Biomedical subjects

L Pálfalvi

Publications and source records attributed to L Pálfalvi.

12 recordsLinked to original sources

PubMed2005

Laparoscopic abdominal radical trachelectomy.

BACKGROUND: Radical trachelectomy is a fertility preserving alternative for young women with early stages of cervical cancer. Currently, a technique of abdominal radical approach is used in a few centres. With growing availability of laparoscopy, a novel technique of laparoscopic radical trachelectomy might be an alternative. CASE: Presented is one case of laparoscopic pelvic lymphadenectomy with radical trachelectomy in young woman with IB cervical cancer. No intraoperative or postoperative complications occurred. Operation time reached 250 min, estimated blood loss was 250 ml. Limited follow-up of 9 months was uneventful and patient indicates normal menstrual pattern and satisfactory sexual intercourse. CONCLUSION: Laparoscopic abdominal radical trachelectomy with pelvic lymphadenectomy might be an alternative technique in the treatment of early stages cervical cancer in patients who desire future pregnancy. The procedure is in principle identical to the standard abdominal radical hysterectomy. Centres practising laparoscopic radical hysterectomy can adopt the technique without any special surgical training.

Adult↗

PubMed2000

[Successful outcome of an intrauterine twin pregnancy combined with ectopic pregnancy].

Authors present a case of twin intrauterine pregnancy combined with ectopic pregnancy. The simultaneous pregnancies occurred after the use of clomiphene citrate. In this case viable intrauterine twin gestation was observed by vaginal ultrasound examination, the simultaneous ectopic pregnancy was observed by laparotomy. Right salpingectomy was performed. The intrauterine twin pregnancy continued normally to the 35th week of pregnancy, finished with normal vaginal delivery. The healthy twin boys weighed 2650 g and 2070 g left the hospital in a good general condition on the 5th past delivery day. Authors discuss the etiology, the mode of diagnosis and the therapy of this rare condition.

Adult↗

PubMed1995

A simplified version of the "Indiana pouch" technique for urinary diversion. Experience of the first 18 cases.

During the last 3 years, a modified technique of the continent urinary diversion, known as the "Indiana pouch" has been performed in 18 patients as part of pelvic exenteration. The narrowing of the ileum and/or the site of Bauchin valve was excluded from the procedure. In order to achieve anti reflux effect, ureters were implanted to the urinary reservoir by the "split cuff nipple" technique instead of tunnelling ureters. Sufficient urine continence and lack of urine reflux in the ureters indicated that satisfactory function could be achieved by the simplified technique. A quality of life questionnaire has suggested that most of our modified Indiana Pouch patients coped well. Operative technique, indications, operative results, and complications are discussed.

Adult↗

PubMed1994

[Experience with urinary conduit procedures].

Between 1989 and 1993, 32 urinary conduit procedures were carried out at the Department of Gynaecological Oncology, National Institute of Oncology Budapest. Of these, 26 patients with pelvic tumour underwent total or anterior pelvic exenteration. The urinary conduit operation was performed in associated with radical hysterectomy due 2 vesico-urinary fistula in 2 patients, and as a palliative procedure in 4 instances (bladder fistula 2, bladder fistula and ureter occlusion 1 and bilateral ureteric obstruction 1). Mean age of the patients was 46, range 20-73 years. 23 patients underwent bladder replacement with "Bricker pouch" or ileal conduit, mostly in the first 2 years, and as a palliative procedure. Kock pouch was constructed in 3 and an Indiana pouch in 6 women. There was no intraoperative mortality. 3 patients died in the postoperative period, none of them due to complication of the urinary diversion procedure. Postoperative bleeding occurred in one ileal conduit that ceased spontaneously and in one Indiana pouch that required reoperation. Haematuria was a common finding in the first 3 to 5 days following surgery. Urinary leakage in the abdominal cavity lasting for 7 to 10 days postoperatively occurred in almost all instances in those who underwent a Bricker pouch. This did not require surgical intervention. 3 patients with Bricker pouch experienced pyelonephritis. Continent pouches are emptied by self-catheterization, 6-8 times daily. There were no other early complications. Techniques of urinary diversion are discussed.

Adult↗

PubMed1993

Vascular injuries in the surgical management of gynaecological malignancies.

From 1989 to 1991 we performed 184 radical gynaecological interventions. In the vast majority of the cases lymph node dissection was part of the procedure. Thirteen out of the 184 patients suffered vascular injury, accounting 7% complication rate. The sites of the injured vessels included the external iliac artery in four patients, the vena cava in three, the external iliac vein in five and the femoral vein in one patient. All of them were primarily sutured; no prosthesis or venous patch was needed. In four cases postoperative complications occurred in relation to vascular surgery: two deep thrombosis of the femoral vein and two occlusions of the external iliac artery. The latter two patients had permanent sequelae, i.e. difficulties in walking. Our study suggests that vascular injuries represent an utmost important intraoperative risk in the course of lymph node dissection in gynaecological malignancies. Thus, gynaecological surgeons performing radical operations must be prepared to deal with the problem.

Blood Vessels↗

PubMed1993

Perioperative complications of 116 radical hysterectomies and pelvic node dissections.

Perioperative morbidity and mortality were studied in 116 patients who underwent radical hysterectomy and lymph node dissection. Type II radical hysterectomy was performed in two, type III in 97, type IV in 12 and type V in five patients, and the perioperative morbidity was assessed accordingly. Because of the short follow-up time the late sequelae could not be evaluated. There was no operative death. Haemorrhage was the most common complication and it was more frequent and serious in type IV and V classes. Prolonged bladder atony was also frequent, particularly in type IV radical hysterectomy. The infection rate was comparable. One patient developed ureteric fistula, and one woman had ureteric stricture. Lymphocyst formation, nerve damage, lymphoedema and thromboembolic disease were rarely encountered and there was no bowel obstruction. Injury to the great vessels was a major problem. It appears that the rate of complications in this study is acceptable and comparable with or favourable to other reported series. In spite of this, every effort should be made to reduce the operative morbidity as far as possible.

Adult↗

PubMed1982

Pure-tone and speech intelligibility disturbances in patients with ototoxic disorders.

The prevalence and severity of hearing impairment caused by ototoxic drugs are surprisingly high. This emphasizes the importance of the questions arising from the treatment. In 33.7% of the cases, the hearing impairment caused by ototoxic antibiotics was of severe degree and in 25.4%, it was extremely severe. Parenteral, topical or oral administration of aminioglycoside antibiotics is dangerous. Because of the very poor speech intelligibility, most probably not only the spiral organ but the vestibulocochlear nerve and the higher auditory pathways are also affected by these antibiotics. In some cases, the severe distortion in sound perception cannot be compensated even by a hearing aid of the best quality, and lip-reading which was advised occasionally was without any result. To prevent these toxic effects, these drugs should be administered very parsimoniously and then under very strict conditions and close control.

Aminoglycosides↗

PubMed1970