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Biomedical subjects

I Penka

Publications and source records attributed to I Penka.

At least 19 recordsLinked to original sources
PubMed2003

[Do we comply with the standard classification of staging in colorectal carcinoma after curative resection?].

BACKGROUND: Lymph node status is the most important prognostic and predictive factor in curatively resected colorectal cancer. According to TNM staging system, a minimum number of 12 regional lymph nodes is to be examined for the correct staging. In addition to the status of lymph nodes other important prognostic factors should be reported by the pathologist. METHODS: A retrospective study was performed to analyze how many of regional lymph nodes were examined in colorectal cancer specimens in two hospitals (Czech Republic) during the last few years. Availability of other prognostic factors important for the management of the disease after surgery was always investigated. RESULTS: In the hospital "A", the examination of lymph nodes were not sufficient in 43.8% of 121 cases analyzed, in the hospital "B", the number of examined lymph nodes was less than a minimum of 12 in all 162 cases. There were often no data available regarding to a histological examination of resection margins, grading and angioinvasion. CONCLUSION: Reporting of the standard and most important prognostic factors in colorectal cancer was not sufficient in two selected hospitals and it may not be much better in others. It might have a deteriorating influence on the outcomes despite of successfully performed primary surgery. Search for the new prognostic and predictive factors, that would help us to stratify the patients for the optimal tailored therapy is surely needed, but the standard staging parameters, as are the lymph node involvement, resection margins, grading and angioinvasion, must not be forgotten as occurred to be in many cases of our study.

Biopsy↗
PubMed2003

[Segmental absence of intestinal musculature].

Herein we describe a case of 33-year old woman repeatedly affected by incomplete ileus. Primary segmental absence of lamina muscularis propria has been found in this patient. Histological examination revealed areas of small intestine with total absence of muscularis propria followed by areas of the intestinal wall characterised by normal histological structure. No necrosis, inflammation, and fibrosis supporting the secondary origin of this lesion was found.

Adult↗
PubMed2002

[Lymphatic mapping and sentinel lymph node biopsy in selected carcinomas of the digestive tract].

The current status of lymphatic mapping and sentinel node biopsy in patients with selected carcinomas of the digestive tract is described. The possible future use of the method in patients with gastric, small bowel and colorectal malignancies is considered. Preoperative lymphatic mapping and reliable identification of sentinel node (nodes) in patients with gastrointestinal cancers may lead to tailored resections or limited surgical procedures. On the other hand, extended lymph node dissection may be performed in those patients in whom the sentinel node(s) contains tumour cells or in cases where skip lymphatic nodes metastases appear. The method offers the opportunity of improving staging (ultrastaging) by identification of patients with early dissemination in lymphatic nodes where conventional methods are not sensitive enough. These patients should be considered for traditional adjuvant treatment or be included in trials with more effective adjuvants regimens. Large prospective multicenter studies are needed to find out if the sentinel node concept is valid in gastrointestinal cancer. If the answer is yes, several basic diagnostic and therapeutic measures may be changed in favour of cancer patients.

Coloring Agents↗
PubMed2001

[Effect of carbon dioxide pneumoperitoneum on selected parameters of the acid-base equilibrium in laparoscopic cholecystectomy].

The authors focused attention on a hitherto less well known area of the effect of capnoperitoneum during laparoscopic cholecystectomy on homeostasis of the internal environment, i.e. values of the acid-base balance and its changes during surgery and the early postoperative period. From a randomized perspective study ensued that intraabdominal pressure and the reduction of the intraabdominal CO2 pressure from 15 mmHg to 10 mmHg did not have a significant effect on parameters of the acid-base balance in the investigated group of patients as compared with a control group. From the results it is apparent that possible danger of acidosis as a result of CO2 absorption from the abdominal cavity, deterioration of the splanchnic blood supply or a negative impact of the intraabdominal overpressure on the cardiovascular apparatus is sufficiently compensated by the respiratory system during artificial pulmonary ventilation. There is however a certain danger of acidosis during the immediate postoperative period after extubation when the patients are not yet able to compensate possible fluctuations of the acid-base balance and are according to the authors' measurements in a state of mixed or respiratory acidosis. But even in this respect no statistically significant difference was observed between the two groups. These assessments were made in relatively healthy patients, i.e. group I and II according to the ASA classification, therefore these results will apply even mor in groups of risk patients of higher ASA categories. In particular in these patients it is useful to adjust the insufflation pressure individually to lower values in order to reduce to a minimum possible negative impacts of the capnoperitoneum.

Acid-Base Imbalance↗
PubMed2000

[Compression anastomosis in acute resection of the colon].

The authors draw attention to the possible use of a biofragmentable anastomotic ring (BAR) for anastomosis of the gut, used by the authors for construction of an anastomosis after acute resection of the colon under particularly risky conditions with infection and advanced deterioration of the intestinal wall. In both instances when this alternative method was used the postoperative course was uneventful and the patients were discharged without complications into domiciliary treatment.

Adult↗
PubMed2000

[Carcinoma of the colon invading the duodenum and pancreas].

In the submitted case-history the authors present the case of a 60-year-old woman with an extensive tumour of the transverse colon penetrating into the duodenum and head of the pancreas with an intimate relation to the upper mesenteric vein. An extensive curative en bloc resection included right-sided hemicolectomy, hemi-pancreatoduodenectomy and partial parietal resection of the upper mesenteric vein. The pathologist identified in the resected tissue a medium differentiated adenocarcinoma of the large intestine damaging the head of the pancreas and infiltrating the duodenal wall. The lymph nodes were negative and no metastatic affections were revealed. The postoperative course was without serious complications. The few cases of this type reported in the literature illustrate the possibility of successful resection and thus a substantially improved prognosis of the affected patient.

