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Biomedical subjects

P Vávra

Publications and source records attributed to P Vávra.

At least 19 recordsLinked to original sources
PubMed2006

[Laparoscopic colorectal surgery for carcinomas--assessment of the authors' patient group].

AIM OF THE WORK: The aim was to assess short-term and long-term results of miniinvasive procedures for colorectal carcinomas. METHODS: This prospective study assessed patients indicated for laparoscopic procedures for their large intestinal or rectal carcinomas from 1993 to 2004. Primarily, their peroperative complications, postoperative course and long-term results were assessed. The Kaplan-Meier analysis was used to assess long-term survival rates. RESULTS: Over the 11-year period, a total number of 399 patients (236 males and 163 females) were laparoscopically operated for colorectal carcinomas. In 284 patients, the tumor was located in the colon region and in 115 patients in the rectal region. The stage B and C (Dukes classification), medium to highly differenciated, tumors prevailed. Resection of the sigmoid, right-sided hemicolectomy, low anterior resection of the rectum and amputation of the rectum were the most frequently conducted procedures. 311 procedures (78%) were curative, 88 were paliative (22%). Peroperative complications occured in 16 patients (4%), reoperations were required in 34 patients (8.5%). The recovery time for peristalsis was on the second postoperative day, on average. Food load was, on average, tolerated since the third postoperative day and the first stool appeared, on average, on the fourth postoperative day. Early mortality rate reached 6.5%. Postoperative hospitalization lasted, on average, 12 days. In our patient group, a five-year survival rate without relapses was 80% in the carcinoma patients and 68% in the rectal carcinoma patients. CONCLUSION: Laparoscopic colorectal surgery is a safe method with a number of pros for a patient as well as a surgeon in a comparable oncological radicality as that of the open method.

Adult↗
PubMed2006

[Safe distance of the inferior resection line in the rectal carcinoma surgery].

The authors present results of a study of a distal intramural spread of the rectal carcinoma beneath its aboral margin, which was conducted over several years. The authors closely cooperated with the Pathological Anatomy Institute of the Faculty Hospital in Ostrava, where each preparation was examined not only macro- and microscopically, but also the tumor's microscopic spread beneath its macroscopic margin was assessed in standard distances of 2 mm, 5 mm, 1 cm, 2 cm and 5 cm. The study did not record tumorous spread at the distance of 5 cm from the aboral margin of the tumor. The authors also confirmed that the distal intramural spread of the tumor is fairly rare and, at the same time, it signifies a highly advanced and aggressive disorder with a poor prognosis. Therefore, the authors favor management with a maximum quantity of the sphincter- saving procedures, with a sufficiently radical mesorectal excision, which they consider the essential method of the radical surgical treatment. Furthermore, the authors have not recorded cases of the differenciated adenocarcinoma spread, even at the distance of 2 mm from the aboral margin of the tumor. All positive findings of the distal intramural spread have been recorded in medium- low differenciated adenocarcinomas.

Carcinoma↗
PubMed2006

[The first case of management of the rectovaginal fistule using transanal endocsopic microsurgery].

The authors present an unusual and, according to the available literature data, so far unused method--management of the rectovaginal fistule, using a T.E.M. technique (transanal endoscopic microsurgery). In their case-review of a female patient, they present advantages of this technique in a case of a rare disorder - a benign rectovaginal fistule. All of the following employment of a harmonic scalpel in the T.E.M. method, as well as of a tissue adhesive Tissucol and of a surgical rectoscope in the vaginal phase of the procedure, deserve attention of surgeons and gynaecologists.

Female↗
PubMed2006

[Rare cases of acute urineous peritonitis as a consequence of a spontaneous rupture of the urinary bladder].

Perforation of the urinary bladder is, in most cases, caused by a blunt or penetrative trauma, respectively by an iatrogenic trauma. A spontaneous rupture of the urinary bladder is very rare. In the literature, its relation with alcohol abuse is speculated. Due to their minimal frequency rates, the diagnosis is very difficult and, not uncommonly, the diagosis is verified only upon surgical revision. The authors present two cases of urgent diffuse peritonitis originating from spontaneous perforations of the urinary bladder.

Acute Disease↗
PubMed2005

[Surgical treatment of distally located rectal carcinomas using the rendez-vous method--a laparoscopic resection in combination with T.E.M].

The aim of this work is to introduce a surgical procedure, which would make operations of distally located rectal carcinomas indicated for abdominoperineal extirpation of the rectum possible while maintaining intestinal continence and full functioning of the sphincter system. At the same time, we have aimed at the maximum use of all pros of contemporary miniinvasive surgical techniques. We have labelled our proposed surgical technique the "rendez-vous technique". The trial group includes the original group of 10 patients, who have been operated in our clinic since April 2004, using the rendez-vous technique. We are aware of the fact, that the trial group is small, however we believe that this trial group is the starting group, which will continue to enlarge and that it will bring results to the patients themselves, as well as for a valid prospective study in order to confirm or challenge the proposed method's effectiveness.

Female↗
PubMed2005

[Virtual colonoscopy as a part of the algorithm of the facultative examinations prior to the colorectal carcinoma procedure].

