Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.6868
Jose Caballero-Alvarado, Victor Lau Torres, KATHERINE LOZANO, Carlos Zavaleta-Corvera
Introduction: Acute appendicitis is one of the most frequent emergencies in hospitals around the world; it requires early surgical treatment in complicated cases. One of the challenges that the surgeon faces during appendectomy is when the base of the appendix is compromised by either a perforation or gangrene. To show the surgical strategies that have been reported, as well as the complications associated with a compromised appendicular base in a complicated acute appendicitis.Methods: A bibliographic search was carried out in the databases of Pubmed, Embase, Web of Science, and Google Scholar. The search expression (“appendiceal stump closure” OR “Closure of the appendiceal stump” OR “Management of appendiceal stump”) was used to search for articles. The inclusion criteria were observational studies (case reports, case series, or cross-sectional, case-control, or cohort studies).Discussion: Different techniques have been reported for the treatment of a compromised appendicular base. Among the most used are primary closure, partial resection of the cecum, cecostomy tube, ileocecectomy, and right hemicolectomy. The most frequent complications are surgical site infection, intra-abdominal abscess, postoperative ileus, intestinal obstruction, and others.Conclusions: The appendicular base, compromised by necrosis or perforation, requires adequate treatment in order to prevent dehiscence of the appendicular stump sutures and fecal peritonitis. A number of surgical options have been reported
简介:急性阑尾炎是世界各地医院最常见的急诊之一;复杂病例需早期手术治疗。在阑尾切除术中，外科医生面临的挑战之一是阑尾底部是否因穿孔或坏疽而受损。显示已报道的手术策略，以及与复杂急性阑尾炎阑尾基底受损相关的并发症。方法:在Pubmed、Embase、Web of Science、Google Scholar等数据库中进行文献检索。搜索表达式(“阑尾残端闭合”或“阑尾残端闭合”或“阑尾残端管理”)用于搜索文章。纳入标准为观察性研究(病例报告、病例系列或横断面、病例对照或队列研究)。讨论:不同的技术已被报道用于治疗阑尾基底受损。其中最常用的是初级关闭，盲肠部分切除，结肠造口管，回肠切除术和右半结肠切除术。最常见的并发症是手术部位感染、腹内脓肿、术后肠梗阻、肠梗阻等。结论:阑尾底部坏死或穿孔，需要适当的治疗，以防止阑尾残端缝合线破裂和粪便性腹膜炎。已经报道了许多手术选择
{"title":"Complicated acute appendicitis with compromised appendiceal base: A review of surgical strategies","authors":"Jose Caballero-Alvarado, Victor Lau Torres, KATHERINE LOZANO, Carlos Zavaleta-Corvera","doi":"10.5604/01.3001.0053.6868","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6868","url":null,"abstract":"Introduction: Acute appendicitis is one of the most frequent emergencies in hospitals around the world; it requires early surgical treatment in complicated cases. One of the challenges that the surgeon faces during appendectomy is when the base of the appendix is compromised by either a perforation or gangrene. To show the surgical strategies that have been reported, as well as the complications associated with a compromised appendicular base in a complicated acute appendicitis.Methods: A bibliographic search was carried out in the databases of Pubmed, Embase, Web of Science, and Google Scholar. The search expression (“appendiceal stump closure” OR “Closure of the appendiceal stump” OR “Management of appendiceal stump”) was used to search for articles. The inclusion criteria were observational studies (case reports, case series, or cross-sectional, case-control, or cohort studies).Discussion: Different techniques have been reported for the treatment of a compromised appendicular base. Among the most used are primary closure, partial resection of the cecum, cecostomy tube, ileocecectomy, and right hemicolectomy. The most frequent complications are surgical site infection, intra-abdominal abscess, postoperative ileus, intestinal obstruction, and others.Conclusions: The appendicular base, compromised by necrosis or perforation, requires adequate treatment in order to prevent dehiscence of the appendicular stump sutures and fecal peritonitis. A number of surgical options have been reported","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.3998
Joanna Żurkowska, Paweł Jaworski, Artur Binda, Krzysztof Barski, Wiesław Tarnowski
The problem of gastroesophageal reflux disease among bariatric patients is constantly growing. While bariatric surgery is the most effective method of treating obesity and related diseases, not all surgical procedures lead to improvement or resolution of gastroesophageal reflux disease. The search for the "ideal" surgical procedure for this group of patients is ongoing. The relatively recently introduced SASI procedure seems to have a beneficial effect on GERD symptoms and may be an alternative anti-reflux procedure in obese patients. The presented paper is a review of the latest literature on the impact of SASI procedure on the symptoms of gastroesophageal reflux disease.
