Magyar sebeszet最新文献

Introduction: A crucial element of colorectal surgery is ensuring a safe anastomosis. In order to avoid the most significant complication - anastomotic leakage - two factors are essential: adequate blood supply and a tension-free suture. After extended resections, the mobilised colon sometimes cannot be connected to the rectal stump without tension. In these cases, transmesenteric placement of the transverse colon may facilitate a tension free anastomosis.

Methods: The results of transmesenteric colorectal anastomoses performed at the Surgical Department of the BAZ County Central Hospital and University Teaching Hospital are reviewed and compared with literature data.

Results: Eight patients underwent transmesenteric colorectal anastomosis. No anastomotic insufficiency was observed. Intra-operative blood loss, postoperative intestinal passage induction were similar to those expected with conventional anastomosis. Six cases were completed by laparoscopy, two by laparotomy, and two patients have been converted after laparoscopy.

Conclusion: Extended left sided colorectal resections may result in inadequate residual bowel length, which could compromise the anastomosis. When the mobilised left colon does not reach the rectum without tension, transmesenterically placed transverse colon can be used. This surgical technique, which can also be performed laparoscopically, represents a safe alternative of achieving a tension-free anastomosis.

Introduction: In case of chronic pancreatitis with inflammatory enlargement of the pancreatic head, several operations exist for the treatment, such as the Beger-, Frey-, Whipple-procedures and the Berne modification. A comparison of the results of these procedures is presented in this study. In addition to this, innovations in pancreatojejunal and biliodigestive anastomosis are also described.

Material and methods: 231 pancreatic head resections were carried out between 1991 and 2021. The data were retrospectively evaluated. Late results were also examined using questionnaires.

Results: The Berne modification and the Frey-procedure were more advantageous, than the Whipple- and the Beger-operation in terms of operating time, need for transfusion (P < 0,001), while regarding, the postoperative intensive care unit and total hospital stay both procedures were more favourable, than the Whipple one (P < 0,001). The early morbidity rate was the highest after the Whipple-procedure (P = 0,004). These differences were statistically significant. The reoperation and mortality rates were comparable between the groups. The quality of life of the patients was acceptable, nevertheless in the majority of the cases the alcohol and nicotine abuse was not stopped.

Conclusion: The Frey-operation and the Berne modification were the most advantageous, regarding the early postoperative outcomes. However the latter one is preferable, due to its simplicity. During these procedures a single layer continuous suture technique was used for the pancreatojejunal anastomosis, and an extrapancreatic biliodigestive anastomosis is recommended for the solution of cholestasis. due to the superior results.

On December 1, 1951, the Institutes of Surgical Anatomy and Operative Techniques were founded in Hungary. In the academic year 1951/1952, only lectures were held for the students, in an increased number of hours during the semester, there was no practical opportunity yet due to the structural organization of the institutes. The actual teaching of the subject only started in the academic year 1952/1953 for the fourth year (semester 8-9) in the form of 1 h of lecture and 2 h of practical training per week, for a total of 40 h per semester. In the second semester, the subject was closed by a final examination. Regarding the institute in Debrecen, the authors present the beginning of teaching the subject based on contemporary documents.

This publication was prepared on the occasion of the 25th anniversary of Professor Mihály Boros as the head of the Institute for Surgical Research, Szeged, and summarises the educational and research achievements between 1998-2023, with the intention to show the importance of combining pre-clinical and clinical surgery, surgical training and experimental surgical research.