Search PubMed⌕ Search

Biomedical subjects

P Pafko

Publications and source records attributed to P Pafko.

At least 37 records · Page 2Linked to original sources
PubMed2004

[Is a scalpel required to perform a thoracotomy?]].

The purpose of this prospective study was to determine whether electrocautery as a means of creating thoracic wound result in increased wound infection rates. Seventy-three patients were randomized prospectively into two groups. Group A-coagulation, where the first half of the incision was done with scalpel and the second half with coagulation-fulgurate. Group B-cut mode, where half of incision was done with scalpel and half with blend cut mode. All wound complications were recorded and divided into infectious (grade 1: induration and erythema with no secretion, grade 2: grade 1 and serous secretion, grade 3: contaminated wound with pus formation) and non-infectious complications (haematoma with its evacuation). Scalpel and electrosurgical thoracotomy incision in elective surgery are similar in terms of early and late wound complications when used to perform anterolateral thoracotomy. Therefore, the choice of which method to use remains only a matter of surgeon preference.

Adult↗
PubMed2004

[Role of the surgeon in the treatment of myasthenia gravis and thymoma].

Surgical treatment of myasthenia gravis at the 3rd Department of Surgery, 1st Faculty of Medicine, Charles University in Prague, has long tradition. It originated in sixties of the 20th century. Over 1000 operations of a thymus has been carried out since that time, especially thymectomy for myasthenia gravis (MG) and for less frequent thymomas. The complete removal of thymus--thymectomy accompanied with exenteration of the fat in frontal mediastinum belongs to the principal MG surgery. According to our experience, the optimal approach to the thymus is a partial sternotomy. The jugular approach is not regarded as sufficiently radical. Videothoracoscopic approach and operation are possible but they are longer. They represent a method of choice at some workplaces. The combined MG treatment (conservative medicamentous and surgery treatment) brings in 80% a visible improvement and a deletion of symptoms of the disease.

Humans↗
PubMed2004

[Specific features of lung collection from a donor with a beating heart: criteria and technique].

Lung transplantations remain the latest organ transplantation gaining a broad spectrum of clinical applications. It has become an approved treatment method for patients suffering from lung disorders in the terminal phase. The number of transplantations is limited by a lack of suitable organs, increasing patients waiting lists mortality rates. This article provides information on criteria required for the lung collections to be accepted, and also, a detailed description of the combined lung and heart collection technique for unilateral of bilateral lung transplantations. The above technique has been used routinely, undergoing several modifications, in the Czech Republic since 1997, when the lung transplantation programme commenced. 60 lung collections from exited donors were performed until the end of 2003. The aim of the information provided in this article, is to aid mutual cooperation with M.D.s caring for the donor and cooperation of surgeons of all teams, participating in the multiorgan transplantation, which will finally allow the number and quality of the collected organs to be increased.

Brain Death↗
PubMed2004

[Lung transplantation for primary pulmonary hypertension].

Significant advances in the treatment of primary pulmonary hypertension (PPH) have been achieved in the past decade. Continuous intravenous prostacyclin and lung transplantation are complex and effective approaches in the therapy of PPH. Indication, technique, postoperative care and results of lung transplantation for PPH are discussed.

Humans↗
PubMed2004

[Treatment of benign stenoses of the large airways at the Faculty Hospital Praha-Motol during 1998-2003].

The authors present diagnostic and therapeutical results in the group of 80 patients with benign stenoses of large airways, who were hospitalized at the TRN ward (Department of TB and respiratory disorders) of the Faculty hospital Motol in Prague between the years 1998-2003. 62 patients sufferred from stenoses in cosequence of their tracheal intubation or tracheostomy. In 18 cases the stenoses resulted from other disorders or pathological condidtions (Wegener's granulomatosis, status post lung transplantation, etc.) 38 patients were sent for surgery. Up until the date of the assessment (September 2003), 8 of them had had a relaps of the condiditon. 6 operated subjects had their restenosis corected using bronchological methods, 2 subjects had to undergo reoperation, which is 5.2% of the total number of the operated subjects. The remaining 42 patients were treated using the interventional bronchological methods (electrocauther, laser, stents) which proved curative in 35 patients, i.e 44% of the whole group. In 7 inoperable patients the above methods failed, 6 of them having a permanent tracheostomy and one female-patient exited 2 days after an incomplete recanalization. In the subgroup of 18 patients with other than postintubation stenoses, stent operations were the most frequent (12 times), 4 patients were cured using other methods of interventional bronchology, and resection of the stenosis was indicated in two cases. Up until the date of the assessment, 65 subjects had survived and 15 exited. 5 of them died 3-14 months (median of 4 months) following the surgical procedure of other disorders than of the respiratory airways stenoses. 10 unoperated patients, with a single exception, also died due to other causes than the tracheobroncheal lesions (the survival rate median was 9 months). Following the initial freeing of the airways, the authors call for considering a surgical therapeutical option in each case. Provided the surgical approach was contraindicated, the interventional bronchological methods would replace it appropriately.

