17-91). There were 87.8% males and 12.2% females. 96 patients were assigned to the one-day surgery programme. CONCLUSION: We believe that the use of the TOM method in the laparoscopic treatment of the inguinal hernia is grounded and that, with further development of new prosthetic materials, it will obtain a broader spectrum of applications.

Adolescent↗

PubMed2001

[Methods of intraperitoneal placement of mesh in laparoscopic surgery of inguinal hernias (IPOM--Intraperitoneal Onlay Mesh)].

BACKGROUND: Intraperitoneal onlay mesh is a new method of laparoscopic inguinal hernia repair shortening an operative time and reducing its cost, which is very safe and less burdening a patient. METHODS: 325 males and 37 females at the mean age of 47.3 years were operated on electively for symptomatic inguinal hernia by IPOM method. In all cases we used a polyester mesh impregnated with silicone. RESULTS: The mean operative time was 18 minutes for unilateral procedure and 28 minutes for bilateral one. There was no serious complication during the operation even the post-operative time and no recurrency following this type of the operation. CONCLUSION: IPOM hernioplasty can be a method of choice in the inguinal hernia repair because of this procedure is very simple, cheap and safe for a patient. We have to wait for a long-term results to validate the hitherto existing ones, even if they are very optimistic.

Female↗

PubMed1999

Miniinvasive approach to the treatment of liver cysts.

During the period from 1995 to 1997 we followed and treated six patients for liver cysts. Diagnostics was based not only on clinical examination but also on ultrasonography and computational tomography (CT). Surgery is applied in solving larger cysts damaging liver parenchyma and causing pressure symptomatology. Nowadays most cysts can be solved by means of laparoscopy.

Adult↗

PubMed1997

[Laparoscopic reconstruction in inguinal hernias].

The author describes his experience with laparoscopic plastic operations of inguinal hernias by means of a prolene net. This tension-free method makes rapid convalescence and return to normal life possible. A very important advantage as compared with classical procedures is the substantially lower percentage of relapses. Advanced experience (639 plastic operations) by the TransAbdominalPrePeritoneal method justify the following conclusions: The operation is much less painful, it is cheaper (if we take into account the costs of a longer stay in hospital and longer work incapacity after classical plastic operations of inguinal hernias) and there is a lower percentages of relapses (0.6%). The author has the most favourable experience using a net with a preperitoneal transabdominal approach. The very good results obtained with 639 operations are a reason for optimism. The development of new techniques will, no doubt contribute to a clearer view of this complicated problem.

Hernia, Inguinal↗

PubMed1994

[Surgical laparoscopy in inguinal hernias, results of 143 operations].

The authors present a new surgical approach in inguinal hernias by the laparoscopic route, using a prolene mesh and a transabdominal preperitoneal approach. The advantages are excellent anatomical orientation, reduction of relapses, reduction of the postoperative discomfort, shorter convalescence and more rapid return to work. The future will show whether the described procedure is optimal.

Hernia, Inguinal↗

PubMed1994

[Report on 3061 laparoscopic cholecystectomies].

The results of 3061 laparoscopic cholecystectomies made by 58 surgeons in nine departments--feasibility 88.9%, low morbidity rate (n = 2071) 11.8%, high morbidity rate 2.48%, mortality rate 0.22%, residual choledocholithiasis 1.36%, preoperative use of endoscopic methods 1.0%, revision in a total of 1.8%--are as a rule less favourable than summarized statistical data from abroad. Similarly as in data abroad the incidence of biliary lesions is not satisfactory--0.65%. The incidence of fistulas (0.13%) revisions on account of haemorrhage (0.29%) and surgical preoperative accidents (0.24%) was lower. Departments which use thermocoagulation have a significantly lower incidence of lesions (0.14% - p < 0.06) than teams working with electrocoagulation.

Cholecystectomy, Laparoscopic↗

PubMed1993

[Laparoscopic cholecystectomy and choledocholithiasis].

Laparoscopic operations are a revolution in surgery. So far they were developed most in surgery of the biliary pathways. The authors emphasize the necessity to extend diagnostic and therapeutic examination methods of the biliary pathways pre-, intra- and postoperative ERCP, pre- and intraoperative cholangiography, choledochotomy, choledochoscopy, concrement extraction. Only then laparoscopic operations attain their full importance with all advantages--postoperative comfort, reduced period of treatment, hospitalization and convalescence, cosmetic effect. The authors present in the submitted paper their own experience and world-wide trends--mainly in the USA and France.

Cholangiopancreatography, Endoscopic Retrograde↗