Pub Date : 2024-02-08DOI: 10.5604/01.3001.0054.2676
E. Karatay, Abdulkadir Eren, M. Javadov
Introduction: The main cause of groin pain is inguinal hernia (IH). The most commonly used imaging for diagnosis is ultrasonography (USG), and which is also useful in distinguishing between indirect-direct hernia. Aim: In this study, measurements were made with USG in the semi-erect position (45) in addition to the supine position, and the effectiveness of this position in detecting the defect was investigated.Material and Method: The cases diagnosed with IH by USG between March 2019 and October 2023 were evaluated retrospectively. According to the defect diameter, the cases were divided into three groups: group a (≤1.5 cm), group b (1.5-3 cm) and group c (≥3 cm) in the supine position. 252 patients with unilateral IH were identified.Results: For group a the mean value was 1.090.23(0.64-1.48) cm in the supine and 1.280.26(0.88-1.67) cm in the semi-erect (p<0.001). For group b, the mean value was 2.290.29(1.57-2.82) cm in the supine and 2.410.31(1.65-2.94) cm in the semi-erect (p<0.001). For Group c, the mean value was 3.570.23(3.28-4.05) cm in the supine and 3.620.24(3.32-4.10) cm in the semi-erect (p<0.05).Conclusion: USG, which provides reliable findings in the diagnosis of IH, is an easily accessible modality. Unlike previous studies, in this study, the semi-erect position was used for the first time in IH cases and was shown to be effective in determining the optimum diameter of the defect.
简介腹股沟疼痛的主要原因是腹股沟疝（IH）。最常用的影像学诊断方法是超声波检查（USG），它还有助于区分间接疝和直接疝。目的：在本研究中，除仰卧位外，还采用半直立位（45°）进行 USG 测量，并研究该体位在检测缺损方面的有效性：对 2019 年 3 月至 2023 年 10 月期间经 USG 诊断为 IH 的病例进行回顾性评估。根据缺损直径将病例分为三组：仰卧位 a 组（≤1.5 厘米）、b 组（1.5-3 厘米）和 c 组（≥3 厘米）。结果显示：A组的平均值为1.5厘米，B组为1.5-3厘米，C组为≥3厘米：a 组的平均值为：仰卧位 1.090.23（0.64-1.48）厘米，半直立位 1.280.26（0.88-1.67）厘米（p<0.001）。b 组仰卧时的平均值为 2.290.29（1.57-2.82）厘米，半直立时的平均值为 2.410.31（1.65-2.94）厘米（p<0.001）。c 组的平均值为：仰卧位 3.570.23（3.28-4.05）厘米，半直立位 3.620.24（3.32-4.10）厘米（P<0.05）：结论：USG可为IH的诊断提供可靠的结果，是一种易于使用的方法。与以往的研究不同，本研究首次在 IH 病例中使用了半直立位，结果表明半直立位能有效确定缺损的最佳直径。
{"title":"Diagnostic impact of using the semi-erect position in the evaluation of inguinal hernia with superficial ultrasonography","authors":"E. Karatay, Abdulkadir Eren, M. Javadov","doi":"10.5604/01.3001.0054.2676","DOIUrl":"https://doi.org/10.5604/01.3001.0054.2676","url":null,"abstract":"Introduction: The main cause of groin pain is inguinal hernia (IH). The most commonly used imaging for diagnosis is ultrasonography (USG), and which is also useful in distinguishing between indirect-direct hernia. Aim: In this study, measurements were made with USG in the semi-erect position (45) in addition to the supine position, and the effectiveness of this position in detecting the defect was investigated.Material and Method: The cases diagnosed with IH by USG between March 2019 and October 2023 were evaluated retrospectively. According to the defect diameter, the cases were divided into three groups: group a (≤1.5 cm), group b (1.5-3 cm) and group c (≥3 cm) in the supine position. 252 patients with unilateral IH were identified.Results: For group a the mean value was 1.090.23(0.64-1.48) cm in the supine and 1.280.26(0.88-1.67) cm in the semi-erect (p<0.001). For group b, the mean value was 2.290.29(1.57-2.82) cm in the supine and 2.410.31(1.65-2.94) cm in the semi-erect (p<0.001). For Group c, the mean value was 3.570.23(3.28-4.05) cm in the supine and 3.620.24(3.32-4.10) cm in the semi-erect (p<0.05).Conclusion: USG, which provides reliable findings in the diagnosis of IH, is an easily accessible modality. Unlike previous studies, in this study, the semi-erect position was used for the first time in IH cases and was shown to be effective in determining the optimum diameter of the defect.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140459876","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 : 2024-01-31DOI: 10.5604/01.3001.0053.9855
Łukasz Świątek, H. Stępak, Zbigniew Krasiński
Introduction: Chronic venous disease (CVD) is a rising problem in Western countries. There are several stages of CVD that can be treated in different ways. One of the methods of treating varicosity, Stage C2 of CVD, is through endovenous laser ablation (EVLA). While still being developed, this method is popular due to its short operation time, less bleeding, quick recovery, and lack of surgical scars. Compression therapy with compression stockings has been widely used as a conservative treatment of early-stage CVD and it's also used EVLA. However, there are no strong recommendations to use compression therapy after this kind of surgery. Aim and method: The aim of this paper is to review existing knowledge about the benefits