Studie hodnotí přínos CT navigace u endoskopických operací VDN a zlepšení kvality života pacientů po operaci. V prospektivní studii (779 operací u 439 nemocných v období 2011-2015) jsme srovnávali efektivitu a rozsah chirurgického výkonu, vztah k přidruženým chorobám (alergie, astma bronchiale). Dále jsme hodnotili kvalitu života operovaných dotazníkem SNAQ-11. Vyhodnotili jsme také výsledky primárních a revizních operací VDN a porovnávali jsme stav čichu po operačních výkonech provedených bez a s CT navigací. Pooperačně jsme dosáhli zlepšení kvality života o 79 %, v rozmezí od 72 do 83 %. Zachování nebo zlepšení čichu u primárních operací bylo dosaženo v 86 %, u revizních výkonů v 55 %. Užití CT navigace v chirurgii VDN minimalizuje počet operačních komplikací při operování v obtížných anatomických podmínkách. U alergiků užitím CT navigace dosahujeme výrazně lepšího stavu čichu po operaci. Revizní operace snižuje šanci na pooperační zlepšení čichu. Všechny revizní operace VDN by měly být prováděny zkušeným operatérem a ideálně s využitím CT navigace.

Background and aim: One of the most common indication of CT navigation surgery is the surgery of nasal sinuses and especially the revision surgery. The aim of this paper was to prove importance of surgical radicality of FESS on the improvement of quality of life and/or improvement of the sense of smell in particular surgical groups and on reduction of the number of revision surgeries. Patients and Methods: In the 5-year period between 2011 and 2015 in prospective study we performed a total of 374 navigated procedures (in 198 subjects) and 405 classical endoscopic endonasal paranasal operations (in 241 subjects). The decision about use of the CT navigation depended mostly on the quality of the CT scans. If the protocol used for the imaging allowed subsequent navigated procedure, then the navigation procedure was preferred. The quality of life was studied on a cohort of 439 patients as a prospective cohort study: on operated patients was the quality of life assessed using the SNAQ – 11 questionnaire (Sino nasal assessment questionaire - Czech version). The surgery was performed by a randomly selected surgeon from our rhinology group. For investigationg the olfactory function the Sniffin Sticks test was routinly used. The regularly postoperatiove follow-ups for our patients were scheduled in intervals of 1, 4, 12 weeks and 6 and 12 months in the first year after surgery, and later once to twice yearly. Results: We observed an improvement of 79% in quality of life, with a range from 72 to 83%. Olfactory deterioration is the most sensitive indicator of recurrent chronic rhinosinusitis. We reviewed the relationship between sense of smell and procedures performed both with and wihout the use of CT navigation. With surgical treatment, the sense of smell was maintained or improved in 86% of patients, while this figure reached only 55% in revision procedures. We observed significantly better results with navigated surgery, at a ratio of 85% to 46%, regardless of whether a primary operation or revision was performed. In patients without allergies, the results with and without navigation were the same. Conclusion: Allergic patients operated with CT navigation had a significantly better sense of smell than patients operated by the endonasal method without CT assistance. The postoperative sense of smell in patients without allergies is comparable in both methods and all members of both groups had improved quality of life.

• MeSH
• Surgery, Computer-Assisted * methods   utilization   MeSH
• Smell MeSH
• Endoscopy * methods   MeSH
• Quality of Life MeSH
• Humans MeSH
• Otorhinolaryngologic Surgical Procedures * methods   MeSH
• Tomography, X-Ray Computed methods   utilization   MeSH
• Postoperative Period MeSH
• Prospective Studies MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Surgery, Computer-Assisted * history   methods   instrumentation   utilization   MeSH
• History, 20th Century MeSH
• Humans MeSH
• Minimally Invasive Surgical Procedures * history   methods   instrumentation   utilization   MeSH
• Hospital Departments history   MeSH
• Check Tag
• History, 20th Century MeSH
• Humans MeSH
• Publication type
• Historical Article MeSH

