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Biomedical subjects

F Antos

Publications and source records attributed to F Antos.

At least 19 recordsLinked to original sources
PubMed2004

[The Czech experience in peritonectomy and hyperthermic perioperative cytostatic lavage in the treatment of peritoneal malignancy].

UNLABELLED: Peritoneal tumor dissemination has been considered as an incurable condition with fatal outcome. However cytoreductive surgery followed immediately by hyperthermic chemoperfusion has been described both for the treatment and prevention of locoregional cancer spread from various origins. This paper summarizes our experience in this field. PATIENTS AND METHODS: 28 patients were operated on for peritoneal dissemination of malignant tumors between 1999 and 2002 in the Surgical Department of the University Hospital Bulovka. Total or limited peritonectomy was carried out in these patients. In addition intraperitoneal perioperative hyperthermic chemoperfusion was performed using an electrolyte solution containing Mitomycin C, Cisplatin or Carboplatin. The perfusion was performed for 90 minutes, reaching a real hyperthermia of 41 to 43 degrees C. RESULTS: The overall morbidity was high (85.7%), the perioperative mortality (30 days) was 10.7%. Only 3 (15.7%) of 19 patients in whom complete peritonectomy could be carried out died during the follow-up period of 3 months to 3.5 years. CONCLUSION: There is an increasing evidence of both experimental and clinical studies showing the therapeutic and prophylactic usefulness of peritonectomy and perioperative hyperthermic chemoperfusion in patients with peritoneal carcinomatosis. However, well designed randomised trials are necessary to establish the role of this promising technique.

Adult↗
PubMed2001

[Pelvic exenteration in the treatment of locally advanced tumors of surgical, gynaecological and urological origin].

Pelvic exenteration is a radical extirpative procedure designed to treat pelvic malignancy that has invaded more than one of the hollow organs of the gastrointestinal or genitourinary tracts. The operation comprises several radical procedures: resection of the rectum, hysterectomy (with adnexectomy) with partial or complete vaginectomy, pelvic lymphadenectomy and total (or partial) cystectomy with diversion of the urinary tract. The retrospective analysis of our results in 27 patients treated in the years 1995 to 2000 by means of pelvic exenteration showed a 7.4 % hospital mortality and 59.3 % morbidity rate. The recurrence and survival rates were adequate. This surprisingly favourable outcome in our patients should encourage Czech surgeons to perform this difficult procedures more often.

Colorectal Neoplasms↗
PubMed2000

[Use of a tack for hemorrhage in the presacral plexus].

In operations where the rectum must be mobilized, frequently haemorrhage from presacral venous plexuses occurs. If the haemorrhage is massive, this is a serious complication, which may threaten the patient's life. In those instances we use a "drawing-pin" to arrest haemorrhage. The possibility to use a "drawing-pin" is not generally known and therefore the authors present their clinical experience with this method.

Hemorrhage↗
PubMed2000

[Biliary peritonitis].

Biliary peritonitis is one of the infrequent types of acute abdomen. It is encountered in particular in older people and is associated with a high lethality. The diagnosis is difficult because the symptoms are not typical and frequently not very expressed. The importance of the disease is enhanced by the fact that a certain percentage of the cases develops as a complication and direct consequence of medical intervention. As several of these cases were encountered at our clinic in recent years and we had the opportunity to observe the "natural" course of the disease up to the lethal end in a female patient who refused all invasive diagnostic and therapeutic interventions, we present the clinical picture of the disease incl. auxiliary and laboratory examinations and the course of the disease.

Aged↗
PubMed1999

[Treatment of colonoscopic perforations].

Perforations of the large intestine during colonoscopy are relatively rare but serious complications of this routine examination. In recent years the approach to their treatment has changed in favour of more conservative procedures, in particular in perforations which occurred during polypectomy. In the authors' department during the last five years 12 patients were treated with perforations which occurred during colonoscopy. Ten patients were operated on (4x suture of the perforation, 2x primary anastomosis, 5x derivation of the gut), two patients were successfully treated by conservative methods without surgery. Fifty per cent of the operated patients had complications. Nobody died. The mean period of hospitalization was 27.9 days in the operated patients and 4.5 days in those who did not undergo surgery. From the results ensues that a differentiated approach must be used in perforations and in indicated cases (perforations after polypectomy, satisfactory condition of the patient, minimal assumed contamination of the abdominal cavity) a conservative method can be used. Correct surgical tactics reduce the morbidity and mortality.

Adolescent↗
PubMed1999

[Drainage of the abdominal cavity using a simple and reliable system].

Experience with drains is more than 2000 years old, but instructive. In abdominal surgery nowadays indications for prophylactic drainage are diminishing as peroperative antibiotic administration has a similar effect. Therapeutic drainage is however still important and drainage is also useful after extensive operations, surgery of the lesser pelvis and operations with major bacterial contamination. The authors present their practical experience with a simple system of wrapped drains (Medisillen-Rubena, Brno) and a cover with an adhesive plate (B-Braun-Biotrol) which they used in 660 abdominal drainages with a very good effect.

Abdomen↗
PubMed1997

[Initial experience with anorectal manometry with the PC Polygraf apparatus in surgery].

The authors present their initial experience with anal manometry using a PC Polygraph of Synectics Medical Co. They discuss the manometric examination of 14 patients with ulcerative colitis, incl. 12 who were operated. In all 12 patients an ilea-pouch-anal anastomosis was made. By manometry a postoperative drop of pressures at rest was found and partly also of pressures during muscular contraction as well as shortening of the zone of high anal pressure. The resulting values, however, did not influence continence, except for temporary soiling, the frequency of bowel movements being 2-8. Anal manometry is an important objective examination of the sphincter function as it makes it possible to compare values before and after therapy. It must be however combined with other anorectal physiological tests such as endosonography, EMG, defaecography etc.