The authors present their own initial experience with virtual colonoscopy. Both benign and malignant stenosing processes of the colon and rectum, which make examining oral parts of the colon using colonoscopy or irrigography impossible, are the main indication for the procedure described. The authors' first experience with this method is totally positive. The more experienced the examiners, the better interpretation of the findings not only by radiologists but also by operating surgeons. In certain indications, the examination has its firm place in the algorithm of the facultative examinations prior to the colorectal carcinoma surgical procedures.

Colonography, Computed Tomographic↗
PubMed2004

[A laparoscopic management of an iatrogenic lesion of the colon during a colonoscopy].

The colon injury during a colonoscopy is a rare, however a serious complication, requiring, mostly, a surgical management. Only few patients may undergo a conservative treatment. The authors discuss the problem of the iatrogenic colon perforation during the colonoscopy and they assess a benefit of the miniinvasive surgery in the diagnostics and treatment algorithm. The main benefit is seen in the reduction of the surgical intervention risks, in the surgical trauma minimalisation, in more favourable postoperative status and in the possibility of the definitive injury management.

Aged↗
PubMed2003

[Crohn disease and laparoscopic surgery].

AIM OF THE STUDY: To evaluate possibilities of laparoscopic surgery in the treatment of Crohn's disease. METHODS: A retrospective evaluation of the group of 14 patients, operated on in the period of 2/1997 to 2/2003. RESULTS: In the group of 7 women and 7 men, laparoscopy was used for ileocecal resection in six cases (43%), resection of ileotransversoanastomosis in four cases (29%) and abdominal-peritoneal amputation of rectum once (7%). The surgical intervention lasted 125 min on the average. The post-operation complications were not recorded and the conversion was not necessary. The post-operation course was complicated by suppuration three times in laparotomy (21%) and once by paralytic ileus (7%), which required one reoperation. The peristaltics was resumed in the 2nd post-operation day on the average, when the patients began to refuse analgesics. The patients started to accept the liquid diet in the 3rd post-operation day on the average and stools appeared on the day 4 after the surgery. The median of post-operation hospitalization in cases of uncomplicated course was 8 days on the average. No patient was lost. CONCLUSIONS: The laparoscopic surgery represents a safe alternative in the therapy of Crohn's disease, being associated with a more favorable post-operation course and a better cosmetic effect in this group of patients with lower age average.

Adolescent↗
PubMed2002

[Hand-assisted laparoscopic surgery of the colorectum].

Hand-assisted laparoscopic surgery extends the possibilities of laparoscopic operations while preserving the miniinvasive character of the operation. The objective of the work is, based on the authors' experience with a group of 28 patients operated by this method for diseases of the colorectum to describe the surgical technique, present their results and emphasize the indications and advantages of this procedure.

Adult↗
PubMed1998

[Double gallbladder].

The authors demonstrate on an exceptional case the possibility of laparoscopic surgery in a patient with the rare finding of vesica fellea duplex. They also draw attention to the algorithm of examination methods and possible errors in these exceptional cases.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1998

[Laparoscopic gastrostomy: report on 20 cases].

At the surgical clinic of the Faculty Hospital in Ostrava-Poruba since November 1993 till June 1998 20 laparoscopic gastrostomies were performed. The main indication was to ensure enteral nutrition in patients where, due to obstruction of the oesophagus, it was impossible to implement percutaneous puncture gastrostomy. The surgical procedure lasted on average 37 minutes and was completed successfully in all patients. Three patients died within thirty days. This procedure made it possible that eighty percent of the patients could be discharged from hospital and go home.

Adult↗
PubMed1993

[The stress interview after acute myocardial infarct].

Patients suffering from myocardial infarction (MI) form the high risk group. Residual ischemia, impaired left ventricular function and dysrhythmias are life endangering. Sudden death is more frequent in this group than in the one of patients with CHD. Therefore before discharge from the hospital we applied to the patients after MI series of noninvasive methods to disclose ventricular dysrhythmias. 136 patients after MI, mean age 56 (36-74), were examined. From those 90 patients underwent early exercise test and stress interview--application of common and specific mental stress. Holter ambulatory monitoring was applied to 18 post MI patients and echocardiography to 23 ones. A control group constituted 20 apparently healthy men, mean age 54 (44-64), which underwent exercise test and stress interview too. We have shown the incidence of ventricular dysrhythmias is always significantly higher (p < 0.01) in the post IM group than in the healthy one at exercise test and stress interview. The incidence in the post MI group is 49.4% at specific stress, 38.2% at common stress and 34.5% at exercise test. Significantly higher is the incidence at specific stress than at common stress or early exercises test, respectively (p < 0.05). Patients with dysrhythmias at both mental stresses have significantly lower exercise performance and workload at exercise test narrow correlation with disclosure at Holter monitoring is observed. Stress interview aids identification of risk group of post MI patients with serious ventricular dysrhythmias and demonstrates importance of psychotherapeutic care after MI. This method of mental stressing completes noninvasive test s and it is good way to II. phase of rehabilitation after myocardial infarction.

Adult↗