Úvod: Cílem této studie bylo porovnat dva systémy uzavírání žil kyanoakrylátovým lepidlem, VenaSealTM a VariClose®, v léčbě povrchové žilní insuficience. Metody: Byla provedena retrospektivní analýza pacientů léčených od dubna 2018 do dubna 2022 kyanoakrylátovými lepidly pro insuficienci povrchových žil dolních končetin v jednom centru. Výsledky: Systém VariClose® byl použit u 27 pacientů (30 žil) a systém VenaSealTM u 97 pacientů (125 žil). Medián sledování pacientů léčených systémy VariClose® a VenaSealTM dosahoval 267 (IQR 223) a 201 (IQR 280) dnů. Po roce došlo k rekanalizaci u 11 žil léčených systémem VariClose® a u 5 žil léčených systémem VenaSealTM. Míra okluze odhadnutá Kaplanovou-Meierovou metodou v 30, 90, 180 a 360 dnech činila pro žíly léčené systémem VariClose® 100 %, 96 %, 83 % a 42 % a pro žíly léčené systémem VenaSealTM 100 %, 98 %, 96 % a 91 % (p < 0,01). Závěr: Systém VenaSealTM měl významně lepší míru okluze než systém VariClose®.

Objective: The goal of this study was to compare the cyanoacrylate venous sealing systems VenaSealTM and VariClose® in the treatment of superficial venous insufficiency. Methods: A single-centre retrospective analysis on patients treated between April 2018 and April 2022 with cyanoacrylate adhesives for lower limb superficial truncal vein insufficiency was performed. Results: The VariClose® system was used in 27 patients (30 veins) and the VenaSealTM system in 97 patients (125 veins). The median follow-up periods for patients treated with VariClose® and VenaSealTM systems were 267 (IQR 223) and 201 (IQR 280) days, respectively. At one year, recanalization occurred in 11 veins treated with the VariClose® system and 5 veins treated with the VenaSealTM system. The occlusion rates estimated by the Kaplan-Meier method at 30, 90, 180, and 360 days were 100%, 96%, 83%, and 42% for veins treated with the VariClose® system and 100%, 98%, 96%, and 91% for veins treated with the VenaSealTM system (p <0.01). Conclusions: The VenaSealTM system had significantly better occlusion rates than the VariClose® system.

• Klíčová slova
• VenaSealTM, VariClose,
• MeSH
• Kaplanův-Meierův odhad MeSH
• kyanoakryláty * aplikace a dávkování   farmakologie   terapeutické užití   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• varixy terapie   MeSH
• vena saphena chirurgie   patologie   MeSH
• vény patologie   MeSH
• výsledek terapie MeSH
• zařízení na uzavírání cév MeSH
• žilní insuficience terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

INTRODUCTION: Portomesenteric vein resections are a well-established part of pancreatectomies for advanced tumors that invade the portomesenteric axis. There are two main types of portomesenteric resections: partial resections, where only part of the venous wall is removed and segmental resection, where the full circumference of the wall is removed. The aim of this study is to compare short-term and long-term outcomes between these two techniques. METHODS: This is a single-centre retrospective study of the patients with pancreatic cancer who underwent pancreatectomy with portomesenteric vein resections between November 2009 and May 2021. RESULTS: From a total of 773 pancreatic cancer procedures, 43 (6%) patients underwent pancreatectomy with portomesenteric resections: 17 partial and 26 segmental. The overall median survival was 11 mo. For the partial portomesenteric resections, the median survival was 29 mo, and for the segmental portomesenteric resections, it was 10 mo (P = 0.019). The primary patency of the reconstructed veins after partial resection was 100% and after segmental resection was 92% (P = 0.220). Negative resection margins were achieved in 13 patients (76%) who underwent partial portomesenteric vein resection and 23 patients (88%) who underwent segmental portomesenteric vein resection. CONCLUSIONS: |Although this study is associated with worse survival, segmental resection is often the only way to safely remove pancreatic tumors with negative resection margins.