Adolescent↗
PubMed2004

[Computer tomography and staging of bronchogenic carcinoma. Prospective study].

BACKGROUND: The aim of our study was to determine validity of computed tomography in staging of non-small cell lung cancer. METHODS AND RESULTS: Sixty-two patients with NSCLC were operated at our department between March and September 2003. Lymph nodes with the shortest diameter over 10 mm on CT were considered abnormal. Primary tumor was correctly determined by CT scans in 77 % of cases, lymph nodes involvement in 63 %. Stage of NSCLC was correct in 53% of all patients. Negative predictive value for N1 and N2 was 80 %, resp. 88 %. CONCLUSIONS: Even with improvement in CT technology, validity of CT in staging of NSCLC remains low. We consider that mediastinoscopy can be avoided in the presence of normal mediastinal CT findings due to high negative predicative value of nodal improvement.

Carcinoma, Bronchogenic↗
PubMed2004

Surgical contribution to the management of primary hyperparathyroidism.

Surgical management of primary hyperparathyroidism is a very effective method. The target is to cure primary hyperparathyroidism and to reach normal calcium levels. This results in an improvement of health condition and resolution or at least moderation of symptoms. Complications are infrequent and mortality is very low. Surgical management is definite, safe and effective. Authors of this article address the diagnosis of primary hyperparathyroidism, clarify bone, metabolic and biochemical syndromes and present series of 151 patients that have been operated on at the 3rd Department of Surgery of the Motol University Hospital, Prague, with the diagnosis of primary hyperparathyroidism. The survey is focused on the primary hyperparathyroidism concomitant diseases and on the possible sequelae in the postoperative period.

Adolescent↗
PubMed2003

[Appendectomy--classical or laparoscopic?].

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.

Appendectomy↗
PubMed2003

[Surgical treatment of bronchogenic carcinoma 1970-2001].

BACKGROUND: Lung cancer (LC) is a permanent medical and social problem. 5709 patients died in the year 2000 of this disease in Czech Republic. Its incidence in men is 100/100,000 and it shows only small trend to decrease. In women the incidence has reached 22/100,000 and is still rising. The ratio males/females in the whole country is 4:1, in pulmonary department of University hospital Motol is close to 2:1. The optimal way of treatment is a surgery. METHODS AND RESULTS: From the data about diagnostics and operability in Pneumological Clinic of the 1st Medical Faculty of the Charles University (former 2nd Clinic of Tuberculosis and Respiratory Diseases) and from adequate data obtained from the Pulmonary department of University hospital Motol we can see that the number of operated patients increased from 20% in 1970 to 28% in 2001. When compared two set of patients operated in the period 1985-1990 and 1998-2001 we learned the change of the ratio males/females (from 17:1 to 2:1), lower number of pneumonectomies (from 34% to 31%), lower number of exploratory thoracotomies (from 13% to 5%), decrease of perioperative mortality from 10% do 2%. The percentage of correct clinical when compared to pathological TNM staging was similar in both periods (55% in the period 1985-1990 and 53% in the period 1998-2001). In the article we describe also results of diagnostics, induction and adjuvant treatment and possibilities of the increase of operability of the patients with lung cancer. CONCLUSIONS: The authors think that despite some improvements in several parameters, the 5-year survival of patients with lung cancer is in our country and the whole world still unsatisfactory. We recommend the revision of current attitude to the screening of lung cancer and we recommend joining the running European-American trials of screening of such patients with the help of low-dose spiral CT.

Carcinoma, Bronchogenic↗
PubMed2003

[Benign clear cell tumors of the lung--sugar tumors].