of compression therapy and to identify a recommended time period for its use after EVLA. The databases used in the review were Pubmed and Cochrane. Results: Studies focusing on compression therapy for varicose veins after EVLA have questioned the prolonged use of compression therapy, as it brings no additional benefits and might be difficult for patients to adhere to. The existing studies recommended a period no longer than 1–2 weeks. No significant differences were found in reoccurrence rate or return to normal activities between compression and non-compression groups. It has been proven that compression therapy significantly reduces postoperative pain and the consumption of analgesics. Discussion: Compression therapy seems to be a safe option for low pain management. There is a need for further research involving the impact of compression therapy after EVLA, especially in group of low energy settings, as the results of treatment are promising.
{"title":"The role of compression therapy after endovenous laser ablation (EVLA) – review","authors":"Łukasz Świątek, H. Stępak, Zbigniew Krasiński","doi":"10.5604/01.3001.0053.9855","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9855","url":null,"abstract":"Introduction: Chronic venous disease (CVD) is a rising problem in Western countries. There are several stages of CVD that can be treated in different ways. One of the methods of treating varicosity, Stage C2 of CVD, is through endovenous laser ablation (EVLA). While still being developed, this method is popular due to its short operation time, less bleeding, quick recovery, and lack of surgical scars. Compression therapy with compression stockings has been widely used as a conservative treatment of early-stage CVD and it's also used EVLA. However, there are no strong recommendations to use compression therapy after this kind of surgery. Aim and method: The aim of this paper is to review existing knowledge about the benefits of compression therapy and to identify a recommended time period for its use after EVLA. The databases used in the review were Pubmed and Cochrane. Results: Studies focusing on compression therapy for varicose veins after EVLA have questioned the prolonged use of compression therapy, as it brings no additional benefits and might be difficult for patients to adhere to. The existing studies recommended a period no longer than 1–2 weeks. No significant differences were found in reoccurrence rate or return to normal activities between compression and non-compression groups. It has been proven that compression therapy significantly reduces postoperative pain and the consumption of analgesics. Discussion: Compression therapy seems to be a safe option for low pain management. There is a need for further research involving the impact of compression therapy after EVLA, especially in group of low energy settings, as the results of treatment are promising.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139590748","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 : 2024-01-31DOI: 10.5604/01.3001.0053.9856
Mateusz Gabryszewski, A. Kasielska-Trojan, A. Sitek, Bogusław Antoszewski
Introduction: The anterolateral thigh flap is an example of a free flap widely applied for reconstruction of tissues within various areas of the body. Aim: The aim of the study was to determine the most common locations of the ALT flap perforators in men and women as well as to clarify any potential differences in the location of the vessel in male vs. female subjects. Material and method: In years 2021–2022, a study was conducted at the Plastic, Reconstructive, and Aesthetic Surgery Clinic in a group of 90 volunteers (45 women and 45 men, a total of 180 lower extremities) to determine the location of the anterolateral thigh flap perforator against the flap surface using a portable Doppler probe. Results: Variable locations were revealed for the anterolateral thigh flap perforator within the study. In women, the perforator is located more distally from the anterior superior iliac spine, most frequently within the inferolateral quadrant, while being located closer to the anterior superior iliac spine, and most frequently within the superolateral quadrant, in men. No perforator was found in 3.3% of the examined limbs. No statistically significant differences were observed between the course of the perforators within the left and right lower limbs in individual patients.Conclusions: The location of the ALT flap perforator is subject to sexual dimorphism, which facilitates the investigation area being narrowed down to the well-defined locations of its most frequent occurrence when planning anterolateral thigh flap reconstructive procedures.
