Search PubMed⌕ Search

Biomedical subjects

L Martínek

Publications and source records attributed to L Martínek.

At least 19 recordsLinked to original sources
PubMed2006

[Laparoscopic colorectal surgery for carcinomas--assessment of the authors' patient group].

AIM OF THE WORK: The aim was to assess short-term and long-term results of miniinvasive procedures for colorectal carcinomas. METHODS: This prospective study assessed patients indicated for laparoscopic procedures for their large intestinal or rectal carcinomas from 1993 to 2004. Primarily, their peroperative complications, postoperative course and long-term results were assessed. The Kaplan-Meier analysis was used to assess long-term survival rates. RESULTS: Over the 11-year period, a total number of 399 patients (236 males and 163 females) were laparoscopically operated for colorectal carcinomas. In 284 patients, the tumor was located in the colon region and in 115 patients in the rectal region. The stage B and C (Dukes classification), medium to highly differenciated, tumors prevailed. Resection of the sigmoid, right-sided hemicolectomy, low anterior resection of the rectum and amputation of the rectum were the most frequently conducted procedures. 311 procedures (78%) were curative, 88 were paliative (22%). Peroperative complications occured in 16 patients (4%), reoperations were required in 34 patients (8.5%). The recovery time for peristalsis was on the second postoperative day, on average. Food load was, on average, tolerated since the third postoperative day and the first stool appeared, on average, on the fourth postoperative day. Early mortality rate reached 6.5%. Postoperative hospitalization lasted, on average, 12 days. In our patient group, a five-year survival rate without relapses was 80% in the carcinoma patients and 68% in the rectal carcinoma patients. CONCLUSION: Laparoscopic colorectal surgery is a safe method with a number of pros for a patient as well as a surgeon in a comparable oncological radicality as that of the open method.

Adult↗
PubMed2006

[The rectal carcinoma treatment history].

The authors demonstrate a history of the rectal carcinoma surgical therapy, based on the available literature data or on oral information. Furthermore, they add their own experience with treatment of the rectal carcinoma, the disorder, which in the Czech Republic and, namely, in the Northern Moravian region, has one of the highest worldwide incidence rates.

Colorectal Surgery↗
PubMed2006

[A contribution of the anorectal angle measurement according to Schiessel to assessment of the safe distance of the inferior resection line in the rectal carcinomas surgical procedures].

Surgical procedures of the anus for rectal malignancies are amongst the most difficult procedures within abdominal surgery. Especially when the tumor is located in the middle and distal third of the rectum and the surgeons aim to conduct a sphincter-saving procedure, the pre-operative diagnostics is a pre-requisite for a successful treatment. The authors aim to inform the medical community on a non-traditional and rarely used examination method of the anorectal angle prior to surgical procedures of the rectal carcinomas.

Adult↗
PubMed2006

[The first case of management of the rectovaginal fistule using transanal endocsopic microsurgery].

The authors present an unusual and, according to the available literature data, so far unused method--management of the rectovaginal fistule, using a T.E.M. technique (transanal endoscopic microsurgery). In their case-review of a female patient, they present advantages of this technique in a case of a rare disorder - a benign rectovaginal fistule. All of the following employment of a harmonic scalpel in the T.E.M. method, as well as of a tissue adhesive Tissucol and of a surgical rectoscope in the vaginal phase of the procedure, deserve attention of surgeons and gynaecologists.

Female↗
PubMed2006

[Minimally invasive surgery in the Czech Republic].

