Biomedical subjects

V Spidlen

Publications and source records attributed to V Spidlen.

16 recordsLinked to original sources

PubMed2007

[Reconstruction of a crushed chest with HI-TEX PARP NT implant].

The authors present the case of a 57-year-old man with polytrauma, who was injured in a train accident. Together with other injuries, he also sustained multiple comminuted fractures on the left half of the rib cage. These subsequently required surgical intervention because of thoracic instability and impending lung injury. Extensive damage to the thoracic skeleton was treated by removal of the damaged tissues and replacement by the HI-TEX PARP NT implant. The presented procedure is being discussed as an alternative to metallic fixation in thoracic instability in cases of devastating injury or injury resulting in bone and tissue loss.

Coated Materials, Biocompatible↗

PubMed2006

[Spontaneous pneumothorax].

Spontaneous pneumothorax comprises app. 0.1-2 % of surgical diseases. There are four subtypes; primary, secondary, catamenial and neonatal. Aetiology of primary pneumothorax is not exactly known since there is no direct relation to any basic lung disease. Nevertheless, in most patients (80-85 %), it develops due to the rupture of an emphysematous bulla or a subpleural air bubble, i.e. blebs. On the other hand, secondary pneumothorax is a result or a complication of a verified localized or general lung disorder. Catamenial pneumothorax is a recurrent lung collapse in women at the time of menstruation. Neonatal pneumothorax is found typically in immature or premature newborns, often in association with congenital lung disorders. From the pathological point of view, it is an acute disorder of distribution of blood gasses in lungs with subsequent hypoxemia, which can be identified as an acute thoracic event. The clinical picture of pulmonary collapse is characterised by a triad of symptoms++dyspnoea, pleuritic pain and dry and non-productive cough. The diagnosis is usually determined on the base of history and after a careful clinical examination. It is then verified on lung X-ray. The objective of therapy of spontaneous pneumothorax is to restore permanent lung expansion to the original extent. Conservative treatment is chosen in the first episodes of pneumothorax with small extent and without further complications or symptoms. In the rest of cases, the surgical treatment is necessary, which includes puncture of the pleural cavity, drainage and surgical revision using videothoracoscopy or thoracotomy. In general, in case of the first episode of pulmonary collapse it is recommended to perform less radical procedure, i.e. drainage of the pleural cavity. Recurrences of the disease are indicated for surgical treatment; primarily miniinvasive procedures, in which the site of air leaking from lung parenchyma is closed and also an artificial pleural symphysis is created to prevent recurrence of the collapse. This type of procedure provides best results; recurrence is not exceeding 3%.

Humans↗

PubMed2005

[A postoperative bronchopleural fistule--a success of the conservative treatment (a case review)].

Disintegration of the bronchial stub following the lung resection procedures together with development of the bronchopleural fistule and the postoperative empyema of the thorax, remain a feared complication following all lung resections, but especially pneumonectomies. In this case review, the authors report on a successful conservative management case, which followed an unsuccessful surgical revision and an attempt for the endobronchial stent introduction. 20 months following the closure of the fistule, the patient shows no signs of a relapse of the disorder.

Aged↗

PubMed2005

[Open inguinal hernioplasty, comparison of various techniques--a pilot study].

The authors compare inguinal hemioplasties using a classical method, Lichtenstein method and PHS method from the point of view of a surgeon, as well as using subjective assessments by patients. Each group consists of 11 patients. The authors assess the following parameters: use of analgesics, duration of hospitalization, daily routine restriction and pain.

Aged↗

PubMed2004

[Role of videomediastinoscopy in diagnostic procedures of pathological conditions in the mediastinum].

Due to recent advances in videotechnology and a worldwide comback of invasive staging methods of the lung cancer, mediastinoscopy has been revived. In the Surgical Clinic of the Faculty Hospital in Plzen, the authors carried out 54 videomagnetoscopic examinations of 53 patients aged 58.1 years on average, in total, during the period from 2000 till 2003. Mostly, in 41 cases (76%) the examination was performed as a part of the lung cancer staging procedure. None of the patients exited in direct correlation with the surgical procedure. Complications, not requiring reoperation, were reported in 2 cases. The lung carcinoma staging findings agreed with the postoperative N disease classification in 86% of the examined cases. Five cases (14%) were underestimated and always the superior lobe carcinomas were concerned, out of which four of them were on the left. At the same time, the non-invasive staging examination using computer tomography (CT) in the mediastinal lung cancer dissemination examination, proved to show a high rate of false-positive findings, when compared to that with videomediastinoscopy. Mediastinoscopy remains the supreme method in determining other pathological affections of the middle mediastinum, if properly indicated. The authors carry out the above miniinvasive examination as a part of the lung cancer staging method in all patients with the CT-confirmed mediastinal lymphonodes enlarged over 1 cm. They consider this method a necessary part of this disease staging protocol, in cases of the left superior lung lobe tumors combined with videothoracoscopy. At the same time the authors recommend it as the method of choice in diagnosing other pathological processes of the middle mediastinum, mainly for its high efficiency rate and its low rates of complications.

Adult↗

PubMed2003

[Intralobar pulmonary sequestration].

