Search PubMed⌕ Search

Biomedical subjects

V Drahonovský

Publications and source records attributed to V Drahonovský.

7 recordsLinked to original sources
PubMed2004

[Laparoscopic fundoplication. Indications and preoperative examinations].

AIM: The aim of this study is to assess success rates and risks of laparoscopic antireflux procedures, based on 2000 completed surgical procedures. METHODOLOGY: We compared our experience with literature data. We concenterated on indications, preoperative examinations range and the procedure's technique itself. RESULTS: It is advisable to indicate patients with already advanced disorders and hiatal hernias, after the procedure's principles and possible side-effects have been explained to them. It is also advisable to carefully indicate young, polymorbid and depressive patients. The higher the expertise of the operating team, the less contraindications for the procedure occur. The preoperative examination should be sufficient enough to exclude any diagnostic errors. Fibroscopy, preferably conducted repeatedly, is necessary. PH-metry and oesophageal manometry may aid to exclude incorrect indications and, on the contrary, may confirm the diagnosis in cases of non- typical clinical manifestations. Radiography may depict hernias, stenoses, the oesophagus length, its relation to the diaphragm. CONCLUSION: The result of any antireflux surgical procedure depends on its correct indication, on a complete exhaustion of the patient's history data, on a rational assessment of the preoperative examination results. Education of the patient is necessary.

Fundoplication↗
PubMed2004

[Laparoscopic fundoplication. The surgical technique].

The antireflux plastic procedures have a broad spectrum of its variations. The best results have been recorded with circular procedures with a good mobilization of the distal oesophagus and cardia, with or without interruption of the vasa brevia. The hiatal suture is always conducted. The rim (cuff) should be short, 25-30 mm, applied loosely around the mobilized abdominal oesophagus with an inserted gastric tube (at least 12 mm). The surgeon must consider any peroperative fingdings. All his movements, location and application of each stitch would decide about the procedure's successful outcome.

Fundoplication↗
PubMed1997

[The laparoscopic fundoplication technique and postoperative complications].

The authors performed in the course of 3 years 200 laparoscopic fundoplications on account of oesophageal reflux. Only in one case they used the classical approach and once they converted to the classical procedure. The short-term results are encouraging. The number of complications was comparable with those reported abroad. A complete antireflux effect was achieved in 95% of the operated patients. In the authors opinion the main success of the operation is the sparing dissection of the hiatus, maximum sparing of the vagus innervation, the creation of a sufficiently large window behind the oesophagus and differentiated use of antireflux plastic operations, depending on the preoperative examination and the peroperative finding. The authors prefer the circular Nissen-Rossetti plastic operation, they do not use antitelescopic suture nor severing of the vasa brevia. To prevent penetration of the stomach into the mediastinum they use only in major diaphragmatic defects sparing suture of the hiatus or fixation of the upper suture of the cuff to the top of the hiatus. They resolve major defects by implantation of a net into the hiatus. Their favourable results make, when comparing conservative and surgical treatment, laparoscopic fundoplication the most desirable procedure.

Endoscopy↗
PubMed1997

[Safe preparation of the hiatus--conditio sine qua non].

The authors discuss the method of laparoscopic fundoplication which is becoming the method of choice for surgical treatment of oesophageal reflux. They analyse crucial points of the operation with regard to its safety.

Endoscopy↗
PubMed1996

[Laparoscopic fundoplication].

The authors performed at their previous and present workplace a total of 52 operations on account of oesophageal reflux, incl. two classical ones, one conversion and in 49 instances they made Nissen-Rossetti fundoplications. Two minor complications were managed during operation, two postoperative complications were treated conservatively without effect on the results of surgery. All patients were relieved of their complaints and terminated year-long anti-reflux therapy. Laparoscopic fundoplication is a small invasion sparing the internal organs and abdominal wall; makes it possible to terminate medication; there is no risk of hernia in the scar. The operation is thus a rational solution of reflux complaints and optimal prevention of complications of reflux diseases.

Adult↗
PubMed1993

[Laparoscopic cholecystectomy].

The authors present an account of their experience assembled during one year with laparoscopic operations of the gallbladder. They indicated 248 patients for CHE incl. 237, i.e. 95.6%, for laparoscopic CHE. No deaths, no major complications, 6.5% conversions in elective indications, 23% in acute indications. Six patients with residual choledocholithiasis are in the authors' opinion a signal calling for more accurate detection of CHLDL before and during LCHE.

Adolescent↗