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AIM: To describe our experience with esophagectomy for esophageal cancer and, the development and treatment of complications arising from the surgery. MATERIAL AND METHODS: From 2007 to 8/2010, esophagectomy for esophageal carcinoma was performed in 75 patients at the 1(st) Surgical Clinic. Primary esophagectomy was indicated in 20 patients with T1N0 stage or in cases where neoadjuvant treatment was contraindicated. 55 patients with T2,3N0,1 stages received neoadjuvant radiochemotherapy. Esophagectomy was performed via an abdominal approach (transhiatal laparoscopy in 44 patients, laparotomy in 3 patients) and a thoracic approach (thoracoscopy in 10 patients, thoracotomy in 18 patients). RESULTS: In 18 cases, one or both pleural cavities were opened by means of dissection of the mediastinal pleura during the transhiatal laparoscopic esophagectomy. The morbidity was 26.6% and the following complications were encountered: pulmonary (15 patients), anastomosis dehiscence (5), postoperative bleeding in the mediastinum (1), fistula between trachea and transposition (1), paresis of the left recurrent nerve (8), infectious complications in the abdominal cavity (2), thoracic cavity (1), and early complications (2). The sixty-day mortality was 8% and this was mostly due to pulmonary complications (4 patients) but included coronary thrombosis (1) and transposition necrosis (1). CONCLUSION: The dominating complications of esophagectomy were pulmonary (20 %). The remaining serious complications cannot be completely eliminated but if diagnosed in time and treated in a correct algorithm they do not have to imminently threaten the lives of patients.

Článek

Assessment of renal graft function depending on pre-transplant morphology

Biomedical papers of the Medical Faculty of the University Palacký, Olomouc Czech Republic. 2006 ; 150 (1) : 171-177.

Biomed. Pap. Fac. Med. Palacký Univ. Olomouc Czech Repub. (Print)
ISSN 1213-8118
Medvik
Zdroj

BACKGROUND: Histopathological assessment of kidney prior to transplantation is a part of the comprehensive information gathered on the transplanted organ. In our study we monitor the influence of individual morphological findings (glomeruli, arteries, arterioles, interstitium, tubules) and degree of histopathological changes in the kidney function after transplantation. METHODS: From 1994 to 1997, 117 cadaveric kidneys were histopathologically examined and subsequently transplanted. Biopsy in a form of wedge excision was obtained during the organ procurement after in situ kidney perfusion and its removal from donor's body. Evaluated were glomerulosclerosis, intimal fibrosis of arteries, arteriolar hyalinization, interstitial fibrosis and tubular changes (vacuolar dystrophy of tubular epithelium, desquamation of tubular epithelium, brush border of proximal tubules, tubular dilatation, haemoglobin cylinders in distal tubules). Kidney recipients were monitored both for immediate function of transplanted organ and long-term kidney function for a period of five years following. RESULTS: In our group of patients, no unambiguously negative influence of histopathological change in individual morphologies was found either in the immediate or in the long-term function of the transplanted kidney. CONCLUSION: It is possible to transplant kidneys and attain satisfactory results even with these types of histopathological changes: glomerulosclerosis greater or equal to 20 %, mild degree of arterial lesion, moderate arteriolar lesions, moderate lesions of interstitial fibrosis and tubular lesions. The degree of arterial lesions, arteriolar lesions and the degree of interstitial fibrosis closely correlate to the donor's age, hypertension and nontraumatic cerebrovascular accident as the cause of death. Same outcomes were also confirmed with glomerulosclerosis, with the exception of the influence of the donor's age.

MeSH
dárci tkání MeSH
dítě MeSH
dospělí MeSH
ledviny patologie patofyziologie MeSH
lidé středního věku MeSH
lidé MeSH
mladiství MeSH
odběr tkání a orgánů MeSH
senioři MeSH
transplantace ledvin patologie fyziologie MeSH
Check Tag
dítě MeSH
dospělí MeSH
lidé středního věku MeSH
lidé MeSH
mladiství MeSH
senioři MeSH
Publikační typ
časopisecké články MeSH

Článek

Peritoneovenous shunt - modification with the use of long saphenous vein

Biomedical papers of the Medical Faculty of the University Palacký, Olomouc Czech Republic. 2004 ; 148 (1) : 89-90.

Biomed. Pap. Fac. Med. Palacký Univ. Olomouc Czech Repub. (Print)
ISSN 1213-8118
Medvik
Zdroj

The authors describe their own initial experience with saphenoperitoneal modification of the peritoneovenous shunt in intractable ascites solution. Their findings with this easy type of permanent ascites drainage using the "patient's own resources" are puzzling.