AIM: The aim of the study was to assess the present status of minimally invasive surgery in the Czech Republic. METHODS: A questionnaire was sent to all public hospitals in the Czech Republic with the aim to find out absolute numbers of all minimally invasive surgeries in 2004. Consequently the spectrum and extent of miniinvasive procedures in hospitals and the proportion of selected laparoscopic operations in the Czech Republic was evaluated. RESULTS: A total of 109 (67%) of public hospitals replied to the questionnaire. 34,273 minimally invasive surgeries were performed in the Czech Republic in 2004. 33,721 of these operations were laparoscopic, 441 thoracoscopic and 111 of them were performed by means of TEM (transanal endoscopic microsurgery). Laparoscopic cholecystectomies comprised 51% of all laparoscopic operations in the abdominal cavity. Elective cholecystectomies comprised 87%. Laparoscopic appendectomies comprised 19% of all laparoscopic operations in abdominal cavity. The indication was acute appendicitis in 46%. 92% of laparoscopic hernia repairs were inguinal repair, 94% of which were performed with transperitoneal approach. Laparoscopic adhesiolyses comprised 3.8%, laparoscopic fundoplications 2.7% and laparoscopic colorectal procedures 1.3% of all laparoscopic operations in the abdominal cavity. Other surgeries with lower absolute numbers comprised of operations in the regions of oesophagus, stomach, small intestine, liver, spleen, pancreas, kidneys, adrenal glands, vascular system, lumbar sympaticus, gynecological procedures and some diagnostic and therapeutic procedures. Laparoscopic cholecystectomies were performed by all questioned surgical departments, 94% of questioned hospitals performed laparoscopic appendectomy, 85% performed laparoscopic hernia repair and 26% practiced laparoscopic colorectal surgery. In the Czech Republic 76% of cholecystectomies, 38% of appendectomies, 19% of hernia repairs and 7% of colorectal surgeries are performed laparoscopically. CONCLUSION: Minimally invasive surgery is an established and respected method with wide a spectrum of performed operations and increasing numbers of procedures.

Czech Republic↗
PubMed2005

[Surgical treatment of distally located rectal carcinomas using the rendez-vous method--a laparoscopic resection in combination with T.E.M].

The aim of this work is to introduce a surgical procedure, which would make operations of distally located rectal carcinomas indicated for abdominoperineal extirpation of the rectum possible while maintaining intestinal continence and full functioning of the sphincter system. At the same time, we have aimed at the maximum use of all pros of contemporary miniinvasive surgical techniques. We have labelled our proposed surgical technique the "rendez-vous technique". The trial group includes the original group of 10 patients, who have been operated in our clinic since April 2004, using the rendez-vous technique. We are aware of the fact, that the trial group is small, however we believe that this trial group is the starting group, which will continue to enlarge and that it will bring results to the patients themselves, as well as for a valid prospective study in order to confirm or challenge the proposed method's effectiveness.

Female↗
PubMed2005

[Intraoperative correction of low cardiac output back to its physiological values improves the postoperative progress in patients undergoing extensive intraabdominal surgical procedures].

Perioperative optimalization of haemodynamics is associated with improved post-operative development, as presented in most published studies. This study has confirmed that intra-operative correction of cardiac output back to it's physiological level is associated with improved post-operative course in the group of patients undergoing major elective intraabdominal surgery. Statistically significant decreasing of post-operative complications (4.7% vs 17.7%), decreased length of stay (LOS) in the ICU by 33% and decreased LOS in the hospital by 24% was recorded. Interpretation of the study could be limited by using non-indexed cardiac output values and higher female presentation in the group of patients (although statistically not significant).

Abdomen↗
PubMed2004

[A laparoscopic management of an iatrogenic lesion of the colon during a colonoscopy].

The colon injury during a colonoscopy is a rare, however a serious complication, requiring, mostly, a surgical management. Only few patients may undergo a conservative treatment. The authors discuss the problem of the iatrogenic colon perforation during the colonoscopy and they assess a benefit of the miniinvasive surgery in the diagnostics and treatment algorithm. The main benefit is seen in the reduction of the surgical intervention risks, in the surgical trauma minimalisation, in more favourable postoperative status and in the possibility of the definitive injury management.

Aged↗
PubMed2003

[Transanal endoscopic microsurgery of rectal tumors--indications and initial results].

The authors describe their first results of T.E.M. (transanal endoscopic microsurgical) treatment of rectal tumours. In a group of 20 patients they demonstrate the pitfalls of the method, emphasize the necessity of accurate indication and diagnosis. They test the TEM method as a narrowly specialized modern non-invasive technique which holds its place in rectal surgery.

Endoscopy, Gastrointestinal↗
PubMed2003

[Manually-assisted laparoscopic nephrectomy in a living donor].

