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Biomedical subjects

P Matis

Publications and source records attributed to P Matis.

At least 19 recordsLinked to original sources

[Arterial embolisms in the extremities].

The authors discuss the causes of development of embolism into the peripheral vessels. The most frequent site of embolism in the lower extremity is the a. femoralis communis and a. poplitea, in the upper extremity the brachial and cubital artery. Frequently a premonition of myocardial infarction is involved which was not reflected in ECG changes but was confirmed on autopsy. The most frequent source of embolization into the periphery is atrial fibrillation. The success of treatment depends on early surgical intervention (embolectomy), local thrombolysis and postoperative administration of anticoagulants. Late removal of the embolus causes local and general changes, loss of the extremity and increases the morbidity and mortality.

Aged↗

Transoral application of EEA stapler after subtotal oesophagectomy.

OBJECTIVE: To describe a new transoral technique of cervical oesophagogastric and oesophagojejunal anastomoses using the EEA stapler. DESIGN: Prospective clinical study. SETTING: University Hospital, Bratislava, Slovakia. SUBJECTS: Two patients with squamous cell carcinoma of the middle and distal third of the oesophagus. INTERVENTIONS: Transhiatal subtotal oesophagectomy without thoracotomy, and cervical oesophageal anastomosis by transoral EEA stapling. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: Transoral stapling was successful in both patients with no anastomotic leaks. The patients were discharged on the 14th and 21st postoperative days, respectively. CONCLUSIONS: Transoral stapling of the cervical anastomosis gave good results in two patients. More development and evaluation are needed.

Anastomosis, Surgical↗

[Gastroduodenal hemorrhage].

Haemorrhage is a serious complication of peptic ulcer disease. It is an indication for urgent diagnostic and therapeutic endoscopy, which is at present the method of first choice. All patients with gastroduodenal peptic ulcer bleeding, who underwent endoscopy in Ist Department of Surgery in Bratislava between January 1995 and December 1999, were considered for retrospective study. A total of 291 patients (195 male and 96 female) underwent urgent endoscopy with a finding in 34.7% of patients with gastric ulcer and in 65.3% patients duodenal ulcer. The finding was Forrest I in 23%, Forrest II in 25.7% and Forrest III in 51.3% patients. Endoscopic hemostasis was used in 12.37% of patients. A first haemorrhage was found in 82.9% patients, a recurrent one in 17.1% patients. 41.5% of patients had positive peptic ulcer history. Surgical treatment was indicated in cases, when bleeding was not controlled by endoscopic means, or in cases of recurrent bleeding within 48 hours in 19 patients (6.52%).

Female↗

[Surgical treatment of acute diverticulitis of the large intestine].

The authors analyze in this paper covering a ten-year period (1990-1999) a group of patients with acute perforated diverticulitis. The patients were classified according to Hinchey's classification. During this period 35 patients were operated with a high preoperative morbidity. With regard to the low number of complications of acute diverticulitis the authors do not prefer early preventive resections of non-complicated diverticulitis, but they tend to extend indications, first of all in cases of repeated recurrences, haemorrhage and in case of stenosis. In the IIIrd and IVth stage according to Hinchey's classification dominates Hartmann's operative procedure. But the authors agree with the trend to perform resection with primary anastomosis in the IIIrd stage, especially in cases of a good status of the patient and short duration of the disease. In cases of acute perforated diverticulitis operated in the first 24-hour interval the mortality rate was 23.1%.

Acute Disease↗

Melatonin content in plasma and large intestine of patients with colorectal carcinoma before and after surgery.

The distinct melatonin rhythm with higher concentrations during the darktime was found in plasma of both control patients and patients with colorectal carcinoma. Moderate surgery did not induce any changes in plasma melatonin levels, but a pronounced increase in both the day- and nighttime melatonin concentrations was found after surgical treatment for colon cancer. The melatonin content in the tumor tissue did not differ from that in the proximal and the distal parts of the resected gut, which were without signs of malignant changes. Neither concentrations of serotonin nor 5-hydroxyindole acetic acid differed among analyzed parts of the gut. Daytime melatonin concentrations in gut tissue (314.7 +/- 87.8 pg/g of wet tissue) were more than ten times higher than the daytime levels in circulation. It was hypothesized that increased levels of this hormone in the gastrointestinal tract may play an important protective role against the development of colorectal cancer via stimulation of the immune system, protection against free radicals, and interaction with fatty acid uptake and metabolism.

Aged↗

[Antibiotic prophylaxis in surgery].

Infection remains a serious complication after surgical produces. The main risk factors for developing infection are: 1. endogenous-host related, 2. exogenous-produce related, 4. environmental-related ones. Systemic antibiotic prophylaxis significantly reduces the incidence of potentially serious infective complications. It is indicated in procedures with incidence of infective complications more as 5%, in clean contaminated wounds and also in produces, in which infection has fatal consequences (vascular surgery, heart surgery, traumatology). The decision to use antibiotic prophylaxis depends upon the operation to be performed, the findings at operations, the general health of the patient and pharmacological and antibacterial properties of the agent. Timing of the first dose (administration not more as 1 hour preoperatively) and duration not more as 24 hours are very important. We use the second generations of cephalosporins (cefuroxim and after antibiotic rotation cefamandol) in antibiotic prophylaxis obligatory in vascular surgery, pacemaker implantation, traumatology and in colorectal surgery (there in combination with metronidasol) with mean infection rate in clean surgical procedures from 0.5 to 1.5%. Complications after antibiotic prophylaxis are very rare. However antibiotic prophylaxis can not compensate the correction of medical problems preoperatively and the meticulous surgical technique.

Antibiotic Prophylaxis↗

Urgent proctocolectomy in ulcerative colitis.

UC being a typical medical disease is encountered by the surgeon only in the stage of toxic megacolon or in case of severe complication during conservative treatment such as perforation, haemorrhage, obstruction or malignity. The authors operated urgently 6 young women with all these complications performing total proctocolectomy, constructing ileal pouch with complete stapling technique. In spite of high rate of complications the results are promising. The best prevention of malignant change and complication is the earlier indication for operative treatment which offers the ideal treatment for patients with UC.

Adolescent↗

[Alternative use of the EEA stapler in subtotal esophagectomy].

Authors describe the successful usage of EEA stapling by reconstruction after subtotal oesophagectomy of carcinoma in the middle third of oesophagus. EEA stapling was pushed in transorally and oesophagogastric anastomosis was made. Neither pre- or post-operative complications occurred by this procedure. Patient left the hospital on 14th day afer the operation. Authors consider transoral application of EEA stapling as effective alternative in creation of oesophagogastric anastomosis after subtotal oesophagectomy.

Adult↗

[Adrenal tumors and surgical approaches to the adrenal glands].

In 1987 at the First Surgical Clinic in Bratislava four patients with adrenal tumours were operated. Hormonally inactive tumours are, however, diagnosed late on account of their latent growth. To the diagnosis of tumours sonography and computed tomography contributed in a major way. Adrenal tumours must be radically removed, sometimes even with surrounding organs (kidney, spleen, pancreas). Malignant tumours have a very adverse prognosis.

Adrenal Gland Neoplasms↗

[Pancreatic fistulas].

The authors analyze the causes, diagnostic and therapeutic procedure in internal pancreatic fistulae. Based on the case-histories of two patients, they demonstrate the importance of ERCP, fistulography, pleurography as well as of surgical tactical procedures. They describe conservative and surgical treatment and their indications.

Adult↗