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Biomedical subjects

J Simsa

Publications and source records attributed to J Simsa.

At least 19 recordsLinked to original sources

Sentinel node biopsy in gastric cancer: preliminary results.

BACKGROUND: Extent of lymphadenectomy in gastric cancer is one of the still unresolved and ongoing questions. Whether extensive procedures lead to better survival remains controversial. The detection of sentinel node could become a helpful method to define the desirable extent of lymph node dissection for each particular patient. MATERIAL AND METHODS: Prospective, single-centre, clinical trial. Sentinel node is identified using vital blue dye. After performance of D2 lymphadenectomy, the pathologist minutely investigates all lymphatic nodes by histological and immunohistochemistry techniques. RESULTS: During a period of 36 months, an attempt to localise the sentinel node for biopsy was made in 22 patients. The successful rate of sentinel node detection with a good relation between metastatic involvement of the sentinel node and other nodes was 56% (13 out of 22 patients). All these patients suffered from small tumours and early stage of the disease. In large tumours and advanced stages, blue dye stained the tissue around the tumour diffusely rendering the identification of true sentinel node impossible. Fresh frozen section of the sentinel node resulted in two patients in a false negative outcome because of micrometastatic involvement. CONCLUSIONS: Sentinel node biopsy in gastric cancer using vital staining is a feasible method. Reliable results were seen in early stage of the disease. Fresh frozen section of sentinel node has probably a low sensitivity for detection of micrometastases.

Feasibility Studies↗

[Surgery of hemorrhoids using the Long method and its complications].

BACKGROUND: The aim of this article is an assessment of new surgical procedure--stapled hemorroidectomy according to Longo. We do concentrate on surgical complications and possibilities of it's management. METHODS: Prospective, clinical follow up of patients in which stapled hemorrhoidectomy was performed during the period of 2 years (1st December 2000--30st November 2002). Observation concentrates on surgical complications of this method. All patients had a clinical check up 3 weeks and 3 months after surgery. In case of any problems treatment and follow up continues. RESULTS: Stapled hemorroidectomy was performed during the period of 2 years in 52 patients (100%). There was 11 patients (21.2%) with some of surgical complication. The most serious one was massive rectal bleeding after surgery, which has been observed in 4 patients (7.6%). Other surgical complications observed in our group were anal stenosis, local infection, acute anal fissure and retention of urine. CONCLUSION: Stapled hemorroidectomy is now one of feasible alternatives for surgical treatment of hemorrhoids. Serious surgical complications observed in our patients were bleeding from the stapled suture line and anal stenosis. The aim of this article is to refer possible surgical complications of this method, it's prevention and management.

Adult↗

[Lymphadenectomy in gastric carcinoma--present status, new trends and personal experience].

The only hope for long time survival in gastric cancer is radical surgery with complete tumour removal. Lymphadenectomy as a part of surgical procedure helps to remove tumour completely. The value of lymphadenectomy for staging is clear and surgeons have no doubt about it. Therapeutic effect of lymphadenectomy with improvement of the prognosis remains uncertain. In this work we would like to discuss current trends in lymphadenectomy in gastric cancer, especially evaluating the value and extent of the procedure.

Adult↗

[Gastric carcinoma--the sentinel node concept: initial experience].

Gastric cancer is a serious malignant disease. The only hope for long time survival is radical surgery. It consists of gastrectomy and also resection of adjacent lymphatic tissues. The extent of lymphadenectomy is one of the currently discussed questions. D2 lymphadenectomy is now becoming standard also in our country. This extensive procedure can be quite difficult and needs an experienced surgeon. It is also connected with prolonged operation time and higher costs. According to some authors, this procedure is also associated with a higher morbidity. The question, whether D2 lymphadenectomy should be performed, could be answered by the sentinel node concept, which is the topic of our work.

Adenocarcinoma↗

[Intestinal duplication. A rare disease in the differential diagnosis of cystic abdominal tumors].

Intestinal duplications are described as uncommon congenital anomalies rarely diagnosed in adults. A case of young woman with obscure abdominal symptomatology is demonstrated. After investigation the cause of it was disclosed surgically. During operation a cystic ileal duplication was exposed and resected. Despite of difficulties calling for another operation, the case was successfully solved. Based on the author's experience some aspects of these diseases--etiopatogenesis, symptoms, possibilities of examination and complications are discussed and surgery as the main treatment is emphasized.

Abdominal Neoplasms↗

Use of 29-gauge spinal needles and a fixation device with combined spinal epidural technique.

One hundred patients between 15-46 years, undergoing elective surgery, were given spinal anaesthesia using 29-gauge spinal needles introduced through a Tuohy needle with a fixation device. Successful spinal anaesthesia was achieved in 98%. A success rate of 100% was achieved when a combined spinal epidural technique was used. Ninety-eight percent of the patients would prefer the same anaesthesia procedure for similar kind of surgery in the future.

Adolescent↗