Sequestration is defined as an area of abnormal pulmonary tissue not connected with the bronchial tree, supplied by an aberrant systemic artery and without a normal pulmonary function. Extralobar (ELS) and intralobar (ILS) forms are distinguished. During the year 2002 the authors diagnosed and operated upon two cases of the intralobar form of pulmonary sequestration, and in last 25 years five cases - 4 x ILS and 1 x ELS. Reported are a 35 year old man with relapsing infections of the sequester and a 21 year old woman where the sequestration was accidentally found without clinical symptoms. The focus was localized in both cases in the left lower lobe of the lungs, anomalous supply arteries derived from the thoracic aorta. Venous drainage of the sequester was different - in the man a systemic drainage via the v. azygos, in the woman via the pulmonary veins was found. In one case the diagnosis was made on the basis of angiography and computer tomography, in the other case it was made on the basis of multidetector CT angiography (MDCTA). Both findings were treated by primary surgical intervention lobectomy. The postoperative course was uneventful.

Adult↗

PubMed2003

[Less common tumors of the pleural cavity].

Among tumourous affections of the pleural cavity dominate metastatic processes while primary pleural neoplasms are relatively rare (only 5%). The authors present 4 case-records of less common primary benign pleural tumours which were operated at the Surgical Clinic of the Faculty Hospital in Plzen during 2000. Three women and one man of different age groups were involved. In three patients accidental findings were involved, in one instance in conjunction with multiple injuries, the fourth patient was examined on account of pulmonary complaints. The diagnosis was based on the skiagram and specially on the CT of the lungs, individually also other methods were used. All findings were radically eliminated--twice by thoracotomy, twice using miniinvasive procedures. Histological examination revealed twice desmoidal fibromatosis, once a benign fibrous pleural tumour and once a rare variant of Castleman's disease. The postoperative period was free from major complications, without the need of surgical revision. Two years after surgery all patients are free from detectable signs of relapse. The authors submit at the same time an integrated view on the problem of pleural neoplasias, they discuss in particular the pitfalls of the diagnosis of these lesions, possible treatment, incl. the use of suitable endoscopic methods, and the prognosis of different types of tumours. A more detailed histopathological analysis of the described findings is given.

Adult↗

PubMed2003

[Tracheobronchial injuries--experience with diagnosis and therapy].

The incidence of penetrating injuries of the respiratory pathways is permanently low and relatively stable, on the other hand, it may be assumed that there is an increasing rate of tracheobronchial injuries during blunt accidents of the chest in particular in conjunction with the increased rate of traffic injuries. Serious injuries are involved, in particular because of their high morbidity and mortality; frequently they are part of associated injuries and polytraumas. In 1999-2002 at the Surgical Clinic of the Plzen-Lochotín Faculty Hospital a penetrating stab wound of the cervical trachea was treated in an 11-year-old boy and injuries of the large bronchi of adult men resulting from blunt chest injuries during car accidents. All three injuries were associated with a typical symptomatology of pneumocolon and pneumomediastinum, or persistent pneumothorax and respiratory complaints resp. The definite diagnosis was established in two instances shortly after admission, based on results of CT and bronchoscopic examination, in the case of the injury of the middle bronchus only on the following day during surgical revision combined with preoperative bronchoscopy. Treatment was surgical in all instances. Twice the lesion was sutured, in one case pulmonary resection was performed. No significant postoperative complications were observed nor any deaths. The main factors which influence in a decisive way the prognosis of the casualty and the therapeutic result are in the authors' opinion, consistent with data in the literature, early assessment of the diagnosis of tracheobronchial injury and early adequate therapeutic action. In the diagnosis a dominant position is held in addition to CT in particular by treacheobronchoscopy. In case of surgical treatment reconstruction operations are preferred.

Adult↗

PubMed2003

[Patient survival analysis in surgery of bronchogenic carcinoma from 1986 to 1997].

Surgery is the most effective treatment of lung cancer (LC) in early stage disease (I-IIIa) of non small cell lung carcinoma (NSCLC). Even in resectable patients there are differences in survival accordingly to some prognostic factors. In 12 years period (1986-1997) there were 363 resected patients, in 350 of them lung cancer was confirmed. This group was analysed according to morphologic types, stages, and sex of patients, co morbidity and the type subsequent adjuvant therapy in relation to survival. Sensitivity and specificity of staging methods were also evaluated as well as the impact of staging accuracy to survival. Epidermoid cancer was found in 193 patients (55%), adenocarcinoma in 124 (36%), large cell-anaplastic type in 29 patients (8%) and small cell lung cancer in 4 patients (1%). Early postoperative mortality is 4%. 5 year after surgical resection survive 26% (90 patients). Other results are given in the text. Surgery of LC remains optimal therapeutic method. Survival of patients after lung resection doesn't change significantly in last years, even that we can use much more better diagnostic methods now. The way for the future seems to be the preoperative chemotherapy and the biologic target therapy. We need more precious staging procedures and more effective adjuvant therapeutic schedules in early as well as more advanced stages.

Adult↗

PubMed2002

[Stab injuries of the heart].