{"title":"Variability of anterolateral thigh flap perforator locations – clinical implications","authors":"Mateusz Gabryszewski, A. Kasielska-Trojan, A. Sitek, Bogusław Antoszewski","doi":"10.5604/01.3001.0053.9856","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9856","url":null,"abstract":"Introduction: The anterolateral thigh flap is an example of a free flap widely applied for reconstruction of tissues within various areas of the body. Aim: The aim of the study was to determine the most common locations of the ALT flap perforators in men and women as well as to clarify any potential differences in the location of the vessel in male vs. female subjects. Material and method: In years 2021–2022, a study was conducted at the Plastic, Reconstructive, and Aesthetic Surgery Clinic in a group of 90 volunteers (45 women and 45 men, a total of 180 lower extremities) to determine the location of the anterolateral thigh flap perforator against the flap surface using a portable Doppler probe. Results: Variable locations were revealed for the anterolateral thigh flap perforator within the study. In women, the perforator is located more distally from the anterior superior iliac spine, most frequently within the inferolateral quadrant, while being located closer to the anterior superior iliac spine, and most frequently within the superolateral quadrant, in men. No perforator was found in 3.3% of the examined limbs. No statistically significant differences were observed between the course of the perforators within the left and right lower limbs in individual patients.Conclusions: The location of the ALT flap perforator is subject to sexual dimorphism, which facilitates the investigation area being narrowed down to the well-defined locations of its most frequent occurrence when planning anterolateral thigh flap reconstructive procedures.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139591146","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 : 2024-01-15DOI: 10.5604/01.3001.0054.2674
Joanna Aguirre Talledo, J. Caballero-Alvarado, Maria De la Cruz Davila, Carlos Zavaleta-Corvera
Objective: To determine whether Roux-en-Y gastric bypass is more effective than vertical sleeve gastrectomy in the remission of type 2 diabetes mellitus.Methods: A systematic review and meta-analysis was performed, the literature search was performed in 4 Web of Science, Medline/PubMed, Embase, Scopus and Medline/Ovid databases, 1323 results were identified, followed by screening and 14 articles selected and included in the systematic review were obtained. Primary and secondary outcomes were measured through an RR with a 95% CI.Results: The primary outcome of T2DM remission was 15% in favor of VSG, RR: 1.15; [95% CI: 1.04 – 1.28]. For secondary outcomes, hypertension remission was 7% in favor of RR VSG: 1.07; [95% CI: 1.00 – 1.16]. Remission of dyslipidemia was 16% in favor of RR VSG: 1.16; [ 95% CI: 1.06 – 1.26]. BMI after surgery was in favor of RYGB MD: -1.31; [95% CI: -1.98 – -0.64]. For excess weight loss was in favor of VSG with a MD: 6.50; [95% CI: 4.99 – 8.01]. In relation to total cholesterol, they were favorable for RYGB in 65% MD: -0.35; [95% CI: -0.46 – -0.24], with a value of p<0.05. For LDL values our results were favorable for RYGB at 69% MD: -0.31; [95% CI: -0.45 – -0.16], p<0.01 value.Conclusion: Laparoscopic sleeve gastrectomy is more effective in DM2 remission, hypertension remission, dyslipidemia remission, weight loss compared to Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is more effective in lowering BMI, lowering total cholesterol, LDL and TG compared to laparoscopic sleeve gastrectomy.
