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M Pesková

Publications and source records attributed to M Pesková.

At least 19 recordsLinked to original sources
PubMed2000

[Fixation of a non-adjustable gastric band using an anterior gastric wall cuff (randomized study)].

We have been concerned with bariatric surgery at the First Surgical Clinic of th General Faculty Hospital, First Medical Faculty, Charles University Prague since 1983. In 1983-1986 vertical gastroplasties were made, between 1986 and 1993 non-adjustable gastric bands were provided by the laparotomic approach. Since 1993 when we were the first to implement a gastric band operation (GB) by the laparoscopic route, this method is used as the standard method. In 1993-1998 we made at the First Surgical Clinic 517 laparoscopic GB operation on account of morbid obesity in patients with a body mass index of 34-49 kg/m2. The group comprised 449 women and 59 men. The most frequent late complication in our group of morbidly obese patients who had a laparoscopically administered GB was in 5.1% enlargement of the proximal pouch above the GB by dilatation of its wall or slippage of the anterior wall proximally under the GB with a subsequent disorder of gastric evacuation and vomiting. We tried to reduce the incidence of this complication by fixing the GB by a cuff made from the anterior gastric wall. To test the effectiveness of the suggested fixation of the non-adjustable GB by a cuff we implemented in 1998-1999 a prospective randomized study in a group of 80 morbidly obese patients divided into experimental group n1-GB + C with the cuff and a control group n2-GB - C without a cuff. We investigated the incidence of the mentioned complication and the changed volume of the pouch above the GB after one year. Endoscopic assessment of the size of the pouch above the GB after surgery and after one year revealed that in group n1-GB + C the mean increase of the pouch volume was 14.6 ml, i.e. 124% of the original size, while in group n2-GB - C the mean increase of the volume was 33.6 ml, i.e. 154.1% of the original size (p < 0.001). Based on the assembled results and aware of the fact that small groups were involved, we should like to express the assumption that the suggested modification, i.e. fixation of a non-adjustable GB by a cuff made from the anterior gastric wall can reduce the incidence of the complication of slippage of the anterior gastric wall proximally above the bandage.

Adult↗
PubMed2000

[Manually-assisted laparoscopic surgery].

The authors describe and discuss a new method of minimally invasive surgery--hand-assisted laparoscopic surgery. For the analysis they used recent data from the literature and their own experience. The main advantage is greater safety, better diagnosis by palpation and better preparation in the abdominal cavity. The main disadvantage is the cost of the method.

Humans↗
PubMed1999

[Preventing the development of secondary infections in severe acute pancreatitis].

Severe acute pancreatitis is in its first stage characterized by the syndrome of systemic inflammatory response (SIRS). The extent of activation of the mediator defense cascade of the organism depends on a hitherto unknown primary insult which cannot be influenced by therapeutic care. The cause of the development of sepsis or multiorgan failure is the supraliminal action of secondary insults (ischaemic reperfusion syndrome, hypoxia, impaired physiological function of the gut). By early and aggressive therapeutic action the effect of these adverse factors can be markedly reduced. Then also better therapeutic results in severe acute pancreatitis may be expected.

Humans↗
PubMed1999

[Long-term results of ileo-rectal anastomosis in familial polyposis].

The authors present their experience with 93 patients operated at the First Surgical Clinic of the General Faculty Hospital and First Medical Faculty, Charles University Prague on account of familial adenomatous polyposis (FAP) assembled during 36 year starting in 1962. They analyze 91 patients followed up in collaboration with the First Medical Clinic of the General Faculty Hospital and First Medical Clinic Charles University Prague. Seventy-two of the patients were operated and in 55 of them an ileorectoanastomosis was made following subtotal colectomy. Two important findings were made. From the group of 91 patients incl. primary patients who suffered already from advanced malignant disease of the large bowel a total of 38.5% died. In the rectal stump after ileorectoanastomosis on average within 16 years after operation in 16.4% of the patients a malignant tumour was found. This leads to the belief that patients should be recommended colectomy with ileoanoanastomosis with an ileal reservoir. This operation was performed during the last five years in nine patients with this condition, using a one-stage or two-stage procedure with temporary ileostomy.

Adenomatous Polyposis Coli↗
PubMed1999

[Incarcerated Waldeyer's hernia as the cause of necrosis of the small intestine (case report)].