• MeSH
• lidé MeSH
• nádory slinivky břišní * patologie   MeSH
• pankreatektomie * metody   MeSH
• resekční okraje MeSH
• retrospektivní studie MeSH
• vena mesenterica chirurgie   MeSH
• vena portae chirurgie   patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• chirurgové statistika a číselné údaje   MeSH
• lékařská onkologie metody   statistika a číselné údaje   trendy   MeSH
• lidé MeSH
• průzkumy a dotazníky statistika a číselné údaje   MeSH
• vaskulární nádory chirurgie   MeSH
• výkony cévní chirurgie metody   statistika a číselné údaje   trendy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVES: The aim of this study was to assess occlusion rates of saphenous veins treated with the VariClose vein sealing system. METHODS: A retrospective analysis including a total of 64 patients from four centres from the Czech Republic. Occlusion was defined as a non-compressible vein with absence of flow with exception to the first 3 cm from the saphenofemoral or saphenopopliteal junction on duplex ultrasound. RESULTS: In 64 patients a total of 79 veins were treated. Technical success of the procedure was achieved in 74 (94%) of cases. The mean follow-up was 5.5 months. The closure rates calculated by the Kaplan-Meier method at 1, 3, 6 and 12 months were 94%, 85%, 69% and 36%, respectively, and there were no significant differences between centers. The average difference in VCSS score before and after the procedure was 1.8. CONCLUSIONS: The present study demonstrated surprisingly worse occlusion rates than the current literature.

• MeSH
• lidé MeSH
• retrospektivní studie MeSH
• varixy * diagnostické zobrazování   chirurgie   MeSH
• vena saphena diagnostické zobrazování   chirurgie   MeSH
• výsledek terapie MeSH
• žilní insuficience * diagnostické zobrazování   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: One of the three commercially available cyanoacrylate venous glues used for the treatment of saphenous vein insufficiency is the VariClose® vein sealing system. Previous studies have documented a high rate of occlusion and minimal postoperative complications. The aim of this study was to compare occlusion rates and clinical outcomes of endovenous laser treatment with the VariClose® vein sealing system in the treatment of truncal vein insufficiency. PATIENTS AND METHODS: Retrospective non-randomized single center study with prospectively collected data comparing endovenous laser treatment and VariClose® procedures between April 2018 and November 2019. RESULTS: VariClose® was used in 27 patients (30 veins) and endovenous laser treatment in 42 patients (51 veins). The occlusion rate at one, three, and six months were 96%, 85%, and 65% for VariClose® procedures and 100%, 100%, and 97% for endovenous laser treatment procedures (p = 0.01), respectively. Reduction of VCSS scores before treatment and at the last postoperative follow-up visit in the VariClose® group dropped by an average of 1.8 ± 1.6 and in the endovenous laser treatment by an average of 3.3 ± 2.9 (p = 0.01). CONCLUSION: VariClose® vein sealing system is inferior to endovenous laser treatment as a treatment option for varicose veins as it has a higher recanalization rate.

• MeSH
• laserová terapie * škodlivé účinky   metody   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• varixy * diagnostické zobrazování   chirurgie   MeSH
• vena saphena diagnostické zobrazování   chirurgie   MeSH
• výsledek terapie MeSH
• žilní insuficience * diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Background: Key anatomical factors mean that individuals needing arteriovenous access are unique and have different possibilities for fistula creation. The aim of this article is to describe a new classification system for all patients needing haemodialysis vascular access in the upper extremity with the purpose to simplify sharing the information about suitability for surgical access creation depending on vascular anatomy. Methods: According to the patient's vascular anatomy in right and left superior extremities, patients were separated into three arteriovenous access stages (AVAS). The AVAS was validated by three blinded observers using a sample of 70 upper limb arteriovenous maps that were performed using ultrasound on patients referred for vascular access assessment. A sample size calculation was performed and calculated that for three observers, a minimum of 67 maps were required to confirm significant agreement at a Kappa value of 0.9 (95% confidence interval 0.75-0.99). Results: The Kappa value for inter-rater reliability using Fleiss' Kappa coefficient was 0.94 and all patients fitted into the AVAS classification system. Conclusion: The AVAS classification system is a simplified way to share information about vascular access options based on a patient's vascular anatomy with high inter-rater reliability.

