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Biomedical subjects

Z Serý

Publications and source records attributed to Z Serý.

At least 19 recordsLinked to original sources

[Long-term follow-up of patients with diffuse colonic polyps].

During the years from 1968 to 1984, at the First Department of Surgery in Olomouc, 10 patients with diffuse polyposis of the colon were treated. In 5 of them, a familial occurrence of polyposis was dealt with. In three of them, malignity developed. In five unfamilial polyposes, malignity occurred only once. In one patient, the occurrence of malignity was found present immediately with the first manifestation of the disease. In the other patients, it was after an interval of 3 to 17 years after the onset of the disease. Three patients died from generalization of the malignant process. In two of them, carcinoma developed in the remaining part of the colon, once after previous hemicolectomy and once after colectomy. One patient with an advanced disease died one year after proctocolectomy. Two other operated on patients survive after proctocolectomy 12 and 13 years. The other patients who had been operated on before the development of malignity are healthy. The choice of an adequate radicalintervention is of importance. Optimal is the performance of colectomy with ileorectal anastomosis and the regular endoscopic and bioptic follow-up of the stump of the intestine. When proctocolectomy is necessary, it is of advantage to apply Kock's continent ileostomy.

Adult

[Role of manometry in evaluating long-term outcomes of the surgical treatment of functional esophageal diseases].

In the years 1979-1986, 73 patients with esophageal achalasia, 110 patients with the reflux disease of esophagus and paraesophageal herniae, 17 patients with esophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in esophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of esophagus it can contribute to the decision between a conservative and surgical therapy. The postoperative control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

Adolescent

[Surgical treatment of acute cholecystitis (authors' transl)].

On the basis of 15 resp. 25 years of experience with surgical treatment of acute cholecystitis the authors evaluate their results of urgent and acute operations in 1.080 patients in whom the intensive conservative treatment of acute attacks did not sufficiently influence the symptoms of acute cholecystitis. From this group of 1.080 patients operated on urgently or acutely 21 died, the operative mortality being thus 1.9%. The mortality rate was highest after urgent operations where from 58 patients 10 died, the mortality being 17.2%. From the group of 889 acute cases operated on during 12, 24 or 48 hours following hospital admission, only 5 patients died, the mortality rate being 0.6%.

Acute Disease

The effect of lung resection on some blood circulation factors in children.

Eighteen children (8 boys, 10 girls) aged 6-16 years were examined. In all of them the basic diagnosis was bronchiectasia. Catheterization of the lesser circulation global spirometric examination, and perfusion lung scintigraphy with 99mTc both before and 2--4 years after lung resection were performed. Operations performed: 14 cases of lobectomy, one of bilobectomy, three of pneumonectomy. In all of the 14 children after lobectomy the pulmonary arterial pressure remained normal even during exercise. In contrast to this, in the three children after pneumonectomy and in the one boy after bilobectomy the mean pulmonary arterial pressure exceeded 20 mmHg at rest or after exercise. The total pulmonary resistance, converted per square metre of body surface, was--with a single exception [4.7 units before surgery]--within normal limits; after minor resections it rather tended to decrease, whereas in two of four children after major resections it slightly increased. Postoperative perfusion lung scintigram revealed a worsening in comparison with the preoperative finding in practically all of the children. This worsening can be ascribed not only to the restriction of lung tissue, but also to a compensatory emphysema of the remaining parenchyma. In patients with bronchiectasia, extensive resections have uncertain long-term prognosis.

Adolescent

[Reoperation on the bile ducts (author's transl)].

The total of 5560 operations on the gall bladder and bile ducts had been performed from 1951 to 1975, the mortality rate being 1.2% of all operated cases. There were 659 papillosphineterotomies, 82% of these were indicated for choledocholiathiasis associated with papillary changes, the remaining 18% for stenosis of the Vaterian system. 29 patients, i.e. 4.4% died following papillosphincterotomy. The total of 21 patients were reoperated on soon after the first intervention, 17 of them for inflammatory complications with four deaths, 4 for haemorrhage without any death. One of the patients died from a bleeding duodenal ulcer, 3 from postoperative pancreatitis. The last four patients were not reoperated. Later reoperations up to 7 years were performed in 24 cases. The other part of the paper presents an analysis of 35 patients reoperated on for iatrogenic postoperative strictures of the bile ducts mostly due to an injury induced during cholecystectomy or gastric resection.

Bile Ducts