{"title":"Roux-en-Y Gastric Bypass vs Vertical Sleeve Gastrectomy in the remission of type 2 Diabetes Mellitus: A Systematic Review and Metanalysis","authors":"Joanna Aguirre Talledo, J. Caballero-Alvarado, Maria De la Cruz Davila, Carlos Zavaleta-Corvera","doi":"10.5604/01.3001.0054.2674","DOIUrl":"https://doi.org/10.5604/01.3001.0054.2674","url":null,"abstract":"Objective: To determine whether Roux-en-Y gastric bypass is more effective than vertical sleeve gastrectomy in the remission of type 2 diabetes mellitus.Methods: A systematic review and meta-analysis was performed, the literature search was performed in 4 Web of Science, Medline/PubMed, Embase, Scopus and Medline/Ovid databases, 1323 results were identified, followed by screening and 14 articles selected and included in the systematic review were obtained. Primary and secondary outcomes were measured through an RR with a 95% CI.Results: The primary outcome of T2DM remission was 15% in favor of VSG, RR: 1.15; [95% CI: 1.04 – 1.28]. For secondary outcomes, hypertension remission was 7% in favor of RR VSG: 1.07; [95% CI: 1.00 – 1.16]. Remission of dyslipidemia was 16% in favor of RR VSG: 1.16; [ 95% CI: 1.06 – 1.26]. BMI after surgery was in favor of RYGB MD: -1.31; [95% CI: -1.98 – -0.64]. For excess weight loss was in favor of VSG with a MD: 6.50; [95% CI: 4.99 – 8.01]. In relation to total cholesterol, they were favorable for RYGB in 65% MD: -0.35; [95% CI: -0.46 – -0.24], with a value of p<0.05. For LDL values our results were favorable for RYGB at 69% MD: -0.31; [95% CI: -0.45 – -0.16], p<0.01 value.Conclusion: Laparoscopic sleeve gastrectomy is more effective in DM2 remission, hypertension remission, dyslipidemia remission, weight loss compared to Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is more effective in lowering BMI, lowering total cholesterol, LDL and TG compared to laparoscopic sleeve gastrectomy.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507418","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}
ABSTRACTBackground: Necrotizing fasciitis is an expeditiously escalating inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. To aid diagnosis, the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system was devised to stratify the likelihood of infection in patients on presentation. Objectives: Study aimed to investigate and quantify the relationships between the LRINEC scoring system and the outcomes such as need for amputation, length of hospital and mortality stay in patients with necrotizing fasciitis. Method: A total number of 90 Patients were admitted with a provisional diagnosis of necrotizing fasciitis. LRINEC score was calculated for each case based on six laboratory variables at the time of presentation. Enrolled patients were divided into three groups on the basis of LRINEC score. The differences in mortality, length of hospitalization, number of debridement and the need of amputation between these groups were compared. Results: Increasing age, male gender, DM has a poor prognosis in the outcome of necrotizing fasciitis patients. The amputation rates and mortality rates are better correlated with higher LRINEC score. Conclusion: The LRINEC score helps in stratifying the patients into risk categories such as low risk, moderate risk and high risk categories, according to severity in a much organized way and the appropriate management like surgical debridement can be started timely. LRINEC score is a robust index that is capable of detecting early cases of necrotizing fasciitis and is simple enough for routine use. It is a simplified bedside diagnostic tool for early diagnosis and prediction of outcome in patients of necrotizing fasciitis.
{"title":"Efficacy of LRINEC Scoring in Patients of Necrotizing Fasciitis and its Correlation with the Outcome","authors":"Sumit Kumar, Suhas Agarwal, Gaurav Patel, Ishan Sehgal, Sandeep Gara, Pushkar Yadav","doi":"10.5604/01.3001.0053.9502","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9502","url":null,"abstract":"ABSTRACTBackground: Necrotizing fasciitis is an expeditiously escalating inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. To aid diagnosis, the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system was devised to stratify the likelihood of infection in patients on presentation. Objectives: Study aimed to investigate and quantify the relationships between the LRINEC scoring system and the outcomes such as need for amputation, length of hospital and mortality stay in patients with necrotizing fasciitis. Method: A total number of 90 Patients were admitted with a provisional diagnosis of necrotizing fasciitis. LRINEC score was calculated for each case based on six laboratory variables at the time of presentation. Enrolled patients were divided into three groups on the basis of LRINEC score. The differences in mortality, length of hospitalization, number of debridement and the need of amputation between these groups were compared. Results: Increasing age, male gender, DM has a poor prognosis in the outcome of necrotizing fasciitis patients. The amputation rates and mortality rates are better correlated with higher LRINEC score. Conclusion: The LRINEC score helps in stratifying the patients into risk categories such as low risk, moderate risk and high risk categories, according to severity in a much organized way and the appropriate management like surgical debridement can be started timely. LRINEC score is a robust index that is capable of detecting early cases of necrotizing fasciitis and is simple enough for routine use. It is a simplified bedside diagnostic tool for early diagnosis and prediction of outcome in patients of necrotizing fasciitis.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140515627","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 : 2024-01-02DOI: 10.5604/01.3001.0053.9871
Natalia Dowgiałło-gornowicz, Paweł Jaworski, Paweł Lech, Piotr Major
Introduction: It is already known that bariatric surgery can improve the health and quality of life of morbidly obese patients of all ages. Our population is getting older. Which is why the number of bariatric surgeries among obese people over 65 years of age is systematically increasing. Aims: The study aims to analyze the management of patients over 65 years of age in Polish bariatric centers. Material and methods: The study was conducted on representatives from 30 largest bariatric departments in Poland. By collecting surveys, we aimed to analyze changes in qualifications for surgery and care for elderly patients.Results: 13 of 30 (43.3%) representatives responded to the survey. The remaining centers did not qualified patients over 65 years old for the surgical treatment of obesity. The mean percentage of patients over 65, who underwent bariatric surgery was 2.75. Most representatives (69.2%) chose SG as the procedure of choice in patients over 65 years of age. According to 84.6% of surgeons, age did not matter when qualifying patients over 65 years of age for BS. The majority of surgeons (53.8%) believed that bariatric surgery in older patients was comparable to younger patients. 9 (69.2%) surgeons believed that there should be no age limit for bariatric surgery.Conclusions: Only almost half of the bariatric centers in Poland perform operations on patients over 65 years of age. Most Polish surgeons claim that operations on older patients have comparable benefits to younger patients and there is no need for an age limit.
{"title":"Current trends in bariatric surgery in patients olden than 65 year in Poland","authors":"Natalia Dowgiałło-gornowicz, Paweł Jaworski, Paweł Lech, Piotr Major","doi":"10.5604/01.3001.0053.9871","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9871","url":null,"abstract":"Introduction: It is already known that bariatric surgery can improve the health and quality of life of morbidly obese patients of all ages. Our population is getting older. Which is why the number of bariatric surgeries among obese people over 65 years of age is systematically increasing. Aims: The study aims to analyze the management of patients over 65 years of age in Polish bariatric centers. Material and methods: The study was conducted on representatives from 30 largest bariatric departments in Poland. By collecting surveys, we aimed to analyze changes in qualifications for surgery and care for elderly patients.Results: 13 of 30 (43.3%) representatives responded to the survey. The remaining centers did not qualified patients over 65 years old for the surgical treatment of obesity. The mean percentage of patients over 65, who underwent bariatric surgery was 2.75. Most representatives (69.2%) chose SG as the procedure of choice in patients over 65 years of age. According to 84.6% of surgeons, age did not matter when qualifying patients over 65 years of age for BS. The majority of surgeons (53.8%) believed that bariatric surgery in older patients was comparable to younger patients. 9 (69.2%) surgeons believed that there should be no age limit for bariatric surgery.Conclusions: Only almost half of the bariatric centers in Poland perform operations on patients over 65 years of age. Most Polish surgeons claim that operations on older patients have comparable benefits to younger patients and there is no need for an age limit.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140515412","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 : 2023-10-13DOI: 10.5604/01.3001.0053.9305
Przemysław Czarnecki, Jakub Kopeć, Przemyslaw Przewratil
Purpose: The purpose of this retrospective study was to evaluate our combinatorytreatment using ultrasonography, minimally invasive pit-picking, and Nd:YAG lasertherapy against pilonidal disease in adolescent patients.Methods: From June 2017 to December 2020, 147 patients were treated. Thetreatment cycle lasted 6-12 months. In this time, patients underwent pit-pickingprocedures and 6 to 10 Nd:YAG treatments. The remnants of the cyst were removedby laser therapy, which provided easy epilation. Each patient underwent multipleultrasound examinations during the therapy to discover any possible newly formedasymptomatic sinuses. When those sinuses were located, the pit-picking procedurewas repeated. The mean follow-up time for the program was 6 months.Results: Of the total 147 patients who were treated, the first 52 were included in thisstudy with a one-year follow-up post procedure. There were 49 symptom-free patients(96%). One patient underwent surgery in another hospital because of a recurrence andone had a pilonidal disease relapse (4%). Asymptomatic cysts were found in two otherpatients by ultrasound examination. They were all treated in the outpatient departmentwith pit-picking method with good results.Conclusions: Performing sequentially repeated pit-picking procedures combined withthe Nd:YAG laser therapy is an effective treatment method for adolescent pilonidaldisease. Repeatable ultrasonography examinations allow for early diagnosis ofpilonidal sinus relapse. Simultaneous Nd:YAG laser therapy enables efficaciousepilation of the intergluteal cleft and prevents recurrences.Level of evidence - IV
{"title":"Sequential, ultrasound-guided, minimally invasive pit-picking procedure with Nd:YAGlaser epilation treatment for pilonidal disease","authors":"Przemysław Czarnecki, Jakub Kopeć, Przemyslaw Przewratil","doi":"10.5604/01.3001.0053.9305","DOIUrl":"https://doi.org/10.5604/01.3001.0053.9305","url":null,"abstract":"Purpose: The purpose of this retrospective study was to evaluate our combinatorytreatment using ultrasonography, minimally invasive pit-picking, and Nd:YAG lasertherapy against pilonidal disease in adolescent patients.Methods: From June 2017 to December 2020, 147 patients were treated. Thetreatment cycle lasted 6-12 months. In this time, patients underwent pit-pickingprocedures and 6 to 10 Nd:YAG treatments. The remnants of the cyst were removedby laser therapy, which provided easy epilation. Each patient underwent multipleultrasound examinations during the therapy to discover any possible newly formedasymptomatic sinuses. When those sinuses were located, the pit-picking procedurewas repeated. The mean follow-up time for the program was 6 months.Results: Of the total 147 patients who were treated, the first 52 were included in thisstudy with a one-year follow-up post procedure. There were 49 symptom-free patients(96%). One patient underwent surgery in another hospital because of a recurrence andone had a pilonidal disease relapse (4%). Asymptomatic cysts were found in two otherpatients by ultrasound examination. They were all treated in the outpatient departmentwith pit-picking method with good results.Conclusions: Performing sequentially repeated pit-picking procedures combined withthe Nd:YAG laser therapy is an effective treatment method for adolescent pilonidaldisease. Repeatable ultrasonography examinations allow for early diagnosis ofpilonidal sinus relapse. Simultaneous Nd:YAG laser therapy enables efficaciousepilation of the intergluteal cleft and prevents recurrences.Level of evidence - IV","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135857360","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 : 2023-10-13DOI: 10.5604/01.3001.0053.5995
Sergii Savoliuk, Andrii Dembitskyi
Introduction: Chronic venous insufficiency (CVI) occurs in 25-40% of the adult population with the severe forms of CEAP C3–C6 in 17-20% of cases. Study aimed to compare the standard treatment of CVI and the use of endovenous methods, cellular technologies.Materials and methods: I group - 28 patients were treated using modern wound coverings, cell technologies and performing minimally invasive operations. II group - 42 patients underwent crossectomy with stripping of the trunk of the target vein and local treatment with "standard" ointments. Treatment results were evaluated using Venous Clinical Severity Score (VCSS), Numeric Pain Rating Scale (NPRS) and ulcer healing time.Results: After 1 month VCSS score was 13.82.3 and 16.43.3 points in I and II groups; after 3 months, 10.22.1 and 13.62.4 points. VLU was healed in 20 (71.43%) and 16 patients (38%) after 3 months in I and II groups, in 26 (92.86%) and 30 patients (71.43%) after 6 months; 28 (100%) and 40 patients (95.24%) after 12 months. After 1, 3 and 6 months occlusion of the target segment was achieved in 14 (100%) patients of the I group. NPRS scale was significantly lower in patients of I group. In patients of the I group, the hospital stay was 8.22.4 days, II group - 14.53.8 days.Conclusions: The use of modern wound coverings, Platelet Rich Plasma (PRP) and Negative-pressure wound therapy (NPWT) therapy, reduce the period of preoperative preparation, speed up the stage of cleaning and healing of VLU compared to conventional wound coverings.
{"title":"Experience in the use of endovenous methods and cell technologies in the treatment of trophic defects in patients with chronic venous insufficiency C6","authors":"Sergii Savoliuk, Andrii Dembitskyi","doi":"10.5604/01.3001.0053.5995","DOIUrl":"https://doi.org/10.5604/01.3001.0053.5995","url":null,"abstract":"Introduction: Chronic venous insufficiency (CVI) occurs in 25-40% of the adult population with the severe forms of CEAP C3–C6 in 17-20% of cases. Study aimed to compare the standard treatment of CVI and the use of endovenous methods, cellular technologies.Materials and methods: I group - 28 patients were treated using modern wound coverings, cell technologies and performing minimally invasive operations. II group - 42 patients underwent crossectomy with stripping of the trunk of the target vein and local treatment with \"standard\" ointments. Treatment results were evaluated using Venous Clinical Severity Score (VCSS), Numeric Pain Rating Scale (NPRS) and ulcer healing time.Results: After 1 month VCSS score was 13.82.3 and 16.43.3 points in I and II groups; after 3 months, 10.22.1 and 13.62.4 points. VLU was healed in 20 (71.43%) and 16 patients (38%) after 3 months in I and II groups, in 26 (92.86%) and 30 patients (71.43%) after 6 months; 28 (100%) and 40 patients (95.24%) after 12 months. After 1, 3 and 6 months occlusion of the target segment was achieved in 14 (100%) patients of the I group. NPRS scale was significantly lower in patients of I group. In patients of the I group, the hospital stay was 8.22.4 days, II group - 14.53.8 days.Conclusions: The use of modern wound coverings, Platelet Rich Plasma (PRP) and Negative-pressure wound therapy (NPWT) therapy, reduce the period of preoperative preparation, speed up the stage of cleaning and healing of VLU compared to conventional wound coverings.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135857078","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 : 2023-10-13DOI: 10.5604/01.3001.0053.8845
Wojciech Ciesielski, Tomasz Klimczak, Adam Durczyński, Piotr Hogendorf, Janusz Strzelczyk
IntroductionEndoscopic resection of gastrointestinal tract lesions, originating from Japan, is becoming more frequently used in European countries. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) ensure minimally invasive removal of benign, premalignant and early neoplastic tumours of esophageus, stomach and intestine in selected group of patients.AimAim of this study was to determine the outcomes, radical resection rate (R0) and complication rate of ESD procedures performed in our department. Material and methodsThe data from 100 ESD procedures of esophageal, gastric, duodenal and colorectal lesions performed in out unit between 02.01.2020 and 30.06.2023 was collected and analysed retrospectively. Results42 male and 58 female patients in the median age of 64 years old (ranging 31 – 89 yo) underwent ESD. Mean duration of the procedure was 66 minutes (ranging 25 – 185 minutes). Tumours were located in oesophagus in 8 cases (8%), stomach in 25 cases (25%), duodenum in 1 case (1%) and colon in 66 cases (66%). Radical resection was achieved in 98 cases (98%) - 2 patients were qualified for surgical treatment Average size of dissection lesions was 26 x 19 mm. The biggest one was 60 x 60 mm (sigmoid adenoma) and smallest one was 5 x 5 mm (GNET). Complication occurred in 10 patients (10%) – 9 perforations of the wall of intestine (9%) and 1 hamorrhage, which required endoscopic intervention (1%). ConclusionsWith proper qualification, ESD is effective and safe method of treatment for benign, premalignant and early neoplastic lesions of gastrointestinal tract in hands of experienced endoscopists. Following current guidelines satisfying outcomes, comparable with leading center, can be achieved.