{"title":"Effect of SASI procedure (single ileal sleeve anastomosis) on the symptoms of gastroesophageal reflux disease in bariatric patients - a review of the literature","authors":"Joanna Żurkowska, Paweł Jaworski, Artur Binda, Krzysztof Barski, Wiesław Tarnowski","doi":"10.5604/01.3001.0053.3998","DOIUrl":"https://doi.org/10.5604/01.3001.0053.3998","url":null,"abstract":"The problem of gastroesophageal reflux disease among bariatric patients is constantly growing. While bariatric surgery is the most effective method of treating obesity and related diseases, not all surgical procedures lead to improvement or resolution of gastroesophageal reflux disease. The search for the \"ideal\" surgical procedure for this group of patients is ongoing. The relatively recently introduced SASI procedure seems to have a beneficial effect on GERD symptoms and may be an alternative anti-reflux procedure in obese patients. The presented paper is a review of the latest literature on the impact of SASI procedure on the symptoms of gastroesophageal reflux disease.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"250 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9182
Paweł Siwiński, Łukasz Dziki, Michał Mik, Adam Dziki
IntroductionRecurrence of rectal cancer affects from 4% to even 50% of patients after surgical treatment. The incidence may be influenced by numerous factors depending on the patient, the characteristics of the tumor and the type and quality of the surgical technique used.AimsThe aim of this study was to assess the clinical characteristics of rectal cancer recurrence, identify potential risk factors and role of patient surveillance after primary resection of rectal cancer.Materials and methodsThe study comprised patients operated on due to recurrence of rectal cancer at the Department of General and Colorectal Surgery of Medical University of Lodz between 2014 and 2020, who were in the follow-up program at the hospital's outpatient clinic after the primary surgery. Risk factors for disease recurrence were sought by analyzing the characteristics of the primary tumor, treatment history and postoperative care.Results29 patients were included in the study, the majority (51.7%) of the patients were men. The largest group was represented by patients with stage II and III disease. The most frequently performed primary surgery was low anterior resection (LAR) (62.8%). 35% of patients received neoadjuvant treatment prior to primary surgery. We demonstrated that the lack of neoadjuvant treatment before primary surgery increases the risk of cancer recurrence nine times. Higher stage of disease at the point of primary surgery is associated with nearly seven times the risk of recurrence compared to stage I disease.ConclusionsOptimal preoperative staging, reasonable neoadjuvant treatment, proper surgical technique and precise follow-up regimen are essential for further improvement of rectal cancer outcomes.