The authors present the case reports of rare benign clear cells tumors of the lung (CCLT) and drawn attention, that examination from frozen sections can be misleading and definitive histological verification can be done on basis of immunohistochemical analysis and can be different from frozen sections examination.

Diagnosis, Differential↗
PubMed2003

[Surgical treatment of primary pulmonary hypertension--lung transplantation].

Significant advance in the treatment of the primary pulmonary hypertension (PPH) has been achieved in the past decade. Continuous intravenous prostacyclin and lung transplantation have become complex and effective approaches in the therapy of PPH. Indication, technique, postoperative care and results of lung transplantation for PPH are discussed.

Humans↗
PubMed2003

[Laparoscopic extirpation of the rectum--initial experience].

Laparoscopy is still more and more widespread in surgery. It's advantages and disadvantages are still evaluated. It is very complicated to evaluate positive and negative characteristics of laparoscopy. Only to make the indication case to case is the correct approaches in using laparoscopy in abdominal surgery.

Aged↗
PubMed2003

[A surgeon's view on the importance of positron emission tomography--PET (with emphasis on lung neoplasms)].

OBJECTIVE: PET became a successful method in preoperative evaluation of patients with cancer. We question whether PET scan can answer critical surgeons' requests such as distinguish benign and malign lesions, evaluation of cancer dissemination, evaluation of the pleural effusions, and also to detect early cancer recurrence. METHODS: Between September 1999 and December 2001, 39 patients underwent a PET scan and we evaluated its benefit in further treatment of patients. Standard PET techniques were used. RESULTS: In 20 patients (52%) results of PET scan were in correlation of clinical diagnosis and stage of cancer disease, partial difference between FDG-PET and clinical diagnosis was in 8 patients (20%), next treatment was changed in 11 patients (28%). CONCLUSION: We conclude, that dedicated PET could be valuable tool in the diagnosis and staging of cancer disease, especially in verifying cancer dissemination, recurrence of the cancer. PET scan can be misleading in evaluation of the mediastinal lymphnodes and pleural effusions.

Fluorodeoxyglucose F18↗
PubMed2003

[Lung transplantation--present status worldwide and in the Czech Republic].

Lung transplantation has evolved to a standard treatment modality for patients suffering from end-stage lung diseases and it provides very good short- and satisfactory long-term survival. Accepted indications for lung transplantation include chronic obstructive pulmonary disease (COPD) and other causes of emphysema (i.e., alpha-1-antitrypsin deficiency), parenchymal diseases (i.e., idiopathic pulmonary fibrosis), genetic disorders such as cystic fibrosis, vascular diseases (i.e., primary pulmonary hypertension), chronic infectious diseases (i.e., bronchiectasis), as well as rare indications such as lymphangioleiomyomatosis or sarcoidosis. Presented article reviews the current strategies in the treatment of lung transplant recipients, surgical techniques, limitations of and effects of lung transplantation.

Czech Republic↗
PubMed2002

[Bouveret's syndrome: biliary ileus manifested by acute upper gastrointestinal hemorrhage and impaired gastric emptying].

The authors present a very rare case of impaired gastric evacuation, known as Bouveret's syndrome, caused by a large biliary concrement wedged in the duodenum as a result of the development of a cholecystoduodenal fistula in a 77-year-old man. The condition was manifested clinically by developed high ileus and subsequent haemorrhage into the upper GIT. The diagnosis was established on the background of the clinical picture, passage through the upper GIT and endoscopy. As the attempt to remove the concrement endoscopically failed, laparotomy had to be used. In the conclusion of this case-record the authors discuss the method of assessment of the correct diagnosis endoscopically and possibilities of therapeutic strategy.

Aged↗
PubMed2002

[Complications of endoscopic extraction of foreign bodies and their treatment].

Endoscopic extraction of foreign bodies from the upper part of the digestive tract has become recently the method of choice. As this method can be associated with very serious complications which cannot be resolved endoscopically and which may have permanent sequelae, it is important to consider the indication of endoscopic extraction of foreign bodies from the oesophagus or stomach very carefully. Fore illustration the authors present the case of a young female patient who swallowed by mistake a fork During its extraction a serious injury of the oesophagus occurred which had to be treated surgically. In the discussion pros and cons of endoscopic extraction are considered, the main principle being primum non nocere.

Adult↗