Manually assisted laparoscopic nephrectomy from a live donor combines the advantage of a mini-invasive approach with the advantage of the assisting hand in the abdominal cavity to which the surgeon is used from classical operations. The authors performed the first nephrectomy from a live donor by this method on May 13, 2002. Our initial experience with five nephrectomies by this method indicate that every subsequent operation was shorter and the period of warm ischemia was also shorter. There was no postoperative complication. In the second operation suppuration of the minilaparotomy occurred which protracted hospitalization and the convalescent period. The prerequisite of these operations is a certain amount of experience with laparoscopic operations. This type of nephrectomy has the general advantages of a miniinvasive approach, i.e. greater postoperative comfort and a shorter convalescence as compared with an open operation. The period of warm ischaemia does not differ markedly from nephrectmies by the classical procedure.

Adult↗
PubMed2003

[Laparoscopic total gastrectomy--initial experience].

The advantages of mini-invasive procedures have been demonstrated in various surgical interventions. The aim of the authors was to describe, on the basis of their own experience obtained in a group of seven patients, the operation procedure of laparoscopic total gastrectomy, to discuss the advantages and to present their initial experience.

Aged↗
PubMed2003

[Crohn disease and laparoscopic surgery].

AIM OF THE STUDY: To evaluate possibilities of laparoscopic surgery in the treatment of Crohn's disease. METHODS: A retrospective evaluation of the group of 14 patients, operated on in the period of 2/1997 to 2/2003. RESULTS: In the group of 7 women and 7 men, laparoscopy was used for ileocecal resection in six cases (43%), resection of ileotransversoanastomosis in four cases (29%) and abdominal-peritoneal amputation of rectum once (7%). The surgical intervention lasted 125 min on the average. The post-operation complications were not recorded and the conversion was not necessary. The post-operation course was complicated by suppuration three times in laparotomy (21%) and once by paralytic ileus (7%), which required one reoperation. The peristaltics was resumed in the 2nd post-operation day on the average, when the patients began to refuse analgesics. The patients started to accept the liquid diet in the 3rd post-operation day on the average and stools appeared on the day 4 after the surgery. The median of post-operation hospitalization in cases of uncomplicated course was 8 days on the average. No patient was lost. CONCLUSIONS: The laparoscopic surgery represents a safe alternative in the therapy of Crohn's disease, being associated with a more favorable post-operation course and a better cosmetic effect in this group of patients with lower age average.

Adolescent↗
PubMed2002

[Laparoscopic colostomy].

The advantages of miniinvasive operations were proved in a number of surgical procedures. The objective of the authors was, based on their own experience with a group of 11 patients, to describe the procedure, discuss indications, contraindications and advantages of laparoscopically assisted colostomy. This procedure should become the method of choice in the majority of patients indicated for derivation colostomy.

Adult↗
PubMed2002

[Hand-assisted laparoscopic surgery of the colorectum].

Hand-assisted laparoscopic surgery extends the possibilities of laparoscopic operations while preserving the miniinvasive character of the operation. The objective of the work is, based on the authors' experience with a group of 28 patients operated by this method for diseases of the colorectum to describe the surgical technique, present their results and emphasize the indications and advantages of this procedure.

Adult↗
PubMed1999

[Laparoscopically-assisted aortofemoral bypass].

The authors present a case-history of a patient with occlusion of the pelvic arteries where they implemented an implantation of a bifurcation prosthesis with laparoscopic assistance. Preparations of the abdominal aorta, application of clamps, aortotomy and completion of the prostheto-aortal anastomosis was implemented by laparoscopy. The authors own experience and reports in the literature indicate that the laparoscopic approach may represent in addition to angioplasties with stenting a modern mini-invasive approach in vascular surgery.

Aorta, Abdominal↗
PubMed1999

[Laparoscopic hernioplasty--personal experience].

The place of minimally invasive surgery in the treatment of inguinal hernias is still unequivocal so far. The authors submit the results assembled in 400 patients operated by the method of transabdominal preperitoneal implantation of a prolene net (TAPP) in the course of five years. They pay special attention to the incidence of relapses, peroperative and postoperative complications.

Adolescent↗