The authors present a case-record of a rare incarcerated Waldeyer hernia which became the cause of infarsation and necrosis of the free portion of the small intestine in the abdominal cavity, which developed as a result of compression of the upper mesenteric vein by the contents of the hernial sac. The authors draw attention to the asset of CT examination for preoperative diagnosis. US examination failed. They explain why, although a rare acute ileous abdomen is involved, the X-ray picture of levels on the native X-ray of the abdomen is lacking.

Adult↗
PubMed1999

[Splenectomy].

The authors ANALYZE the problem of splenectomy from the historical point of view and also the problem of splenectomy indication. Two different periods separated by a short time interval are compared. Recently the indications for splenectomy have changed because of introduction of new drugs in hematologic treatment. The number of "traumatological" splenectomy remains constant. (Tab. 2, Ref. 18.)

Czech Republic↗
PubMed1999

[Pathophysiology of development of acute pancreatitis].

Acute pancreatitis is a severe illness with unclear prognosis and mortality rate ranging from 5 to 70%. Dynamic observation of changes in systemic inflammatory response of the body may be helpful in estimating the development of acute pancreatitis as well as giving an idea of therapeutical possibilities. It is obvious, that the intensive therapeutic intervention may reduce the influence of secondary insults (ischemic-reperfusion syndrome, hypoxia, disrupted physiological function of the bowel) on pancreatic tissue. Surgery is limited only for precisely specified indications in the latter stage of acute pancreatitis (secondary inflammation of the necrosis). In this paper we conclude some pathophysiological mechanisms involved in the development of acute pancreatitis.

Acute Disease↗
PubMed1998

[Complications in acute pancreatitis].

Acute pancreatitis is discussed from the point of view her complications. The survey of local, organ and system complication is demonstrated, and the Atlanta classification is recalled. The complications are demonstrated at the mild acute pancreatitis and also at the severe acute pancreatitis. The complications are demonstrated on the own group of patients (period 1995-1997). Severe respiratory failure came later, but the letality was high. The renale or hepatorenale failure came formerly and equally as DIC were combined with practically absolutely letality.

Acute Disease↗
PubMed1998

[Complications of splenectomy].

The authors describe the problematic of postsplenectomy complications. The main group of complications came in the group of haematological indication to splenectomy. The high risk of complications present the haematological malignancy. The most serious illness complications came only in this group.

Adult↗
PubMed1998

Long-term results of aggressive weight reduction treatment.

We have checked weight changes in 11 patients eight years after 2-weeks in-patient weight reduction treatment and weight changes of another group of 11 patients three years after gastric banding. Using multiple linear regression we've looked for factors which could influence the aforementioned weight changes. For weight reduction regimens we confirmed only the following connection: BMI reduction in 8 years = 12.256 - 2.827 x BMI reduction in 2 weeks. For gastric banding it was: BMI reduction in 3 years = -7.880 + 2.383 x BMI reduction in 6 months. We therefore conclude that the long term effects of reduction regimens is not influenced by any hormonal or metabolic characteristics of the patient, but can be predicted by the early weight loss of the patient. Patients who lose too much during the reduction regimen will find it more difficult to keep the weight down, whereas patients who lose weight rapidly after gastric banding have the best long term prognosis.

Adult↗
PubMed1998

Bariatric surgery at First Surgical Department in Prague--Czech Republic--history and some technical aspects of the procedures.

BACKGROUND: There is an increasing number of obese population in the Czech Republic in last twenty years. In 1983 we were one of the first surgical departments in the country who started with bariatric surgery on regular basis. METHODS: In the period from 1983 to 1986 we performed vertical banded gastroplasties (VBG) in our department. Because of high rate of various complications arising both from the stomach and from the wound we switched in 1986 to less "aggressive" non-adjustable gastric banding. In 1993 we performed the first round the world laparoscopic non-adjustable banding. In 1994 we started with laparoscopic placement of adjustable gastric bands. RESULTS: In the group of 52 patients who underwent VBG and were followed-up, acceptable weight loss results (-40.5 kg) were achieved in 24 months following surgery. The postoperative complications were high, 17.3% of gastric staple line disruption and 15.3% of wound complications--incisional hernias, discharge etc. Since 1986 we performed non-adjustable gastric banding in 150 patients with the weight loss of -38.4 kg in 24 months following surgery. There was no change in the wound complications rate, but the complications arising from the stomach and the band decreased to 6.3%. Since June 1993 we performed 268 procedures laparoscopically either with non-adjustable bands or since 1994 with the adjustable bands. The wound complication rate decreased to 0.9% and one complication (6.6%) was connected with the adjustable band. CONCLUSIONS: Because of the high rate of postoperative complications connected in our experience with VBG we started with gastric bandings in 1986. Since than the number of complications arising from the stomach decreased substantially. With the laparoscopic technique used in bariatric surgery there was another decrease in wound healing problems. With the adjustable GB a significant decrease in the stomach related complications occurred. Shorter hospital stay is related to the laparoscopic technique. The long-term weight loss results are not significantly different among the procedures mentioned above.

