Biomedical subjects
Publications and source records attributed to M Smejkal.
The authors of this presentation explain their experience with methods of paliative care of oesophagus carcinoma. The indication criteria are described and compared advantages and disadvantages of those methods. There is an accent in most frequent method--oesophagus stent implementation. The results in the group of patients after the stent implementation are described, also complications and other solutions.
The authors present a case-review of a patient with a large retroperitoneal tumor. A right-sided hemicolectomy with a removal of a large retroperitoneal cyst extending behind the liver up to the diaphragm on the right side, was conducted. Histology confirmed a mucous cystadenocarcinoma of the appendix. Furthermore, the authors discuss this fairly rare type of the GIT carcinoma. This tumor is low-invasive, mucus producing and rarely metastazing. During the tumor progression, the tumorous cells enter the peritoneal cavity and cause, so called, pseudomyxoma peritonei. The treatment principle is to complete a radical surgical removal of the tumor and, furthermore, in case of the pseudomyxoma periotenei, also application of the local peroperative chemotherapy.
A case- review describing a desmoid in a young female. The tumor originated at the tendinuous attachment of the m. rectus abdominis on the pubic bone, which had had two relapses. During the third--so far the latest--procedure it required left-sided hemipelvectomy with resection of the rectum and a part of the vagina. The patient was instructed about the serious character of the disease, the requirement for the radical resection and about the requirement for a careful long-term follow-up of the patient after the procedure.
The authors demonstrate on a group of 219 patients, who had in last two years the appendectomy performed, results of care while using open and laparoscopic technique. They compare these depending on chosen parameters, which is the usage of analgetic, the time patients have to stay in hospital after performed operation and comparison of spirometry within specific patients before and after operation. Based on these parameters the authors did not prove clear advantages of laparoscopic appendectomy.
The authors analyze on a case-history the problem of lymphomas of the gastrointestinal tract. The patient was a female who was operated on account of a suspected perforation. On operation multiple perforations of the small intestine were found. A resection was performed. According to the histological results it was a giant-cell B-lymphoma of the small intestine. The postoperative course was without major complications. The patient was referred to the oncological department without further treatment.
The authors discuss, based on a case-report, the diagnostic problems of malignities of the pancreas and ampulla of Vater. In the same patient they found an interesting complication after laparoscopic cholecystectomy (LCHE). It was a female patient who had LCHE four years previously where an ampulloma of the ampulla of Vater was diagnosed with invasion into the pancreas and a suspect secondary in the lower lobe of the right lung. On operation a pulmonary abscess was detected from a retained concrement. Duodenopancreatectomy which was performed did not reveal any tumour in the pancreatic area.
The authors demonstrate on a group of patients operated by a miniinvasive method possible complications of treatment of achalasia of the oesophagus. On a group of 61 patients they analyze all complications and try to detect their causes. They divide complications into peroperative, early and late postoperative ones. The most frequent peroperative complications are perforation of the oesophagus which are as a rule treated by the laparoscopic route. After surgery the most frequent problem is a relapse of achalasia. The latter is sometimes due to inadequate myotomy. This can be prevented by careful surgical technique along with peroperative endoscopic control.
Two collectives of patients of the I. Gynecological-obstetrical clinic Praha/CSSR suffering from cervical cancer are examined after abdominal radical hysterectomy Wertheim-Meigs. Group 1 contained 125 women treated in the years 1957 to 1966, group 2 included 89 women undergoing the operation in the years 1981 to 1986. In group 2 we found a lower rate of perioperative injuries and early and late disturbances of the urinary tract following radical hysterectomy. This may be a result of more careful preparation of the ureter and intensive postoperative care. We examined 56 women of group 2 by urodynamics. There are statistical significant changes of the maximum urethral pressure and bladder compliance after the operation. This values returned to normal limits with increasing distance between operation and follow-up.
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