This comparative prospective study elucidates whether breast reconstruction that is not associated with systemic oncological treatment may trigger a tumour relapse, and if there is any difference between the evaluated recon- struction methods, a simple procedure using an implant versus a TRAM flap, on this hypothetical influence. The study group of 95 patients suffered from stage I-II of breast carcinoma. As regards the available reconstruc- tion procedures, the study group was divided into two subgroups, the first using an implant (n1 = 33) and the second using a TRAM flap (n2 = 62). All oncological problems manifesting during the subsequent 12 months were consid- ered as a response to the reconstruction. The oncological course was compared with two control groups. The first control group (k1 = 82) corresponded to the study group in terms of tumour stage (I-II), average age, time of initial diagnosis, type of primary surgery, i.e. mastectomy with axilla exenteration, and subsequent oncological treatment. The second control group (k2 = 19 625) was based on the National Oncology Register data. It was formed from all patients with breast carcinoma stage I-II from 1985-1994. The disease development in terms of the relative number of relapses and deaths was compared to the number of healthy and living patients, respectively, in the preceding year. The working hypothesis of late breast reconstruction (i.e. not associated with oncological treatment) being a pos- sible trigger effect on the subsequent course of breast cancer has not been confirmed. No statistically significant differences at the 5% significance level were found between individual reconstruction methods and control groups in terms of the number of local relapses and survival length.
- MeSH
- chirurgické laloky metody MeSH
- finanční podpora výzkumu jako téma MeSH
- lidé MeSH
- mamoplastika metody škodlivé účinky MeSH
- nádory prsu chirurgie terapie MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
Over the course of ten years, 119 breast reconstruction procedures using a free TRAM flap transfer were per- formed in our department. In the present review, the authors explain the indication pattern for breast reconstruc- tion. The age of patients undergoing breast reconstruction is given, as well as a description of the time interval between mastectomy and breast reconstruction, which recipient vessels were used, the general and local compli- cations and the complications relating to the anastomosis. The review of the group of patients is supplemented by information on the time interval between breast reconstruction and reconstruction of the nipple areolar complex as well as summarized data on the results of breast reconstruction that were achieved using a free TRAM flap transfer.
- MeSH
- chirurgické laloky metody MeSH
- lidé MeSH
- mamoplastika metody MeSH
- mastektomie metody MeSH
- pooperační péče MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
Formou poznámek rozebrány některé aspekty diagnostiky a léčby nezhojitelných pánevních a perineálních defektů a pištěli. Na základě zkušenosti získané pri ošetření 2 žen s postradiační rektovaginální pištěli a 2 mužů s perineálními sínusy po exstirpaci rekta diskutovány výhody a technické momenty plastiky lalokem z velkého sedacího svalu pri ošetření těchto afekcí.
In the form of a comment some aspects of diagnosis and treatment of unhealed pelvic and perineal defects and fistulas were analysed. Based on author's own experience with the treatment of 2 females with postradiation rectovaginal fistulas and 2 males with perineal sinus after proctectomy the authors discuss some advantages and technical aspects of pedunculated myoplasty by the gluteus maximus muscle.
- MeSH
- chirurgické laloky metody MeSH
- lidé MeSH
- perineum chirurgie patologie MeSH
- pooperační komplikace MeSH
- proktokolektomie rekonstrukční škodlivé účinky MeSH
- radioterapie škodlivé účinky MeSH
- rektovaginální píštěl diagnóza chirurgie MeSH
- svaly chirurgie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Popsána operační metoda uzávěru nebojících se defektů mezi pochvou a konečníkem, resp. uretrou a konečníkem, případně perzistujících sinusů po proktektomii pomocí svalového laloku z velkého hýždového svalu. Výsledky ošetření jsou demonstrovány v sestavě 7 nemocných operovaných autorem během 261etého období; u 6 z nich byl postup úspěšný a vedl ke zhojení defektů.
The author describes a surgical method used to close poorly healing defects between the vagina and rectum, and the urethra and rectum resp. or persistent sinuses after proctectomy by means of a muscular flap of the gluteus maximus muscle. The results of treatment are demonstrated on a group of 7 patients operated by the author in the course of 26 years. In six patients the procedure was successful and led to healing of the defects.
Endorektálny posuvný lalok bol na našom pracovisku zavedený do liečby všetkých typov vysokých anorektálnych fistúl v roku 1994 a od roku 1997 rozšírený na liečbu ischiorektálnych abscesov, pri ktorých bolo identifikované vnútorné ústie fistuly. Príspevok je zameraný na skúsenosti s týmto typom operačného výkonu, jeho techniku, frekvenciu malých inkontinencií, komplikácií a recidív za trojročné obdobie 1995 - 1997.
Since end 1994 all types of high anorectal fistulas were treated by endorectal advancement flap technique. This technique was adopted to treatment of fistulas identified in ischiorectal abscesses in 1997. Our purpose was to demonstrate early experience with this procedure in study focused on minor incontinence, complication and reccurence rate in patients treated in the years 1995 - 1997.
- MeSH
- čelní lalok MeSH
- chirurgické laloky metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory nosu chirurgie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- chirurgické laloky metody MeSH
- hrudní chirurgické výkony metody MeSH
- lidé MeSH
- nádory hrudníku chirurgie terapie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