{"title":"Risk factors and clinical characteristics of rectal cancer recurrence after radical surgical treatment","authors":"Paweł Siwiński, Łukasz Dziki, Michał Mik, Adam Dziki","doi":"10.5604/01.3001.0053.9182","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9182","url":null,"abstract":"IntroductionRecurrence of rectal cancer affects from 4% to even 50% of patients after surgical treatment. The incidence may be influenced by numerous factors depending on the patient, the characteristics of the tumor and the type and quality of the surgical technique used.AimsThe aim of this study was to assess the clinical characteristics of rectal cancer recurrence, identify potential risk factors and role of patient surveillance after primary resection of rectal cancer.Materials and methodsThe study comprised patients operated on due to recurrence of rectal cancer at the Department of General and Colorectal Surgery of Medical University of Lodz between 2014 and 2020, who were in the follow-up program at the hospital's outpatient clinic after the primary surgery. Risk factors for disease recurrence were sought by analyzing the characteristics of the primary tumor, treatment history and postoperative care.Results29 patients were included in the study, the majority (51.7%) of the patients were men. The largest group was represented by patients with stage II and III disease. The most frequently performed primary surgery was low anterior resection (LAR) (62.8%). 35% of patients received neoadjuvant treatment prior to primary surgery. We demonstrated that the lack of neoadjuvant treatment before primary surgery increases the risk of cancer recurrence nine times. Higher stage of disease at the point of primary surgery is associated with nearly seven times the risk of recurrence compared to stage I disease.ConclusionsOptimal preoperative staging, reasonable neoadjuvant treatment, proper surgical technique and precise follow-up regimen are essential for further improvement of rectal cancer outcomes.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9174
Łukasz Łaziński, Mateusz Koziej, Bogusław Antoszewski, Marta Fijałkowska
Skin cancers constitute a group of medical disorders remaining a field of interest of surgeons and dermatologists. Currently, this group is typically divided into malignant melanoma (MM) and keratinocyte cancers (KC).The aim of this study is to analyse the cases of skin cancers treated in the Department of Plastic, Reconstructive and Aesthetic Surgery in Lodz (Poland) during the COVID-19 pandemic (from 2020 to 2022) and then compare the results with the ones from pre-pandemic period (from 2017 to 2019).An analysis of histopathological files from the period between 2020 and 2022 was performed. It was based on the following criteria: sex, age, type of skin cancer, subtype of basal cell carcinoma (BCC), localization and dimensions of the tumor.The study sample consisted of 225 patients presenting 241 cases of skin cancers. There were 74 men and 151 women, the mean age was 71.7. The most common skin cancer was BCC (175 cases, 72.6%) followed by SCC (59 cases, 24.5%), melanoma (5 cases, 2.1%) and other (2 cases, 0.8% - angiosarcoma and sweat gland carcinoma).A marked reduction in the number of skins cancers detected during the pandemic period has been reported. Delay in the surgical treatment of skin tumors does not seem to affect the size of the removed lesion. Some models predicting that tumors would be larger after the confinement period are not applicable in reality. However further investigations with larger samples from multiple centres are needed to confirm these findings and to work out standards how to deal with healthcare crises in the future.
{"title":"Skin cancers occurrence: single-centre experiences from period 2020-2022","authors":"Łukasz Łaziński, Mateusz Koziej, Bogusław Antoszewski, Marta Fijałkowska","doi":"10.5604/01.3001.0053.9174","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9174","url":null,"abstract":"Skin cancers constitute a group of medical disorders remaining a field of interest of surgeons and dermatologists. Currently, this group is typically divided into malignant melanoma (MM) and keratinocyte cancers (KC).The aim of this study is to analyse the cases of skin cancers treated in the Department of Plastic, Reconstructive and Aesthetic Surgery in Lodz (Poland) during the COVID-19 pandemic (from 2020 to 2022) and then compare the results with the ones from pre-pandemic period (from 2017 to 2019).An analysis of histopathological files from the period between 2020 and 2022 was performed. It was based on the following criteria: sex, age, type of skin cancer, subtype of basal cell carcinoma (BCC), localization and dimensions of the tumor.The study sample consisted of 225 patients presenting 241 cases of skin cancers. There were 74 men and 151 women, the mean age was 71.7. The most common skin cancer was BCC (175 cases, 72.6%) followed by SCC (59 cases, 24.5%), melanoma (5 cases, 2.1%) and other (2 cases, 0.8% - angiosarcoma and sweat gland carcinoma).A marked reduction in the number of skins cancers detected during the pandemic period has been reported. Delay in the surgical treatment of skin tumors does not seem to affect the size of the removed lesion. Some models predicting that tumors would be larger after the confinement period are not applicable in reality. However further investigations with larger samples from multiple centres are needed to confirm these findings and to work out standards how to deal with healthcare crises in the future.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9252
Andrzej Żyluk, Paulina Żyluk-Gadowska, Massimo Ceruso
Results of some studies showed that predictors of less favourable outcomes of surgery for carpal tunnel syndrome might include presence of comorbidities, such as diabetes and thyroid gland diseases. However, the role of these factors is not clearly determined.The objective of this study was an investigation of the effect of concomitant diseases on clinical profile and outcomes of surgery for carpal tunnel syndrome.Material and Methods. The study group consisted of 1117 patients, 909 women (81%) and 208 men (19%) at a mean age of 63 years. A total of 972 patients (87%) declared at least one comorbidity, whereas 145 patients (13%) declared no comorbidities The measurements were performed preoperatively and at 6 months post-operatively and included pain intensity, total grip and key-pinch strength, digital sensibility and hand function with the Levine questionnaire. Results. At baseline, the patients with comorbidities had significantly worse digital sensiblility, weaker total grip strength and grater functional impairment of the hand, but only difference in grip strength reached minimal clinical importance. Surgery resulted in significant improvement for all patients, although outcomes at 6 months were less favourable for those with comorbidities with regard to digital sensiblility, total grip and pinch strength and function of the hand. These differences were statistically significant, but only grip strength reached minimal clinical importance. Cnclusion. Presence of comorbidities had statistically and clinically significant negative effect only on the total grip strength pre- and postoperatively, but had no significant effect on outcomes of surgery which was satisfactory in all patients.
{"title":"The effect of comorbidities on a clinical profile and outcomes of surgery for carpal tunel syndrome","authors":"Andrzej Żyluk, Paulina Żyluk-Gadowska, Massimo Ceruso","doi":"10.5604/01.3001.0053.9252","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9252","url":null,"abstract":"Results of some studies showed that predictors of less favourable outcomes of surgery for carpal tunnel syndrome might include presence of comorbidities, such as diabetes and thyroid gland diseases. However, the role of these factors is not clearly determined.The objective of this study was an investigation of the effect of concomitant diseases on clinical profile and outcomes of surgery for carpal tunnel syndrome.Material and Methods. The study group consisted of 1117 patients, 909 women (81%) and 208 men (19%) at a mean age of 63 years. A total of 972 patients (87%) declared at least one comorbidity, whereas 145 patients (13%) declared no comorbidities The measurements were performed preoperatively and at 6 months post-operatively and included pain intensity, total grip and key-pinch strength, digital sensibility and hand function with the Levine questionnaire. Results. At baseline, the patients with comorbidities had significantly worse digital sensiblility, weaker total grip strength and grater functional impairment of the hand, but only difference in grip strength reached minimal clinical importance. Surgery resulted in significant improvement for all patients, although outcomes at 6 months were less favourable for those with comorbidities with regard to digital sensiblility, total grip and pinch strength and function of the hand. These differences were statistically significant, but only grip strength reached minimal clinical importance. Cnclusion. Presence of comorbidities had statistically and clinically significant negative effect only on the total grip strength pre- and postoperatively, but had no significant effect on outcomes of surgery which was satisfactory in all patients.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9291
Julia Fuss, Anna Voloboyeva, Valeriy Bojko, Victor Polovyj, Aleksander Maloshtam
Introduction: Acute cholangitis belongs to urgent conditions in surgery, which are accompanied by high mortality and require clear diagnosis and immediate treatment. One of these biomarkers is the neutrophil-lymphocyte ratio (NLR), but the insufficient number of studies does not allow judging its value as a marker of infectious complications in hepatobiliary surgery.Aim of the study: to determine the predictive value of the neutrophil-leukocyte ratio as a predictor of infectious complications after hepatobiliary surgery.Methods: We evaluated 229 patients with acute cholangitis who underwent biliary drainage. The severity of acute cholangitis was graded according to the Tokyo 2018 guideline. Patients were dichotomized according to the acute cholangitis severity (mild/moderate vs. severe), and blood culture positivity. The baseline NLR, white blood cell (WBC) count, and C-reactive protein (CRP) levels were compared between groups.Results: Of the 229 acute cholangitis patients analyzed, 83 (36.3%) had mild, 111 (48.5%) had moderate, and 35 (15.2%) had severe acute cholangitis. Positive blood culture (n = 114) was more frequently observed in the severe acute cholangitis group than the mild/moderate cholangitis group (83% vs. 43%, p < 0.001). The NLR was significantly higher in patients with severe cholangitis, shock, and positive blood culture. Conclusion: The neutrophil-lymphocyte ratio is a reliable predictor in predicting the risk of developing infectious complications in acute cholangitis. The high predictive value of CRP and PCT, as well as high availability and low cost of performing a clinical blood test, make NLR a more promising test in clinical practice.
简介:急性胆管炎属于外科急症，死亡率高，需要明确诊断和立即治疗。其中一个生物标志物是中性粒细胞-淋巴细胞比率(NLR)，但由于研究数量不足，无法判断其作为肝胆外科感染并发症标志物的价值。研究目的:确定中性粒细胞-白细胞比作为肝胆手术后感染性并发症预测指标的预测价值。方法:229例急性胆管炎患者行胆道引流术。急性胆管炎的严重程度根据东京2018指南进行分级。根据急性胆管炎的严重程度(轻度/中度vs重度)和血培养阳性对患者进行分类。比较两组间基线NLR、白细胞(WBC)计数和c反应蛋白(CRP)水平。结果229例急性胆管炎患者中，轻度83例(36.3%)，中度111例(48.5%)，重度35例(15.2%)。重度急性胆管炎组血培养阳性(n = 114)的发生率高于轻度/中度胆管炎组(83% vs. 43%， p <0.001)。严重胆管炎、休克和血培养阳性患者的NLR明显更高。结论:中性粒细胞与淋巴细胞比值是预测急性胆管炎感染性并发症发生风险的可靠指标。CRP和PCT的高预测价值，以及临床血液检测的高可用性和低成本，使NLR在临床实践中更有前景。
{"title":"Neutrophil to lymphocyte ratio in predicting complications and prognosis in patients with acute cholangitis","authors":"Julia Fuss, Anna Voloboyeva, Valeriy Bojko, Victor Polovyj, Aleksander Maloshtam","doi":"10.5604/01.3001.0053.9291","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9291","url":null,"abstract":"Introduction: Acute cholangitis belongs to urgent conditions in surgery, which are accompanied by high mortality and require clear diagnosis and immediate treatment. One of these biomarkers is the neutrophil-lymphocyte ratio (NLR), but the insufficient number of studies does not allow judging its value as a marker of infectious complications in hepatobiliary surgery.Aim of the study: to determine the predictive value of the neutrophil-leukocyte ratio as a predictor of infectious complications after hepatobiliary surgery.Methods: We evaluated 229 patients with acute cholangitis who underwent biliary drainage. The severity of acute cholangitis was graded according to the Tokyo 2018 guideline. Patients were dichotomized according to the acute cholangitis severity (mild/moderate vs. severe), and blood culture positivity. The baseline NLR, white blood cell (WBC) count, and C-reactive protein (CRP) levels were compared between groups.Results: Of the 229 acute cholangitis patients analyzed, 83 (36.3%) had mild, 111 (48.5%) had moderate, and 35 (15.2%) had severe acute cholangitis. Positive blood culture (n = 114) was more frequently observed in the severe acute cholangitis group than the mild/moderate cholangitis group (83% vs. 43%, p < 0.001). The NLR was significantly higher in patients with severe cholangitis, shock, and positive blood culture. Conclusion: The neutrophil-lymphocyte ratio is a reliable predictor in predicting the risk of developing infectious complications in acute cholangitis. The high predictive value of CRP and PCT, as well as high availability and low cost of performing a clinical blood test, make NLR a more promising test in clinical practice.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9251
Tomasz Klimczak, Janusz Strzelczyk
BackgroundGastroesophageal reflux (GERD) is one of the most common disorders of the alimentary tract. Apart from troublesome symptoms, untreated GERD can lead to Barrett’s esophagus and, as a consequence, esophageal adenocarcinoma. Up to date, most typical treatment of GERD is PPI pharmacotherapy. However, in a number of cases this treatment is not sufficient or the patient does not tolerate PPI-group drugs. In these cases interventional therapy is recommended. Up to date, laparoscopic fundoplication was the only suggested option. Other, minimally-invasive procedures such as Stretta, MUSE, TIFF or EsophyX were not recommended due to the lack of clinical data. In 2014 professor H.Inoue from the Digestive Diseases Center, Showa University in Japan reported the first series of novel, endoscopic anti-reflux procedures: anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation (ARMA).MethodsWe conducted our prospective, single center study in 30 patients ( 14 female, 16 male) with PPI-refractory GERD. All patients underwent FSSG and GERD-HRQL evaluation and GE junction pressure study prior, 6 weeks and 6 months after the procedures. After the procedure, all patients received PPI treatment for 4 weeks.ResultsWe successfully completed the procedures in all 30 patients. Mean procedure time was 42 minutes. No complications occurred. In 86,67% (26) of our patients, we achieved a total remission of GERD symptoms, FSSG scores < 6 and GERD-HRQL scores < 8. ConclusionsThe results of our study show that ARMS and ARMA are simple, safe, improve GERD-related symptoms and restore the GE junction’s anti-reflux capacity.Keywords: ARMA, ARMS, Endoscopic GERD treatment, Endoscopic surgery, Refractory GERD
{"title":"Endoscopic anti-reflux mucosectomy (ARMS) and Endoscopic anti-reflux ablation (ARMA) as a potential treatment for gastroesophageal reflux- single center experience","authors":"Tomasz Klimczak, Janusz Strzelczyk","doi":"10.5604/01.3001.0053.9251","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9251","url":null,"abstract":"BackgroundGastroesophageal reflux (GERD) is one of the most common disorders of the alimentary tract. Apart from troublesome symptoms, untreated GERD can lead to Barrett’s esophagus and, as a consequence, esophageal adenocarcinoma. Up to date, most typical treatment of GERD is PPI pharmacotherapy. However, in a number of cases this treatment is not sufficient or the patient does not tolerate PPI-group drugs. In these cases interventional therapy is recommended. Up to date, laparoscopic fundoplication was the only suggested option. Other, minimally-invasive procedures such as Stretta, MUSE, TIFF or EsophyX were not recommended due to the lack of clinical data. In 2014 professor H.Inoue from the Digestive Diseases Center, Showa University in Japan reported the first series of novel, endoscopic anti-reflux procedures: anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation (ARMA).MethodsWe conducted our prospective, single center study in 30 patients ( 14 female, 16 male) with PPI-refractory GERD. All patients underwent FSSG and GERD-HRQL evaluation and GE junction pressure study prior, 6 weeks and 6 months after the procedures. After the procedure, all patients received PPI treatment for 4 weeks.ResultsWe successfully completed the procedures in all 30 patients. Mean procedure time was 42 minutes. No complications occurred. In 86,67% (26) of our patients, we achieved a total remission of GERD symptoms, FSSG scores < 6 and GERD-HRQL scores < 8. ConclusionsThe results of our study show that ARMS and ARMA are simple, safe, improve GERD-related symptoms and restore the GE junction’s anti-reflux capacity.Keywords: ARMA, ARMS, Endoscopic GERD treatment, Endoscopic surgery, Refractory GERD","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9183
Sylwia Kustalik, Piotr Klejszmit, Jacek Kordiak, Edyta Santorek-Strumiłło, Sławomir Jabłoński
Wound dehiscence is a relatively rare complication after laparotomy consisting of dissection of thepost-operative wound and prolapse of the viscera outside the abdominal cavity and has been shownto be associated with a higher mortality rate. Known risk factors for this condition includemalnutrition and the coexistence of inflammation or cancer.The main purpose of this thesis was to investigate the association between the occurrence of postlaparotomy and the nutritional status of the patient as expressed by selected protein markers.The study was retrospective and based on an analysis of patients treated at the in-house centre fromJanuary 2014 to December 2020. It included a group of patients undergoing laparotomy procedureswho developed evectasia and a group of control group of patients who underwent laparotomy anddid not develop wound dehiscence after the procedure.The analysis showed that lower serum albumin levels were associated with a higher risk of wounddehiscence in patients who underwent laparotomy due to acute abdominal disease. The study andcontrol groups differed significantly in levels of: Hgb, total protein, CRP, lymphocytes, albumin, PCT,NRS.
