Wyniki wyszukiwania - Biblioteka Nauki

1

Results of Surgical Treatment of Colorectal Cancer in Octogenerians Patients

100%

Tarnowski W. , Kamiński P. , Bielecki K.

Polish Journal of Surgery

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2010

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tom 82

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nr 7

410-416

EN

The aim of the study was to estimate factors affecting results of surgical treatment of colorectal cancer in octogenarian patients in comparison with a group of younger patients.Material and methods. Hospital records were reviewed prospectively and data were collected from a consecutive series of 1021 patients operated on because of primary colorectal cancer between 1988 and 2009.Results. One hundred sixteen patients aged minimum 80 years of life were identified with an average age of 83.6 years. They were compared with 905 younger patients with an average age of 61.9 years. Co-morbidity, presentation in ASA 2, ASA 3 and ASA 4 score were significantly higher in octogenarian than in younger patients group. Emergent operations were performed significantly more often in octogenerians than in younger patients as well (31% versus 14% respectively). Resection of cancer and primary bowel anastomosis was performed less often in patients aged over 80 years than in younger patients (58.6% versus 70.9% respectively). Postoperative complications rate was significantly higher among the older than younger patients (43.9% versus 30.7% respectively). Mortality was higher in older than in younger patients (22.4% vs 5.7% respectively).Conclusions. Results of surgical treatment of colorectal cancer in octogenarian patients are affected by higher co-morbidity and more often presentation of ASA 3 and ASA 4 score than in younger patients. Surgical treatment of colorectal cancer in octogenarians is burdened with higher rate of postoperative complications and almost four times higher mortality rate than in younger patients.

2

Intraoperative Difficulties and the Reasons for Conversion in Patients Treated with Laparoscopic Colorectal Tumors

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Tarnowski W. , Uryszek M. , Grous A. , Dib N.

Polish Journal of Surgery

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2012

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tom 84

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nr 7

352-357

EN

The aim of the study was an evaluation of conversion causes and intraoperative difficulties in patients treated with laparoscopic surgery due to colorectal tumours on the basis of authors' own material.Material and methods. in the period 2009-2012 160 patients were operated on because of large bowel cancer, 79 women and 81 men. Average age of patients was 66 years. The conversion was recognized as desuflation of peritoneal cavity, trocars removal and making laparotomy.Results. The conversion was made in 22 cases (13,7%). More in men (16.1%) than in women. The conversion was made twice as likely in T3 and T4 tumors than in T1 and T2.Conclusions. The main cause of conversion in laparoscopic operations of colorectal cancer is local tumor progression.

3

Stenosis after sleeve gastrectomy – cause, diagnosis and management strategy

100%

Binda A. , Jaworski P. , Tarnowski W.

Polish Journal of Surgery

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2013

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tom 85

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nr 12

730-736

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Role of electromyography and functional electrical stimulation in the treatment of anorectal diseases

88%

Borycka-Kiciak K. , Wawiernia K. , Namysł J. , Garstka-Namysł K. , Tarnowski W.

Polish Journal of Surgery

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2015

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tom 87

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nr 4

194-202

5

Peritoneal Adhesions as a Cause of Mechanical Small Bowel Obstruction Based on Own Experience

88%

Morawski B. , Nawrot I. , Klonowski W. , Mądrecki M. , Tarnowski W.

Polish Journal of Surgery

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2015

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tom 86

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nr 11

523-531

EN

Bowel obstruction is a condition which has been known for many years. As time goes by, the problem is still often encountered at surgical emergency rooms. More than 20% of emergency surgical interventions are performed because of symptoms of digestive tract obstruction with the disease mostly situated in the small bowel. Rates of causative factors of the disease have changed over recent years and there have been increasingly more cases of small bowel obstruction caused by peritoneal adhesions, i.e., adhesive small bowel obstruction (ASBO). The aim of the study to analyse the reasons and incidence of adhesive small bowel obstruction during two periods of time (1990-1995 and 2005-2010). Material and methods. We performed a retrospective analysis of medical records of patients hospitalized at the 1st Department of General Surgery and Surgical Oncology of the Provincial Polyclinic Hospital in Płock between 1990 and 1995. The outcomes were compared with another period of 2005-2010. Results. We found that the incidence of adhesive small bowel obstruction increased from 58 cases in the first period to 215 cases in the second one, and the outcomes improved. The proportion of patients who underwent surgery diminished from 38% to 13%. The mean hospitalization time shortened and was 11.3 days and 6.95 days during 1990-1995 and 2005-2010 periods of time, respectively. In the first group, patients who had a surgery were hospitalized for 17.8 days and those who were treated conservatively for 8.08 days. In the second group, the mean hospital stay decreased to 15.6 days and 5.7 days in the case of surgical and conservative treatment, respectively. The age of onset declined from 56.63 years in the first period to 52.54 years in the other one. Conclusions. Analysed data show an increasing number of patients with adhesive small bowel obstruction. The highest risk of the disease was associated with operations on the large bowel and gynaecological procedures.