Stab injuries of the heart belong into the category of fatal injuries. Along with the increased crime rate also the number of these injuries increased and they must be tackled unexpectedly by the surgeon who frequently lacks specialization in cardiosurgery. The authors present the case histories of three patients whom they treated successfully in 2001. All there were males, at the time of admission to the emergency department with marginal stabilization of the circulation. Ultrasound examination of the pericardium revealed in all a haemopericardium with amounts from 150 to 300 ml, one man was operated already with symptoms of progressing tamponade of the pericardium. During surgical revision in the operation theatre always one isolated injury of one of the cardiac departments was treated. The postoperative course was uncomplicated and the patients were discharged into domiciliary care on the 7th and 8th day after surgery resp. Consistent with quoted authors, favourable prognostic factors in penetrating stab wounds of the heart include the following: younger age, early transport to the emergency centre, presence of cardiac tamponade and early surgical revision by a competent surgeon without the necessity of specialization in cardiosurgery. The authors emphasize the rule which pushes examination methods into the background: stab wound in the cardiac area + unstable circulation = surgical revision.

Adult↗

PubMed2001

[Is the lingula suitable for evaluation of pulmonary biopsy? Results of pulmonary biopsies in patients during a 5-year period].

Pulmonary biopsy is commonly performed for the diagnosis of interstitial pulmonary disease. The lingula has technical advantages on account of which it is frequently used. The quality of this tissue is however discutable. The authors submit a retrospective five-year group of 80 patients operated at the Surgical Clinic of the Faculty Hospital Plzen 53 times videothoracoscopically (66.2%) and 27 times by limited thoracotomy (33.8%). Both methods are in the authors opinion sufficiently effective to obtain bioptic material. The guide for localization of the biopsy is computed tomography. Only once from a total of 38 samples (2.6%) collected from the lingula an unequivocal diagnosis was not established. The authors assume therefore that pulmonary biopsy collected from the lingula is still justified.

Adolescent↗

PubMed2000

[300 videothoracoscopy procedures--personal experience].

Videothoracoscopy and video-assisted thoracic surgery are by now already standard therapeutic procedures in thoracic surgery. The authors submit their experience with the method after 300 thoracoscopic operation at the surgical clinic of the Faculty Hospital in Plzen from the end of 1993 to the beginning of 2000. The main indications for this mini-invasive procedure is the treatment of spontaneous pneumothorax, diagnostic biopsy in pulmonary dissemination of obscure etiology, diagnosis and treatment of pleural exudates and elimination of minor peripheral pulmonary lesions. The authors discuss different surgical procedures in the most frequent diagnoses, their advantages and risks, indication criteria, complications. Attention is also paid to the causes of 10% conversions. In case of treatment of a spontaneous pneumothorax the authors consider videothoracoscopy as the method of first choice, while in case of primary carcinoma of the lungs they recommend the classical procedure. Other possibilities for the wider application of thoracoscopy and its development in their own department include in particular traumatic thoracic surgery.

Humans↗

PubMed1997

[Spontaneous pneumothorax: comparison of classical and video thoracoscopic therapy].

The authors present the results of treatment of spontaneous pneumothorax at the Surgical Clinic, Faculty Hospital Plzen in 1994-1996 and compare the effect of classical thoracic drainage and the videothoracoscopic procedure. During the mentioned period 64 patients with spontaneous pneumothorax were treated-28 patients by simple drainage of the pleural cavity and 36 patients by videothoracoscopic treatment with surgery of the pulmonary parenchyma and the parietal pleura resp. In the first group treatment was successful in 60%, in the second one in 83%, the ratio of complications was similar. Only one relapse was recorded after videothoracoscopic treatment of spontaneous pneumothorax. Based on these results and data in the literature the authors prefer unequivocally videothoracoscopic treatment.

Adolescent↗

PubMed1997

[Videothoracoscopy and pulmonary wedge resection].

The authors present a group of 67 patients where, using videothoracoscopy or the V.A.T.S. method (Video Assisted Thoracic Surgery), a wedge-shaped rsection of the lungs was made. The patients were divided into three groups with regard to the basic characteristic of the disease-disseminated pulmonary processes, peripheral pulmonary lesions and bullous pulmonary emphysema and spontaneous pneumothorax resp. The diagnostic and therapeutic contribution of the mentioned method, its good tolerance and short postoperative hospitalization is clearly in favour of this mininvasive method.

Endoscopy↗

PubMed1993

[Surgical treatment of thoracic empyema].

During the seven-year period from 1986-1992 85 patients with a purulent process in the pleural cavity were treated. The author classifies the disease by its aetiology and mentions different surgical approaches. Treatment was successful in the group of pneumonic empyemas and the author mentions also the marked decline of empyemas after resections of the lungs during the last three years.

Adult↗

PubMed1992

[Nosocomial infections in surgical intensive care of multiple injuries].

The authors present an abridged version of the final report of a State research programme. By introduction of a series of provisions and expedient use of funds available for research it proved possible to reduce the incidence of nosocomial infections in surgical patients from 14% to 12% and in a group with multiple injuries in the surgical intensive care unit from 18% to 10%.

Anti-Bacterial Agents↗