• About
• Masarykova nemocnice (Ústí nad Labem, Česko) Authority

• Keywords
• endonazální endoskopická chirurgie,
• MeSH
• Skull Base * surgery   MeSH
• Safety * MeSH
• Surgery, Computer-Assisted * economics   classification   methods   instrumentation   trends   utilization   MeSH
• Endoscopy * instrumentation   trends   utilization   MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Orbit * surgery   MeSH
• Paranasal Sinuses * surgery   MeSH
• Tomography, X-Ray Computed * MeSH
• Image Processing, Computer-Assisted MeSH
• Preoperative Care MeSH
• Check Tag
• Humans MeSH

• Keywords
• totální náhrada kolenního kloubu, osové uspořádání, orientační body,
• MeSH
• Surgery, Computer-Assisted utilization   MeSH
• Femur surgery   MeSH
• Prosthesis Implantation * methods   MeSH
• Knee Joint * surgery   MeSH
• Humans MeSH
• Patella surgery   MeSH
• Tibia surgery   MeSH
• Arthroplasty, Replacement, Knee * methods   MeSH
• Plastic Surgery Procedures * methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Surgery, Computer-Assisted economics   utilization   MeSH
• Humans MeSH
• Robotic Surgical Procedures * economics   utilization   MeSH
• Universal Health Insurance MeSH
• Check Tag
• Humans MeSH
• Publication type
• Newspaper Article MeSH

PURPOSE OF THE STUDY The use of navigation applied to total knee arthroplasty in knees with femoral hardware retained has not been studied. MATERIAL AND METHODS We use navigation in six patients to implant a total knee arthroplasty while retaining the femoral hardware. The retained materials were screws in two cases, diaphyseal plates in another two, intramedullary nails in one and supracondylar tube/plate in another one. Preoperative knee scores were within the 46-66 range, whereas the functional scores were within 40-68. The coronal deformity varied between 30° varus and 5° valgus. RESULTS The final femoral mechanical axis was between 2° valgus and 3° varus; the axis of the limb was between 4° valgus and 3° varus. Knee scores improved in all cases, with scores between 75 and 90 points (p = 0.028); functional scores were between 64 and 90 points (p = 0.043).The final range of mobility was within the 70°-110° range, with a slight improvement over the preoperative status (p = 0.042). No complications have arisen throughout the follow-up (mean 16 months). CONCLUSIONS The use of navigation constitutes a good option in the treatment with total arthroplasties for patients with femoral hardware retained.

• MeSH
• Surgery, Computer-Assisted methods   utilization   MeSH
• Femur surgery   MeSH
• Internal Fixators MeSH
• Middle Aged MeSH
• Humans MeSH
• Statistics, Nonparametric MeSH
• Orthopedic Procedures methods   statistics & numerical data   MeSH
• Range of Motion, Articular MeSH
• Aged MeSH
• Arthroplasty, Replacement, Knee MeSH
• Outcome and Process Assessment, Health Care MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH

Přehled současného využití robotického systému ve světě. Tříleté zkušenosti s 42 robotickými operacemi provedenými od roku 2008 do roku 2011 na gynekologickém oddělení v Ústí nad Labem. Operace provedené převážně pro karcinomy cervixu a endometria; 29 operací s lymfadenektomií.

The article gives a survey of the utilisation of robotic surgery in the world. It presents three years of experience from 42 robotic operations performed from 2008 until 2011 in the Department of Gynaecology-Obstetrics at Masaryk Hospital in Usti nad Labem. The procedures were performed mostly following a diagnosis of endometrial and cervical cancer; 29 of the 42 operations were instances of lymfadenectomy.

• Keywords
• karcinom hrdla děložního, endometria,
• MeSH
• Surgery, Computer-Assisted economics   statistics & numerical data   utilization   MeSH
• Gynecologic Surgical Procedures methods   instrumentation   statistics & numerical data   MeSH
• Carcinoma MeSH
• Middle Aged MeSH
• Humans MeSH
• Lymph Node Excision methods   statistics & numerical data   MeSH
• Minimally Invasive Surgical Procedures economics   methods   statistics & numerical data   MeSH
• Uterine Cervical Neoplasms surgery   MeSH
• Endometrial Neoplasms surgery   MeSH
• Postoperative Complications MeSH
• Retrospective Studies MeSH
• Robotics economics   methods   utilization   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Imaging, Three-Dimensional utilization   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