{"title":"Analysis of the influence of selected protein parameters that are markers of nutritional statusand inflammatory markers on the occurrence of wound dehiscence after laparotomy.","authors":"Sylwia Kustalik, Piotr Klejszmit, Jacek Kordiak, Edyta Santorek-Strumiłło, Sławomir Jabłoński","doi":"10.5604/01.3001.0053.9183","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9183","url":null,"abstract":"Wound dehiscence is a relatively rare complication after laparotomy consisting of dissection of thepost-operative wound and prolapse of the viscera outside the abdominal cavity and has been shownto be associated with a higher mortality rate. Known risk factors for this condition includemalnutrition and the coexistence of inflammation or cancer.The main purpose of this thesis was to investigate the association between the occurrence of postlaparotomy and the nutritional status of the patient as expressed by selected protein markers.The study was retrospective and based on an analysis of patients treated at the in-house centre fromJanuary 2014 to December 2020. It included a group of patients undergoing laparotomy procedureswho developed evectasia and a group of control group of patients who underwent laparotomy anddid not develop wound dehiscence after the procedure.The analysis showed that lower serum albumin levels were associated with a higher risk of wounddehiscence in patients who underwent laparotomy due to acute abdominal disease. The study andcontrol groups differed significantly in levels of: Hgb, total protein, CRP, lymphocytes, albumin, PCT,NRS.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.6850
Akash Akash, Neeraj Saxena
1.1 BackgroundWound infection is the most common post-op complication encountered after open appendectomy. Various studies comparing risk of superficial surgical site infection (SSI) in primary closure (PC) and delayed primary closure (DPC) of wound has been conducted in the past. But there is no uniform consensus regarding the method of wound closure. So aim of this study was comparison of both wound closure techniques.1.2 Material and MethodsThis was prospective study, enrolled 50 patients who underwent open appendectomy. Patients’ demographics, characteristics and operative findings were recorded. Those who were elder than 18 years and had appendectomy with a right lower quadrant incision were included. Patients with any comorbidity, morbid obesity and pregnancy were excluded. Patients were randomized to undergo two techniques of wound closure namely PC and DPC. On follow-up at one week and one month, SSI, post-op pain and LOS were compared among two groups. Clinical assessment included a visual analog scale (1-10) for pain.1.3 ResultsIn our study incidence of SSI in DPC group was significantly lower when compared to PC group (p value=0.0002) while post-op pain and LOS was not significant on comparison between two groups. 1.4 ConclusionWe concluded that DPC was superior to PC of wound in terms of reduction of incidence of superficial SSI. Although with respect to LOS and post-op pain the two techniques of wound closure were not different.Keywords: Superficial Surgical Site Infection, Primary Closure, Delayed Primary Closure, Complicated Appendicitis.