{"title":"Application of Endoscopic Submucosal Dissection (ESD) in treatment of gastrointestinal lesions- single center experience.","authors":"Wojciech Ciesielski, Tomasz Klimczak, Adam Durczyński, Piotr Hogendorf, Janusz Strzelczyk","doi":"10.5604/01.3001.0053.8845","DOIUrl":"https://doi.org/10.5604/01.3001.0053.8845","url":null,"abstract":"IntroductionEndoscopic resection of gastrointestinal tract lesions, originating from Japan, is becoming more frequently used in European countries. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) ensure minimally invasive removal of benign, premalignant and early neoplastic tumours of esophageus, stomach and intestine in selected group of patients.AimAim of this study was to determine the outcomes, radical resection rate (R0) and complication rate of ESD procedures performed in our department. Material and methodsThe data from 100 ESD procedures of esophageal, gastric, duodenal and colorectal lesions performed in out unit between 02.01.2020 and 30.06.2023 was collected and analysed retrospectively. Results42 male and 58 female patients in the median age of 64 years old (ranging 31 – 89 yo) underwent ESD. Mean duration of the procedure was 66 minutes (ranging 25 – 185 minutes). Tumours were located in oesophagus in 8 cases (8%), stomach in 25 cases (25%), duodenum in 1 case (1%) and colon in 66 cases (66%). Radical resection was achieved in 98 cases (98%) - 2 patients were qualified for surgical treatment Average size of dissection lesions was 26 x 19 mm. The biggest one was 60 x 60 mm (sigmoid adenoma) and smallest one was 5 x 5 mm (GNET). Complication occurred in 10 patients (10%) – 9 perforations of the wall of intestine (9%) and 1 hamorrhage, which required endoscopic intervention (1%). ConclusionsWith proper qualification, ESD is effective and safe method of treatment for benign, premalignant and early neoplastic lesions of gastrointestinal tract in hands of experienced endoscopists. Following current guidelines satisfying outcomes, comparable with leading center, can be achieved.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135857359","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 : 2023-10-13DOI: 10.5604/01.3001.0053.5994
AHMET TARIK HARMANTEPE, Enis Dikicier, emre gönüllü, Kayhan Ozdemir, Muhammet Burak Kamburoğlu, Merve Yigit
BackgroundMachine learning is a branch of artificial intelligence based on the idea that systems can learn from data, identify patterns and make decisions with minimal human intervention.. Our aim is to predict acute appendicitis, which is the most common emergency surgery indication, using machine learning algorithms with an easy and inexpensive method.Materials and Methods:Patients who were treated surgically with a prediagnosis of acute appendicitis in a single-center between 2011 and 2021 were analyzed. Patients with right lower quadrant pain were selected. 189 positive and 156 negative appendectomies were found. Gender and hemogram were used as features. Machine learning algorithms and data analysis were made in Python (3.7) programming language.ResultsNegative appendectomies were 62%(n=97) female and 38%(n=59) male. Positive appendectomies were 38% (n=72) female and 62% (n=117) male. The accuracy in the test data was 82.7% in logistic regression, 68.9% in support vector machines, 78.1% in k-nearest neighbors, 83.9% in neural networks, The accuracy in the voiting classier created with logistic regression, k-nearest neighbor, support vector machines and artificial neural networks was 86.2%. In Voting classifier, sensitivity was 83.7% and specificity was 88.6%.ConclusionThe results of our study showed that ML is an effective method in diagnosing acute appendicitis. This study presents a practical, easy, fast and inexpensive method to predict the diagnosis of acute appendicitis.
{"title":"A DIFFERENT WAY TO DIAGNOSIS ACUTE APPENDICITIS: MACHINE LEARNING","authors":"AHMET TARIK HARMANTEPE, Enis Dikicier, emre gönüllü, Kayhan Ozdemir, Muhammet Burak Kamburoğlu, Merve Yigit","doi":"10.5604/01.3001.0053.5994","DOIUrl":"https://doi.org/10.5604/01.3001.0053.5994","url":null,"abstract":"BackgroundMachine learning is a branch of artificial intelligence based on the idea that systems can learn from data, identify patterns and make decisions with minimal human intervention.. Our aim is to predict acute appendicitis, which is the most common emergency surgery indication, using machine learning algorithms with an easy and inexpensive method.Materials and Methods:Patients who were treated surgically with a prediagnosis of acute appendicitis in a single-center between 2011 and 2021 were analyzed. Patients with right lower quadrant pain were selected. 189 positive and 156 negative appendectomies were found. Gender and hemogram were used as features. Machine learning algorithms and data analysis were made in Python (3.7) programming language.ResultsNegative appendectomies were 62%(n=97) female and 38%(n=59) male. Positive appendectomies were 38% (n=72) female and 62% (n=117) male. The accuracy in the test data was 82.7% in logistic regression, 68.9% in support vector machines, 78.1% in k-nearest neighbors, 83.9% in neural networks, The accuracy in the voiting classier created with logistic regression, k-nearest neighbor, support vector machines and artificial neural networks was 86.2%. In Voting classifier, sensitivity was 83.7% and specificity was 88.6%.ConclusionThe results of our study showed that ML is an effective method in diagnosing acute appendicitis. This study presents a practical, easy, fast and inexpensive method to predict the diagnosis of acute appendicitis.","PeriodicalId":43422,"journal":{"name":"Polish Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135857368","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：