6

Laparoscopic Abdominoperineal Resection Of The Rectum – How Is It Done; Initial Results

88%

Grous A. , Uryszek M. , Ciesielski A. , Dib N. , Tarnowski W.

Polish Journal of Surgery

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2013

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tom 85

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nr 10

569-575

EN

The abdominoperineal resection of the rectum is a classical operation performed in case of patients diagnosed with rectal cancer. The development of laparoscopic techniques in recent years, introduced yet another method of treatment, considering patients with rectal cancer- laparoscopic abdominoperineal resection of the rectum. The aim of the study was to present initial treatment results considering the above-mentioned patients. Material and methods. The study group comprised 25 patients (16 male and 9 female) diagnosed with low-rectal cancer, subjected to surgery by means of the above-mentioned method. Mean patient age amounted to 66 years. Three (12%) patients required conversion to classical surgery (laparotomy), while one patient required reoperation, due to presacral vascular bleeding. Complications were observed in 10 (40%) patients. Average hospitalization was 7 days. In case of all patients the radial margin was negative, and mean number of removed lymph nodes amounted to 9.6. Mortality was not observed during the perioperative period. Due to the initial character of the study analysis (mean observation period in case of 68% of patients was shorter than 2 years), oncological results were not subject to evaluation. Conclusions. Laparoscopic abdominoperineal resections are considered as technically difficult operations, requiring significant experience of the operating team. However, they enable the patient to take advantage of the many assets of minimally invasive surgery, with comparable rates of postoperative complications.

7

Gastroesophageal reflux disease – from the point of view of a gastroenterologist, otolaryngologist and surgeon

75%

Jurkiewicz D. , Waśko-Czopnik D. , Pietruszewska W. , Tarnowski W. , Barańska M. , Kowalczyk M. , Jaworski P.

Polish Journal of Otolaryngology

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2021

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tom 75

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nr 2

42-50

EN

Gastrooesophageal reflux disease is the regurgitation of stomach contents into the esophagus, which causes troublesome symptoms or complications for the patient. Before starting the treatment, it is always necessary to objectively confirm gastroesophageal reflux disease, especially in correlation with ENT symptoms, as extra esophageal complications. In diagnostics, the "gold standard" is a 24-hour impedance-pH supplemented with endoscopy. Treatment without objective confirmation of the disease is not recommended, the more so that non-acid gas proximal reflux, detectable only in the MIIpH test, causes the greatest number of laryngological complications. It is important to confirm the coexistence of clinical symptoms of GERD with ESS. Considering the time of treating the disease and its consequences, it is worthwhile to be cautious and careful with the diagnosis of the disease, and the treatment should be carried out for a long time in relation to the recommendation, preferably in cooperation with an ENT specialist and gastroenterologist. The greatest therapeutic effectiveness is achieved by combining PPI with itopride while maintaining the appropriate doses of drugs and observing a sufficiently long duration of treatment, while maintaining the correct dose reduction and drug discontinuation regimen. In case of failure of pharmacological treatment, antireflux surgery should be take into consideration.

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Choroba refluksowa przełyku – spojrzenie specjalisty gastroenterologa, otolaryngologa i chirurga

75%

Jurkiewicz D. , Waśko-Czopnik D. , Pietruszewska W. , Tarnowski W. , Barańska M. , Kowalczyk M. , Jaworski P.

Polish Journal of Otolaryngology

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2021

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tom 75

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nr 2

42-50

PL

Choroba refluksowa przełyku to zarzucanie treści żołądkowej do przełyku, powodujące kłopotliwe dla pacjenta objawy lub powikłania. Przed włączeniem leczenia należy zawsze obiektywnie potwierdzić tę chorobę, zwłaszcza w korelacji z dolegliwościami laryngologicznymi jako powikłaniami pozaprzełykowymi. W diagnostyce „złotym standardem” jest 24-godzinna impedancja-pH, uzupełniona endoskopią. Nie zaleca się leczenia bez obiektywnego potwierdzenia choroby, tym bardziej, że najwięcej powikłań laryngologicznych powoduje refluks niekwaśny gazowy proksymalny, możliwy do detekcji wyłącznie w badaniu MII-pH. Ważne jest potwierdzenie współwystępowania wraz z zespołami pozaprzełykowymi objawów klinicznych GERD (ang. Gastroesophgaeal Reflux Disease). Mając na uwadze czas leczenia choroby i jej konsekwencji, warto rozważnie i ostrożnie podchodzić do rozpoznania choroby, a leczenie powinno być odpowiednio długo prowadzone, w odniesieniu do rekomendacji, najlepiej przy współpracy specjalisty laryngologa i gastroenterologa. Największą efektywność terapeutyczną uzyskujemy poprzez połączenie inhibitorów pompy protonowej (PPI) z itoprydem przy zachowaniu odpowiednich dawek leków oraz przestrzegając odpowiednio długiego czasu leczenia z zachowaniem prawidłowego schematu redukcji dawek i odstawiania leków. W przypadku nieskuteczności leczenia zachowawczego, należy rozważyć leczenie chirurgiczne antyrefluksowe.