• MeSH
• Surgery, Computer-Assisted instrumentation   trends   utilization   MeSH
• Computer-Aided Design instrumentation   trends   utilization   MeSH
• Adult MeSH
• Humans MeSH
• Minimally Invasive Surgical Procedures trends   MeSH
• Practice Patterns, Dentists' MeSH
• Dental Implants, Single-Tooth trends   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Surgery, Computer-Assisted utilization   MeSH
• Digestive System Surgical Procedures MeSH
• Gynecologic Surgical Procedures MeSH
• Thoracic Surgery MeSH
• Cardiovascular Surgical Procedures MeSH
• Humans MeSH
• Minimally Invasive Surgical Procedures utilization   MeSH
• Robotics utilization   MeSH
• Urologic Surgical Procedures MeSH
• Check Tag
• Humans MeSH
• Publication type
• Newspaper Article MeSH

Cíl: Práce hodnotí přínos traktografie kortikospinální dráhy začleněné do neuronavigace při operacích intraaxiálních nádorů mozku, jež se nacházejí v těsné blízkosti kortikospinální dráhy. Soubor a metodika: Traktografie je využívána v kombinaci s elektrofyziologickými metodami (se subkortikální elektrickou stimulací k vybavení motorických evokovaných potenciálů) k nalezení kortikospinální dráhy. Soubor tvoří pět pacientů s intraaxiálním tumorem (astrocytomy gr. II–IV). Výsledky: U všech pacientů v souboru se podařilo elektrostimulací potvrdit kortikospinální dráhu v přibližné lokalizaci předpovězené traktografií. Resekce byla ukončována při vybavení motorických evokovaných potenciálů při stimulačním proudu 15 mA (monopolární stimulace, train čtyř impulzů o frekvenci 500 Hz a šířce 400 μs). V souboru nevznikl nový trvalý neurologický deficit. Závěry: I když se vzhledem k posunům mozkové tkáně, ke kterým dochází při resekci tumoru, domníváme, že nelze dostatečně spoléhat pouze na zobrazení kortikospinální dráhy neuronavigací bez elektrofyziologického ověření jejího průběhu, jeví se traktografie jako cenné vodítko k nalezení průběhu kortikospinální dráhy v operačním poli.

Objective: This study was conducted to assess the benefit of integrating corticospinal tract diffusion tractography into neuronavigation during operations for intra-axial brain tumours located close to the corticospinal tract. Methods: Diffusion tractography was used, together with subcortical electric stimulation, to locate the corticospinal tract. Motor-evoked potentials elicited by stimulation were recorded. The method was used in five patients with intraaxial brain tumour (astrocytoma gr. II –IV ). Results: The corticospinal tract was successfully confirmed by electro-stimulation in the approximate location predicted by diffusion tractography in all patients. Resection of the tumour was terminated when motor-evoked potentials were elicited by a stimulus current of 15 mA (monopolar stimulation, train of four pulses at a frequency of 500 Hz and pulse duration of 400 μs). No patient has since suffered from new permanent neurological deficit. Conclusion: Although we remain convinced that, due to the brain shift that occurs during tumour resection, it is not enough to rely solely on the projections of the corticospinal tract in neuronavigation without electrophysiological validation of the tract course, diffusion tractography integrated into neuronavigation appears to be a valuable guide for the identification of the corticospinal tract in the surgical field.

• Keywords
• traktografie, mozkové nádory, zobrazení difuzních tenzorů,
• MeSH
• Anisotropy MeSH
• Astrocytoma diagnosis   surgery   MeSH
• Surgery, Computer-Assisted methods   utilization   MeSH
• Glioblastoma diagnosis   surgery   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   utilization   MeSH
• Evoked Potentials, Motor physiology   MeSH
• Cerebral Ventricle Neoplasms diagnosis   MeSH
• Brain Diseases diagnosis   etiology   MeSH
• Neurosurgical Procedures methods   MeSH
• Neuronavigation methods   utilization   MeSH
• Pyramidal Tracts physiology   physiopathology   MeSH
• Statistics as Topic MeSH
• Outcome and Process Assessment, Health Care MeSH
• Diffusion Tensor Imaging methods   instrumentation   utilization   MeSH
• Check Tag
• Humans MeSH