Gastroplasty↗
PubMed1998

Increase of soluble cytoadhesive molecules sE-selectin and sICAM-1 and hyperfibrinogenaemia in patients with polytrauma without septicaemia.

Multiple organ failure with thrombophilia is suggested to occur in the course of polytrauma with septicaemia. The aim of the study was to investigate fibrinogen level, other proteins of acute phase response: positive-orosomucoid and negative-transferrin and soluble cytoadhesive molecules in plasma of patients (n = 28) with polytrauma (I-II. stage according to Hannover score) without detectable bacteraemia until 36 hours post injury. The patients treated by massive blood transfusion were excluded. An increase of fibrinogen (Fbg pts 4.34 +/- 2.5 g/l versus control 2.55 +/- 0.55 g/l, p < 0.01), orosomucoid (ORM pts 1.47 +/- 0.8 g/l versus control 0.54 +/- 0.18 g/l, p < 0.01), SE-selectin (sE-sel. pts 92.11 +/- 79.4 g/l versus control 46.6 +/- 29.6 g/l, p < 0.05), sICAM-1 (sICAM pts. 698.3 +/- 54.4 versus control 255.6 +/- 58.0 g/l, p < 0.01) and a decrease of transferrin (Trf pts. 1.77 +/- 0.82 versus control 2.83 +/- 0.71 g/l, p < 0.01) were observed in this patients with polytrauma. We suppose that an increase of fibrinogen and cytoadhesive molecules sE-selectin and sICAM-1 may be induced in patients with polytrauma due to a "non-septic" inflammatory acute phase response in the course of wound healing process after tissue injury too.

E-Selectin↗
PubMed1998

[Splenectomy--an analysis of problems].

The authors discuss problematic of splenectomy on the historical view and also on the problematic indication to splenectomy. They compare two different periods in the small lapse of time. In the last period was the mowe in the indication spectrum to the splenectomy in the continuity with the application of new hematological medicaments in the practice. The number of "traumatological" splenectomy is constant.

Hematologic Diseases↗
PubMed1998

[Complications of splenectomy].

The authors describe the problematic of postsplenectomy complications. The main group of complications came in the group of haematological indication to splenectomy. The high risk of complications present the haematological malignancy. The most serious illness complications came only in this group.

Adult↗
PubMed1998

[A large metastasis of colorectal carcinoma--case report].

The authors present the case-history of a female patient four years after a low resection on account of carcinoma of the rectum who developed a large secondary in the abdominal wall. After its radical resection the patient is free from systemic or local manifestations of the basic disease and free from complaints.

Abdominal Neoplasms↗
PubMed1997

[Use of collagen and gentamycin in the treatment of chronic soft tissue lesions].

The authors describe two case-histories where Garamycin-schwamm was used in the treatment of a chronic fistula and cavities in the subphrenium resulting from treatment of a subphrenic abscess, and in the pelvis minor as a result of a fistula which developed after establishment of an ileoanal intestinal pouch. They confirm the experience of authors abroad with the treatment of chronic cavities in soft tissues as a result of operations, which so far had to be treated by other methods.

Adult↗
PubMed1997

[An unusual cause of intestinal obstruction in the puerperal period (case report)].

The authors present a case report of acute intestinal obstruction which manifested itself on the fourth day after the delivery of twins by Caesarian section. Compression of the rectosigmoid colon by the enlarged uterus--which was as big as a pregnant uterus in its fourth month--was established as the cause of ileus. Acute intestinal obstruction was obviously caused by sudden enormous enlargement of the antero-posterior dimension of the contracting uterus at the aditus pelvis level. The situation was successfully surgically resolved by the employment of temporary tube cecostomy.

Acute Disease↗