Adenocarcinoma↗
PubMed2000

[Late postoperative colonic stenosis caused by the biofragmentable anastomosis ring (BAR)].

The authors focused their attention on the prevalence of late postoperative stenoses of anastomoses following resection of the colon. In 42 patients the anastomosis was implemented by means of a Valtrac ring--i.e. by compressive biofragmentable seamless technique. Within an interval of 6 months after surgery the majority of these patients were subjected to colonoscopic examination with direct visualization of the intestinal anastomosis. The authors did not record any late postoperative stenoses of the BAR anastomosis of the colon. Moreover on colonoscopic examination in the majority of patients the original intestinal anastomosis was only difficult to detect.

Adult↗
PubMed2000

[Adenocarcinoma of the appendix--case report].

The authors describe a case with a rare diagnosis of adenocarcinoma of the appendix in an adult female patient. The patient was indicated for surgical revision on account of acute appendicitis with a peroperative finding suspect of malignity of the vermiform appendix. A radical resection of the ileocoecal area was performed along with part of the ascendant colon and appropriate mesocolon as a primary operation. According to the postoperative histological evaluation of the resected portion the diagnosis of adenocarcinoma of the appendix was confirmed.

Adenocarcinoma↗
PubMed1999

[Continuous loop stitch in single-layer laparotomy suturing].

The authors evaluate their favourable experience with the use of a new absorbable loop suture for one-layer closure laparotomy. The percentage of dehiscences of surgical wounds was lower in the group of patients where Safil Loop suture was used than in the control group. The speed of completing the suture was also greater and the safety of closure of laparotomy was more favourable.

Absorption↗
PubMed1999

[Bar-Valtrac--a modern alternative to conventional intestinal anastomosis?].

The authors describe a modern method of intestinal anastomoses without suture after resections of the gastrointestinal tract, by means of a biofragmentable ring used in 62 patients where the continuity of the digestive tract was restored by means of BAR-Valtrac (Davis Geck Co, USA). The perspective alternative of the common manual and stapler technique BAR anastomosis is evaluated on the basis of data from the literature and the authors own clinical exoerience with regard to the main parameters of healing of the anastomosis and immediate postoperative complications, among which dehiscence of the anastomosis is, no doubt, most important.

Adult↗
PubMed1999

[Pitfalls of biofragmentable anastomotic ring construction].

The authors describe the main problems of the technical implementation and construction of biofragmentable anastomoses by means of the Valtrac ring, used for anastomosis after resections in the area of the gastrointestinal tract in a total of 72 patients. The authors evaluate postoperative technical difficulties and the main aspects of the implementation proper which may be the cause of serious complications during the immediate postoperative period.

Anastomosis, Surgical↗
PubMed1999

[Incidental laparoscopic orchiectomy of intra-abdominal testis].

The authors present an incidental finding of intraabdominal testicle during laparoscopic operation for another diagnosis in an adult man. The surprising finding was managed by laparoscopy without conversion to an open procedure, adhering to rules of oncologic prevention because possible testicular cancer. Had an open approach been chosen in this patient, the intraabdominal testicle would have remained undetected.

Adult↗
PubMed1999

[The BAR-Valtrac for the colon].

The authors present their experience with biofragmentable anastomosis in the area of the colon in 42 patients where they used a biofragmentable ring Valtrac, Davis-Geck Co. to restores continuity after resection. The authors focus their attention on the peroperative technical difficulty of construction of the anastomosis proper and on complications encountered during the immediate postoperative course. The most serious among them is, no doubt, dehiscence of the anastomosis. Based on this experience, the authors express their opinion on the simplicity of the implementation proper of a BAR anastomosis and problems of postoperative complications.

Adult↗
PubMed1999

[Endoscopic visualization of BAR (biofragmentable anastomotic ring)].

The authors present information on the use of a modern sutureless anastomotic connection by means of a biofragmentable ring--BAR (Biofragmentable Anastomotic Ring) which was used in patients to restore the continuity of the GIT after resections in the upper portions of the digestive tract. The authors present their initial clinical experience and emphasize the importance of visualization of biofragmentable anastomoses by gastroscopic examination in case of postoperative complications with the possibility of therapeutic provisions, if necessary.

Adult↗
PubMed1998

[Laparoscopy in oncology patients].

In a group of 23 patients with suspected malignant disease in the abdominal cavity laparoscopy was indicated and 11 times positive findings were obtained--six time a primary tumourous process and five times secondaries. The authors demonstrate on case-histories the advantages of laparoscopy when other examination fail or give dubious results. In their group of patients it always helped to establish a definite diagnosis.

Abdominal Neoplasms↗
PubMed1997

[Repeat laparoscopy in the management of biliary leaks after laparoscopic cholecystectomy].

The incidence of bile leaks increased with the introduction of laparoscopic cholecystectomy in surgery. The present paper is focused on biliary leaks-their diagnosis and treatment in a large group of patients, with special emphasis on a miniinvasive approach. Nine biliary leaks were found (i.e. 0.72%). Four leaks resolved spontaneously, five were treated surgically with good results.

Bile↗