Adolescent↗
PubMed1996

[Comparative study of 2-piece colostomy systems (ConvaTec Combihesive Flexible, Coloplast 2002 and Hollister Guardian in the Czech Republic)].

In three surgical centres in the Czech Republik three modern two-piece colostomic systems where compared which are at present available in the Czech republik, incl. an attempt to assess how they influence the quality of life of the patients. The investigation comprised 117 patients mean age 59 years-93 after colostomy, 13 with ileostomy. The investigated systems were ConvaTec Combihesive Flexible, Coloplast 2002, Hollister Guardian two-piece ostomy systems with a closed sac and inner filter. The main investigated parameters were: tolerance of the products, preference expressed by the patient, the state of the skin beneath the plaster and the index of general health (GWBI). From the investigation ensued that in the Czech Republic the system ConvaTec Combihesive proved very useful and there probably will not be a demand for a change to another system offered by distinguished producers, as such a change would not entail any advantages. It was revealed that when the ConvaTec Combihesive system is used, the skin is maintained in a good condition which has a favourable impact on the feeling of wellbeing and improves the quality of life.

Colostomy↗
PubMed1995

[A method of using intraluminal splints in the treatment and prevention of recurrent ileus of the small intestine].

The authors present a group of 23 patients where splints were used in the loops of the small intestine. The group is divided into two sub-groups. The first one comprises patients where the splint was inserted because of relapsing ileus of the small intestine after previous surgical operations. The second sub-group comprises patients where this operation was performed either preventively or as part of a primary operation or as part of a reoperation called for by complications immediately preceding operation. The internal splint is inserted via jejunostomy and through the loops of the small intestine it is guided by means of a sutured Foley catheter which after proper insertion of the splint is left in the caecum. The authors emphasize the importance of effective decompression of the small intestine during the early postoperative period which is made possible by suction of the ileous contents through lateral openings of the inserted probe. After three years' work, using this method, the authors confirm that it gives good results.

Adult↗
PubMed1995

[Toxic colitis from the viewpoint of the surgeon].

The submitted review deals with the diagnosis and treatment of severe forms of toxic colitis from the gastroenterological and surgical aspect. The author emphasizes the importance of early diagnosis of the disease and early onset of conservative treatment which, however, should not exceed 72 hours without obvious improvement of the patient's condition. For surgical intervention the method of choice is subtotal colectomy with ileostomy and a mucous fistula of the rectosigmoid. In cases of early intervention the lethality is less than 10%; when the operation is late (frequently with complications) it is 30% or more. Better information of medical professionals on the disease is desirable.

Colitis↗
PubMed1995

[Toxic colitis. II. Personal experience].

The author presents his own experience with the diagnosis and treatment of 19 patients with acute manifestations of toxic colitis. Patients with ulcerative colitis developed toxic colitis in 11 instances. The second most frequent background for the development of toxic colitis was pseudomembranous colitis. Conservative treatment before 72 hours was successful only in two patients. Seventeen patients were operated at varying intervals after the onset of the disease (1-21 days) and subtotal colectomy was performed with ileostomy and a mucous fistula of the rectosigmoid. The lethality in the whole group was 10.5%. All patients who died (2) were from the group operated on the 5th-7th day, while in the groups operated on the 2nd-5th and 14th to 21st day there were no deaths. In the group two cases of carcinoma were detected.

Adolescent↗
PubMed1995

[Subtotal colectomy in emergency situations].

One-stage subtotal colectomy is the most radical solution of ileous conditions caused by an obturating tumour of the left half of the colon. The authors report on their experience with this procedure in 10 patients operated in the course of three years. They emphasize the advantages such as oncological radicality, immediate detoxication of the organism, a favourable postoperative course with a low morbidity (10% dehiscences) and lethality (10%), shorter hospitalization period, life of the patients without a stoma, lower costs and satisfactory functional results. For an experienced surgeon, if perfect intensive postoperative care is available, this operation is the method of choice even in very old patients.

Aged↗
PubMed1995

[Surgical wound dehiscence and a technique for laparotomy closure with continuous loop sutures].

The authors evaluate two groups of patients after laparotomy where during the postoperative period complete dehiscence of the laparotomic wound occurred. In the first group A the laparotomies were closed in anatomical layers by individual silon stitches, in group B for closure a single layer continuous PDS loop suture was used. After introduction of this technique the percentage of dehiscent laparotomies declined from 2,2% to 1,2%.

Adult↗
PubMed1995

[Prevention and treatment of persistent perineal sinuses. Literature review and initial experience].

The objective of the work was to demonstrate possibilities of radical treatment of a perineal sinus, a very unpleasant complication after proctectomy. The authors prefer the use of a fasciocutaneous gluteofemoral flap based on the descendent branch of the inferior gluteal artery. The authors describe the whole surgical procedure and recommend to assemble experience with solution of decubital defects in the pelvic region.

Humans↗
PubMed1995

[Desmoids: are there any new developments?].

In the submitted review of the literature the authors evaluate contemporary therapeutic possibilities of mesenterial desmoids. A more detailed pattern of cytotoxic and non-cytotoxic chemotherapy, actinotherapy and hormonal therapy is presented. Surgical resection is limited by the size of the tumour and above all by early detection before the size of 15 cm is reached. In larger tumours conservative treatment by a combination of non-cytotoxic and hormonal treatment is better. Actinotherapy of the intraabdominal region is not suitable. The percentage of relapses is high, a standard therapeutic procedure has not been elaborated so far. Despite rather surprising remissions of desmoids in individual cases the general results of different groups are not encouraging. In a case-history the authors describe their experience with the treatment of a young female patient with a mesenterial desmoid which, however, was not successful.

Adult↗