Biomedical subjects
Publications and source records attributed to V Smolen.
The authors discuss the important problem of healing, infection of surgical wounds and causes of healing per secundam. Despite efforts on the part of surgeons to close the surgical wound, in particular in old people with polymorbidity, hypoproteinaemia and anaemia, disintegration of the surgical wound may occur which cannot be closed and healing must proceed while the abdomen is open.
The paper represents our results of laparoscopic vagotomies. In 1993 was the first successful laparoscopic vagotomy in Slovakia performed, at the 1st Department of Surgery, Faculty Hospital, Bratislava. From this time 10 operations with front superselective and dorsal truncal vagotomy were performed. Effectiveness of vagotomy was controlled after 12 months by examination of the gastric acidity. Decrease of gastric acidity in average above 61% was reached. Laparoscopic vagotomy, despite dominant conservative treatment of peptic ulcer, is the method of choice, if the conservative treatment is unsuccessful. (Fig. 3, Ref. 6.)
BACKGROUND: The objective of all forms of sclerotization by substances irritating the endothelium is the production of a permanent fibrous venous occlusion and reflux points controlling the abnormal flow of venous blood. The high percentage of relapses after surgery-as high as 65% within five years after surgery was the authors' motivation for the evaluation of results of two sclerotization technique: Sigg's Swiss method using Aethoxysclerol as the sclerotizing substance and Fegan's English method using S.T.D. substance. METHODS AND RESULTS: In 1974 to 1994 the authors sclerotized a total of 3161 patients, 84% women (mean age 43.7 years-range 15 to 78) and 16% men (men age 47.3 years-range 17 to 73). In 1973 to 1983 they used Sigg's technique with Aethoxysclerol (0.5 to 4% concentration). This group comprised 1325 patients. In 1983 to 1994 they used only the English technique described by Fegan, using S.T.D. The latter group comprised 1836 patients. In patients where there were doubts about the condition of the deep and perforating venous system they used as a diagnostic method aimed phlebography under sciascopic control (134 patients-4.2%) and as to non-invasive examination methods duplex sonography (235 patients-7.45%) and light reflex rheography (50 patients-1.5%). Comparison of the results did not reveal any statistically significant differences. The best effect was achieved with rapid and complete healing of ulcerations in chronic venous insufficiency in as many as 93/92%. More complications were recorded when using S.T.D., such as necroses at the site of administration, temporary teleangiectasias and hyperpigmentations, the statistical significance being p < 0.05. The most frequent complication when using Aethoxysclerol were collapses in hypotensive patients, the statistical significance being similar. CONCLUSIONS: The authors evaluate the two techniques as simple, effective and safe. They can be used as alternatives of surgical treatment. The advantage is that treatment is ambulatory, it leaves the vena saphena intact in situ and does not involve anaesthetic and surgical risks.
The authors analyze the causes, diagnostic and therapeutic procedure in internal pancreatic fistulae. Based on the case-histories of two patients, they demonstrate the importance of ERCP, fistulography, pleurography as well as of surgical tactical procedures. They describe conservative and surgical treatment and their indications.