{"title":"SUPERFICIAL SURGICAL SITE INFECTION IN DELAYED PRIMARY VS PRIMARY WOUND CLOSURE IN COMPLICATED APPENDICITIS-Open label Randomised Control Trial","authors":"Akash Akash, Neeraj Saxena","doi":"10.5604/01.3001.0053.6850","DOIUrl":"https://doi.org/10.5604/01.3001.0053.6850","url":null,"abstract":"1.1 BackgroundWound infection is the most common post-op complication encountered after open appendectomy. Various studies comparing risk of superficial surgical site infection (SSI) in primary closure (PC) and delayed primary closure (DPC) of wound has been conducted in the past. But there is no uniform consensus regarding the method of wound closure. So aim of this study was comparison of both wound closure techniques.1.2 Material and MethodsThis was prospective study, enrolled 50 patients who underwent open appendectomy. Patients’ demographics, characteristics and operative findings were recorded. Those who were elder than 18 years and had appendectomy with a right lower quadrant incision were included. Patients with any comorbidity, morbid obesity and pregnancy were excluded. Patients were randomized to undergo two techniques of wound closure namely PC and DPC. On follow-up at one week and one month, SSI, post-op pain and LOS were compared among two groups. Clinical assessment included a visual analog scale (1-10) for pain.1.3 ResultsIn our study incidence of SSI in DPC group was significantly lower when compared to PC group (p value=0.0002) while post-op pain and LOS was not significant on comparison between two groups. 1.4 ConclusionWe concluded that DPC was superior to PC of wound in terms of reduction of incidence of superficial SSI. Although with respect to LOS and post-op pain the two techniques of wound closure were not different.Keywords: Superficial Surgical Site Infection, Primary Closure, Delayed Primary Closure, Complicated Appendicitis.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-12DOI: 10.5604/01.3001.0053.9292
Michal Wysocki, Maciej Borys, Krystyna Gałązka, Maciej Stranek, Andrzej Budzyński
IntroductionThe determinants influencing the risk for complications of laparoscopic distal pancreatectomies (LDP) are not yet fully defined, thus we aimed to determine risk factors for serious perioperative morbidity after LDP with spleen preservation, LDP and radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas (RAMPS).Material and methodsRetrospective cohort study of consecutive patients that underwent LDP between January 2019 and December 2022. Study group included patients with serious perioperative morbidity (III – V grades in Clavien-Dindo classification) during 30-days period after operation. Control group consisted of patients without serious perioperative morbidity. 142 patients were included into the following study.ResultsSerious perioperative morbidity occurred in 33 (23.24%) operated patients, while mortality included 3 cases (2.11%). 9/68 (13.2%) patients had serious perioperative morbidity after LDP with spleen preservation (27.3% of perioperative morbidity group). 13/51 patients, i. e. 25.5%, after LDP with splenectomy included in perioperative morbidity group (39.4%). 11 out of 23 patients (47.8%) had serious perioperative morbidity after RAMPS (33.3% of perioperative morbidity group). In multivariate logistic regression need for splenectomy during pancreatectomy (OR 3.66, 95%CI 1.20-11.18) and tumor above 28 millimeters in size (OR 3.01, 95%CI 1.19-9.59) were independent risk factors for serious perioperative morbidity.ConclusionNeed for splenectomy during laparoscopic distal pancreatectomy and tumor size above 28 millimeters were independent risk factors for serious perioperative morbidity after laparoscopic distal pancreatectomies.
{"title":"Splenectomy and tumor size are risk factors for serious perioperative morbidity of laparoscopic distal pancreatectomies","authors":"Michal Wysocki, Maciej Borys, Krystyna Gałązka, Maciej Stranek, Andrzej Budzyński","doi":"10.5604/01.3001.0053.9292","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9292","url":null,"abstract":"IntroductionThe determinants influencing the risk for complications of laparoscopic distal pancreatectomies (LDP) are not yet fully defined, thus we aimed to determine risk factors for serious perioperative morbidity after LDP with spleen preservation, LDP and radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas (RAMPS).Material and methodsRetrospective cohort study of consecutive patients that underwent LDP between January 2019 and December 2022. Study group included patients with serious perioperative morbidity (III – V grades in Clavien-Dindo classification) during 30-days period after operation. Control group consisted of patients without serious perioperative morbidity. 142 patients were included into the following study.ResultsSerious perioperative morbidity occurred in 33 (23.24%) operated patients, while mortality included 3 cases (2.11%). 9/68 (13.2%) patients had serious perioperative morbidity after LDP with spleen preservation (27.3% of perioperative morbidity group). 13/51 patients, i. e. 25.5%, after LDP with splenectomy included in perioperative morbidity group (39.4%). 11 out of 23 patients (47.8%) had serious perioperative morbidity after RAMPS (33.3% of perioperative morbidity group). In multivariate logistic regression need for splenectomy during pancreatectomy (OR 3.66, 95%CI 1.20-11.18) and tumor above 28 millimeters in size (OR 3.01, 95%CI 1.19-9.59) were independent risk factors for serious perioperative morbidity.ConclusionNeed for splenectomy during laparoscopic distal pancreatectomy and tumor size above 28 millimeters were independent risk factors for serious perioperative morbidity after laparoscopic distal pancreatectomies.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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