9

Laparoscopically Assisted Ileo-Colonic Resection in Patients with Crohn’s Disease – Preliminary Report

75%

Borycka-Kiciak K. , Dib N. , Janaszek Ł. , Sołtysiak Ł. , Bukowicka B. , Tarnowski W.

Polish Journal of Surgery

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2013

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tom 85

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nr 9

505-510

EN

Despite increasing number of reports indicating good treatment outcomes, laparoscopic treatment of Crohn’s disease remains controversial. The aim of the study was to compare outcomes of laparoscopically assisted and open ileo-colonic resection in patients with active Crohn’s disease. Material and methods. 82 patients who underwent surgical treatment (44 laparoscopic and 38 open procedures) at the Department of General, Oncological and Gastrointestinal Surgery in Warsaw were enrolled to the study. The following perioperative parameters were compared in both these groups: duration of hospitalization and presence of postoperative complications in at least 12 months of follow‑up. Results. The conversion rate in the laparoscopy group was 29.5%. There were no statistically significant differences between the study groups with regard to duration of the surgical procedure, requirement for perioperative transfusions and total number of postoperative complications (19.3% in the laparoscopy group versus 28.9% in the open surgery group). However, amount of analgesic drugs required in the postoperative period was significantly lower (25±6 vs 43±9, p<0.01) and duration of hospitalization was significantly shorter (9.0 vs 11.3 days, p=0.021) after laparoscopic versus open procedures procedures. Most of the patients with complicated Crohn’s disease who were qualified to laparoscopic treatment, underwent successful treatment using this method. Patients in whom conversion was done, were more likely to be on long term preoperative immunosuppressive therapy versus other patients. Conclusions. Laparoscopy is a demanding procedure from the technical point of view, but provides valuable benefits to patients with Crohn’s disease, including those with a complicated disease. However, this method requires ongoing improvement of technical aspects and thorough analysis of failures to identify factors that could accurately select patients with indications and contraindications to this procedure.

10

Wytyczne leczenia przetok przewodu pokarmowego. Stanowisko Grupy Ekspertów Towarzystwa Chirurgów Polskich

51%

Sobocki J. , Jackowski M. , Dziki A. , Tarnowski W. , Banasiewicz T. , Kunecki M. , Słodkowski M. , Stanisławski M. , Zaczek Z. , Richer P. , Matyja A. , Frączek M. , Wallner G.

Polish Journal of Surgery

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2021

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tom 93

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nr 4

57-69

PL

Wstęp: Nieszczelność przewodu pokarmowego należy do najtrudniejszych problemów w chirurgii przewodu pokarmowego. Związana jest ona z: wysoką chorobowością i licznymi powikłaniami, dużym ryzykiem zgonu, przedłużoną hospitalizacją oraz zwielokrotnieniem kosztów leczenia. Cel: Zadaniem zespołu było opracowanie zaleceń dotyczących leczenia przetok przewodu pokarmowego zgodnie aktualną wiedzą medyczną w celu ograniczenia śmiertelności oraz chorobowości związanej z leczeniem. Materiały i metody: Opracowanie niniejszych zaleceń oparto na przeglądzie dostępnego piśmiennictwa z baz PubMed, Medline i Cochrane Library z okresu od 1.01.2010 do 31.12.2020, ze szczególnym uwzględnieniem przeglądów systematycznych oraz zaleceń klinicznych uznanych towarzystw naukowych. Zalecenia sformułowano w formie dyrektywnej i poddano je ocenie metodą Delphi. Wyniki i wnioski: Przedstawiono 9 zaleceń wraz z omówieniem oraz uwagami ekspertów. Leczenie powinno być prowadzone w oparciu o zespół wielodyscyplinarny (chirurg, anestezjolog, specjalista żywienia klinicznego/dietetyk, pielęgniarka, farmaceuta, endoskopista).

11

Polish guidelines for treatment of patients with parastomal hernia

51%

Śmietański M. , Bury K. , Matyja A. , Dziki A. , Wallner G. , Studniarek M. , Fridiger J. , Szczepkowski M. , Świerblewski M. , Wróblewski T. , Tarnowski W. , Solecki R. , Mitura K.

Polish Journal of Surgery

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2013

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tom 85

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nr 3

152-180

12

Polish Consensus Statement On The Protective Stoma

39%

Szczepkowski M. , Banasiewicz T. , Krokowicz P. , Dziki A. , Wallner G. , Drews M. , Herman R. , Lorenc Z. , Richter P. , Bielecki K. , Tarnowski W. , Kruszewski J. , Kładny J. , Głuszek S. , Zegarski W. , Kielan W. , Paśnik K. , Jackowski M. , Wyleżoł M. , Stojcev Z. , Przywózka A.

Polish Journal of Surgery

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2015

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tom 86

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nr 8

391-404