• Publikační typ
• časopisecké články MeSH

Aneurysma arteriovenózní fistuly (AAVF) je definováno jako dilatace žilního ramene nativní AVF na více než 18 mm. AAVF dělíme na klinicky symptomatické a asymptomatické. K chirurgické léčbě jsou indikováni pouze pacienti se symptomatickým AAVF bez ohledu na jeho velikost a metodou volby je aneurysmorafie.

Publikace se zaměřuje na různá žilní onemocnění a možnosti jejich léčby. Určeno široké veřejnosti.

• MeSH
• nemoci cév * diagnóza   terapie   MeSH
• varixy diagnóza   terapie   MeSH
• vény patologie   MeSH
• Publikační typ
• monografie MeSH
• populární práce MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• angiologie

OBJECTIVE: Aneurysms arising from arteriovenous fistulae are a common finding among dialysed patients and pose a risk of acute bleeding. The aim of this study was to perform a systematic review and meta-analysis evaluating the surgical options for the treatment of aneurysmal arteriovenous fistulae. METHODS: A systematic review and meta-analysis of articles published between January 1973 and March 2019 describing the surgical treatment of arteriovenous fistulae aneurysms. RESULTS: A total of 794 records were identified. After duplicate and low quality studies were removed, 72 full text articles were reviewed and from these 13 were included in the meta-analysis. The total number of patients was 597. Aneurysms were located in the upper arm in 289 (59%) cases and the smallest diameter of a treated aneurysm was 15 mm. The most frequent indication for treatment was bleeding prevention in 513 (86%) cases. Aneurysmorrhaphy was the surgical method of choice in all 13 studies. The pooled primary patency at 12 months was 82% (95% CI 69%-90%, 12 studies, I2 = 84%, p < .01). The 12 month primary patency rates were similar for aneurysmorrhaphy with external prosthetic reinforcement (85%, 95% CI 71%-93%, two studies, I2 = 0%, p = .33) and aneurysmorrhaphy performed using a stapler (74%, 95% CI 61%-83%, four studies, I2 = 0%, p = .48) and without a stapler (82%, 95% CI 60%-94%, six studies, I2 = 92%, p < .01). CONCLUSION: Aneurysmorraphy of arteriovenous fistulae is a procedure with acceptable short and long term results, with a low complication and aneurysm recurrence rate.

• MeSH
• aneurysma chirurgie   MeSH
• arteriovenózní zkrat * škodlivé účinky   MeSH
• čas MeSH
• dialýza ledvin * škodlivé účinky   MeSH
• horní končetina krevní zásobení   chirurgie   MeSH
• lidé MeSH
• průchodnost cév fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

Role of the vascular surgery in oncosurgeryRadikální odstranění nádoru u onkologicky nemocného je základem úspěšné léčby. V případech, kdy nádor infiltruje nebo těsně adheruje k cévním strukturám, je odstranění nádoru spolu s vaskulární rekonstrukcí mnohdy jedinou možností dosažení radikálního výkonu. Nový směr onkochirurgické léčby, označovaný jako onkovaskulární chirurgie, ukazuje, že invaze tumoru do cévního svazku nemá být automaticky vnímána jako bariéra radikální resekce, ale jen jako technická překážka. Uvádíme možnosti onkovaskulární chirurgie u karcinomu pankreatu, jater, ledvin, endometria, retroperitoneálních sarkomů a sarkomů dolních končetin.

Surgical resection remains the cornerstone for the curative treatment of oncological disease. In a situation when a tumour encases a critical arterial or venous structure, long term oncological control may be achieved only through careful preoperative planning within a multidisciplinary team incorporating oncological and vascular specialists. The present review addresses the principles in planning oncovascular surgery, describes the oncovascular procedure in pancreatic, liver, renal and endometriosis cancer as well as vascular involvement in retroperitoneal soft sarcoma and sarcoma in lower extremity. In conclusion, the present review highlights that major vessel involvement of a tumour mass should not necessarily be considered as a barrier to en bloc resection and hence curative oncosurgery procedure.

• MeSH
• cévy patologie   MeSH
• lidé MeSH
• nádory * chirurgie   komplikace   MeSH
• resekční okraje MeSH
• staging nádorů MeSH
• výkony cévní chirurgie * MeSH
• zákroky plastické chirurgie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH