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J Leypold

Publications and source records attributed to J Leypold.

At least 19 recordsLinked to original sources
PubMed2002

[Developments in surgery of the extracranial circulation--findings from a vascular surgery department].

The objective of the paper is to summarize hitherto assembled experience of the department with the application of new approaches to reconstruction operations of the extracranial circulation with emphasis on its most important part, i.e. the carotid circulation. The main feature of this approach is an effort to increase the safety of the operation for the patient at risk which implies among others extension of indications for reconstruction surgery.

Adult↗
PubMed2001

Microsurgery in the diabetic foot.

The treatment of serious tissue defects on the diabetic foot is complicated and tedious because of a combination of pathogenetic mechanisms that influence healing. Diabetic neuropathies (sensory, motor, vegetative), ischaemia and microangiopathies contribute in varying degrees to the adverse healing. The submitted three-year prospective study was focused on an analysis of the pathogenetic factors with the objective of defining the indications for one of three types of microsurgical transfer: 1. a free flap sutured directly to the vessels at the site of the defect (in predominantly neuropathic defects); 2. a free flap sutured to a politeopedal bypass (in predominantly ischaemic defects); 3. a "nourishing" flap sutured by means of a long venous graft to vessels of the medial and upper leg (in patients in whom an inadequate outflow tract does not make revascularisation possible). In the first year of the investigation, thirteen patients were operated on by means of a free muscle flap incl. three "nourishing" and ten sutured at the site of the defect. Twelve flaps were flaped healed; one patient died from myocardial infarction on the second day after surgery.

Diabetic Foot↗
PubMed2001

[Assessment of functional capability of liver parenchyma using indocyanine green before liver resection].

During the period from 1997 to 2000, the total of 129 liver operations were performed at the 2nd Surgical Department of the Masaryk's University in Brno. Malignant tumours were present in 91 cases. In-hospital mortality in patients operated on for malignant liver tumours was 2.1%. No case of death was caused by liver insufficiency. Examination of liver function by use of indocyanine green (ICG) enabling the determination of the extent of possible resection, contributes to the lowering of postoperative morbidity and mortality. The rate of indocyanine green retention up to 6% does not limit the extent of resection, the retention rate up to 15% allows bisegmentectomy or a minor surgery, the retention rate up to 20% allows segmentectomy at the most, and the retention rate up to 30% enables superficial excisions only.

Hepatectomy↗
PubMed2001

Vascular collagen prosthesis of RaK type--long-term patency.

In 1990, the vascular prosthesis of RaK type (collagen-impregnated knitted prosthesis), produced by the Research Institute of Hosiery in Brno, was introduced into clinical practice. In 1998, we published our experience with this type of prosthesis in form of a clinical evaluating study performed according to the methods of the EN 540 European Norm. Now we inform about the results of the studied group followed during 3 years. The long-term patency of the prosthesis in the aortic-phemoral part is 88.8%; the incidence of infection of the vascular prosthesis in our group studied in the 3-year period is 2.5%. Thus we can say that even long-term results confirm our previous good experience with this vascular prosthesis produced in Brno. (Tab. 8, Fig. 1, Ref. 11.)

Aged↗
PubMed2001

[Personal experience with intra-arterial locoregional chemotherapy of liver metastases from colorectal carcinoma].

Locoregional chemotherapy is one of the possible ways of treatment of inoperable metastatic affection of the liver by colorectal carcinoma. The advantage of regional administration of the cytostatic is the possibility to achieve a higher local concentration of the cytostatic associated with a higher percentage of therapeutic responses. In our department we preferred combined locoregional intraarterial chemotherapy (5-fluorouracil/Mitmycin C/Doxorubicin) combined with systemic intravenous chemotherapy (5-fluorouracil/leukovirin). Locoregional cghemotherapy was administered in the majority as chemotherapy of series 2 or 3 with a very good tolerance. In 2/19 patients we observed marked diminution of liver metastases and subsequent operability and with a duration of complete response for 13 and 18 months. In 7/19 patients a partial therapeutic response was achieved. The total therapeutic response (complete and partial) was 47%. Locoregional chemotherapy attains a higher therapeutic response as compared with systemic chemotherapy and is associated with an acceptable toxicity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

[Incidence of carcinomas in goiters and their combination with Hashimoto's thyroiditis].

In the investigated group 300 patients were operated for a thyropathy mostly struma nodosa, tumours were proved in 69 cases; 38 of them were carcinomas of various extent and 3 of them were combined with Hashinoto's lymphomatous goitre. The overwhelming majority of the carcinomas were papillary carcinomas (22 cases). The incidence of papillary carcinoma in Hashimoto's goitre was about 8%; this fact calls for more attention to autoaggressive thyroiditis both in examination of surgical material, and during autopsies in middle-aged women, where this thyroiditis is often clinically silent. Our results suggest an increase in the incidence of carcinoma in Hashimoto's goitre and the generally accepted rarity of this coincidence is questioned. We recorded also a lower incidence of medullary carcinoma than the worldwide average and a more frequent incidence of mixed-type carcinoma.

Adenoma↗
PubMed2000

[Ischemic disease of the lower extremity and lumbar sympathectomy].

We consider lumbar sympathectomy (LSE) to be the last attempt to improve the condition of the limb. Though being aware of inconsistent opinions on LSE, we are not opponents of this method, particularly if it is carried out in a selected group of patients, that is in case of: 1) treatment of frostbites, 2) treatment of patients at an early stage of advanced ischemia whose main symptom is moderate night pain at rest, 3) desiccation of chronically moist ulcerations between the toes, 4) treatment of patients with reflex symptomatic dystrophy (causalgia), 5) Buerger's disease.

Female↗
PubMed2000

[Ruptured abdominal aortic aneurysms].

The authors present the results of a retrospective study concerning 96 patients with an abdominal aortic aneurysm rupture who underwent surgery in the 2nd Department of Surgery in Brno in the time period from 1989 to 1999. In 30 cases (31.2%) there was an isolated retroperitoneal rupture, 66 patients (68.8%) also had haemoperitoneum. The mean age of the patients was 74 years and the male/female ratio was 76 (79.2%): 20 (20.8%). Twelve patients (40%) did not survive the retroperitoneal rupture, and 34 patients (51.5%) did not survive the intraabdominal rupture. Total mortality in the study group was 47.9%. The type of the rupture and the size of the haematoma that is in correlation with the time of diagnosis and operation, are among the most decisive prognostic factors. Patients with a small haematoma show higher survival rates. In large retroperitoneal haematomas accompanied by a haemorrhagic shock, the mortality was about 40% in the presented study group, in intraabdominal ruptures the mortality rate increases to values over 50%. The results are in accordance with foreign literature data, and the authors agree with the opinion that haemodynamically unstable patients with suspected abdominal aortic aneurysm rupture should be, after necessary preparations, urgently operated without complementary examinations.

Aged↗
PubMed1998

[A knit vascular prosthesis of RaK collagen--a clinical evaluation study].

Vascular collagen prosthesis of RaK type (collagen-impregnated knitted prosthesis) made by Výzkumný ústav pletarský (Research Institute of Hosiery) in Brno was introduced into clinical practice in 1990. In comparison with previous type, the collagen-impregnated prosthesis has had a number of advantages and thus it gets into the interests of vascular surgeons. The report presented has given the results of clinical evaluating study carried out at the IInd Clinic of Surgery, Faculty of Medicine, Masaryk University, Brno according to the methods of EN 540 European Norm Proposal for clinical studies. The results obtained from evaluating a set of 107 patients created for this study (besides others, long-term patency of 90.7%, or 0.9% incidence of infection of the vascular prosthesis of Szilagyi III type) have shown that nowadays we have at disposal a very good, reliable and economically acceptable vascular prosthesis of our provenience.

Blood Vessel Prosthesis↗
PubMed1997

[100 emergency ERCPs performed at a surgery department].

Since the year 1989 the authors, surgeons, performed more then 1600 ERCP. In the period of 1992 to 1995 urgent ERCP was indicated in one hundred cases when block of papila Vateri, cholangitis or acute pancreatitis were suspected. Our results in ERCP were: cholangitis with common bile duct stones 14, pancreatitis acuta biliaris 53, pancreatitis acuta nonbiliiaris 28, other diagnosis 1. In 4 cases, ERCP was unsuccessful. Endoscopic papillosphincterotomy (EPS) was indicated in all patients after the successful ERCP with pancreatitis or cholagitis. We achieved success in urgent EPS in 92%. No patient died owing to ERCP or EPS. From our point of view urgent ERCP and EPS are important diagnostical and therapeutical methods in patients with cholangitis and pancreatitis biliaris which may be performed as soon as possible. (in our cases all patients undergo ERCP and EPS no later than six hours after their admission to the hospital). In case of nonbiliaris pancreatitis we prefer and have good results with EPS too, but our number of these patients is too small to be generalized. (Tab. 5, Ref. 13.).

Adult↗
PubMed1997

[Resection of the first rib for the upper thoracic outlet syndrome-- long-term experience].

The authors describe their own experience with the surgical treatment of the upper thoracic aperture syndrome-TOS-during the period of 14 years. During this period on account of this diagnosis at the Surgical Clinic in Brno 112 patients were operated, whereby the resection of the first rib was always done by the transaxillary approach. The authors describe in detail the symptomatology, diagnosis and surgical treatment. They emphasize the advantages of the transaxillary approach. In the conclusion the authors discuss the fact that only in 45% of the operated patients the symptoms disappeared. This leads to reflections on more strict criteria for the surgical treatment of this syndrome.

Humans↗
PubMed1997

Our experience in the surgical treatment of liver tumors in the years 1994-1996.

The study is based on the evaluation of a study group consisting of 61 patients who underwent surgery for liver tumors in the 2nd Surgical Clinic in Brno between 1994 and 1996. Liver resections were carried out in 39 patients, port-systems for regional chemotherapy were implanted in 29 patients. In recent years, port-systems have been inserted even in liver resections in indicated cases. The median survival after liver resection for hepatocellular carcinoma was 43 months, for colorectal carcinoma metastases it was 32 months. The in-hospital mortality was 3.4%.

Antineoplastic Agents↗
PubMed1997

[Carotid-subclavian bypasses (1985-1996)].

A carotic-subclavian bypass is an extraanatomical reconstruction. It is one of the possibilities how to connect the ipsilateral common carotid and subclavian artery. The authors evaluate carotic-subclavian bypasses made during the past 11 years at the Second Surgical Clinic in Brno. In all twelve cases carotico-subclavian bypasses were involved, in none of the patients a subclavian-carotid bypass was involved or direct anastomosis. The author discusses in detail preoperative complaints, associated diseases, postoperative complaints. In his opinion absolute indications for surgery are neurological symptomatic affections even of one trunk, incl. subclavian steal syndrome. They indicate asymptomatic affections for surgery if at least two trunks are affected. The greatest pitfall of the operation is in their opinion the selection of the length and type of vascular prosthesis. They find that the interval patency rate 100% and the cumulative patency rate 85% evaluated by the method of "Life table analysis" with a standard error of patency rate of 9% are comparable with similar reports from abroad.

Blood Vessel Prosthesis Implantation↗
PubMed1997

[Aneurysm of the splenic artery].

The authors describe in their paper possibilities of surgical and intervention treatment of an aneurysm of the lienal artery, their advantages and disadvantages. They evaluate the results of treatment of aneurysms of the lienal artery in three patients treated at the Second Surgical Clinic in Brno in 1993-1996. In the first patient the aneurysm was resected concurrently with splenectomy. In the second patient resection of the aneurysm with end to end anastomosis of the lienal artery was made. In the third patient the method of artificial embolization of the aneurysm of the lienal artery was used. The results are good. The first two patients were discharged ten and nine days resp. after surgery and are in a good clinical condition. The third patient had treatment in four sessions within two months and the final effect is a completely embolized aneurysm of the lienal artery with a preserved blood supply of the spleen and its intact function. The authors maintain that when dealing with an aneurysm of the lienal artery the surgeon has several possibilities and it is up to him which possibility he will chose with regard to anatomical conditions, the patients general condition and his own abilities and possibilities. The authors recommend if possible to preserve the spleen as a functioning organ or to preserve at least its immunological function.

Aged↗
PubMed1997

[Embolisms of the abdominal aortic bifurcation].

The authors evaluate in the submitted paper the results of surgical treatment of embolization into the bifurcation of the abdominal artery at the Second Surgical Clinic in Brno during 1990-1996. A total of 5 patients was involved whereby in all a cardiac cause of the embolization was obvious. The authors deal also with the time which has elapsed between the development of complaints and surgery, the type of anaesthesia, average length of operation. The operation is implemented concurrently by two teams as antero- and retrograde simultaneous bi-transfemoral embolectomy. The authors emphasize the importance of the metabolic condition of the patient as well as cardiac and renal functions before, during and after surgery. They consider the application of peroperative haemodialysis essential. During the postoperative period it is important to find the objective cause of the cardiac deficiency and treat it. Their results--a 40% mortality are comparable with those of other specialized departments. By comparison with a similar group treated at the same department twenty years previously the authors find a decline in the incidence of this disease and explain this phenomenon by an increased number of cardiosurgical operations in this area.

Aorta, Abdominal↗
PubMed1995

Peritonitis biliaris: some aspects of its origin.

As a cause of septic shock, peritonitis biliaris is a very serious condition. We stress the risks of its development and necessity of postoperative drainage in laparoscopic cholecystectomy. The risks include a cholascos which may develop after some radical procedures of a "non-operative" nature on the liver parenchyma and bile passages (transperietal or endoscopic procedures).

Biliary Tract Diseases↗
PubMed1994

[Report on 3061 laparoscopic cholecystectomies].

The results of 3061 laparoscopic cholecystectomies made by 58 surgeons in nine departments--feasibility 88.9%, low morbidity rate (n = 2071) 11.8%, high morbidity rate 2.48%, mortality rate 0.22%, residual choledocholithiasis 1.36%, preoperative use of endoscopic methods 1.0%, revision in a total of 1.8%--are as a rule less favourable than summarized statistical data from abroad. Similarly as in data abroad the incidence of biliary lesions is not satisfactory--0.65%. The incidence of fistulas (0.13%) revisions on account of haemorrhage (0.29%) and surgical preoperative accidents (0.24%) was lower. Departments which use thermocoagulation have a significantly lower incidence of lesions (0.14% - p < 0.06) than teams working with electrocoagulation.

Cholecystectomy, Laparoscopic↗