INTRODUCTION: Duplex ultrasound examination is a gold standard for the investigation of venous system of lower extremities. Its importance is often undervalued especially by surgeons before the intervention itself. The necessity of mapping of the superficial venous system on lower extremities became more important with the progress of endovenous techniques. GOAL: The goal of this summarizing paper is to focus on anatomical and topographical situations of significant anatomical structures during the ultrasound mapping of venous system on lower extremities. MATERIAL AND METHOD: There is described the course of great and small saphenus veins and their junction into the deep venous system including all the other tributaries in the described region there. The description of perforating veins is not left out in the paper, too. The emphasis is put on display of anatomical structures in B-mode of the ultrasound imaging and their relationship to the surrounding anatomical structures. CONCLUSION: It is necessary to keep the guidelines for investigation and consecutively the guidelines for intervention of venous system. This is the only way to eliminate the pathological reflux and insufficient inter- and epifastial veins. This is the chance how to avoid the early recurrence or progression of the disease.
AIM OF THE STUDY: to check the new technique of lymphatic mapping and sentinel node biopsy by colorectal cancer surgery and to improve the lymphatic staging. METHOD: combined technique of lymphatic mapping via Patentblue and the radiocolloid in vivo applied in the rectal cancer surgery. The lymphatic-mapping technique with Patentblue in the colon cancer surgery. Radically or palliative tumour resection. Ex vivo detection of sentinel and non-sentinel lymph nodes in the specimen and their division into peritumoral, intermedial and central level. Serial sectioning examination and immunohistochemistry examination of detected lymph nodes. Statistic process. RESULTS: The methods were used for 107 patients. 1985 lymph nodes were examined, out of which 208 was with metastasis. Positive nodes were detected in 56 patients. In average there were 18.5 nodes per patient. 966 sentinel nodes were detected by colouring and radiocolloid marking. Sentinel nodes showed in 97 patients. In 10 patients, the method failed. In 44 patients, sentinel nodes were positive; 117 positive nodes in total. Skip metastases were detected in 6 percent of the patients. The upstaging of metastatic detection was in 3.7 percent. CONCLUSION: The technique of lymphatic mapping and sentinel node detection significantly increases the number of detected nodes and selects the marks the sentinel ones for further examination. The greatest amount of findings of nodal metastases is in the area closest to the tumour, therefore, when sentinel nodes are negative there, these can be examined more closely, by the method of serial insections or immunohistochemically, and staging of the disease can be made more accurate.
- MeSH
- biopsie sentinelové lymfatické uzliny * MeSH
- kolorektální nádory patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy diagnóza diagnostické zobrazování MeSH
- lymfatické uzliny diagnostické zobrazování patologie MeSH
- radiofarmaka * MeSH
- radioisotopová scintigrafie MeSH
- rosanilinová barviva * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- radiofarmaka * MeSH
- rosanilinová barviva * MeSH
- sulfan blue MeSH Prohlížeč
INTRODUCTION: N. laryngeus reccurens injury is a serious complication in thyroid surgery. Nerve visualization is a procedure preventing its traumatization. The visualization with additional intraopertive neuromonitoring results in further reduction of the n. laryngeus reccurens injury rates. AIM: Verification of the intraoperative neuromonitoring effects on reduction of the n. laryngeus reccurens injury rates. MATERIAL, METHODOLOGY: 309 operated patients were included in the intraoperative neuromonitoring prospective study. A total of 295 patients were included in the study and intraoperative monitoring was performed per protocol. RESULTS: Out of the total of 295 subjects, 1 patient sufferred from permanent paresis, ie. 0.33%, nerves at risk 0.2%. 6 subjects sufferred from transient pareses, i.e. 2.03%, nerves at risk 1.2%, with a prevailing 8-week recovery period of the ORL findings. CONCLUSION: Intraoperative neuromonitoring in thyroid surgery is yet another option for reduction of the n. laryngeus reccurens intraoperative injury rates.
- MeSH
- elektrická stimulace MeSH
- lidé MeSH
- nervus laryngeus recurrens fyziologie MeSH
- paratyreoidektomie škodlivé účinky MeSH
- peroperační komplikace prevence a kontrola MeSH
- peroperační monitorování * MeSH
- poranění nervus laryngeus recurrens * MeSH
- tyreoidektomie škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
INTRODUCTION: Chronic venous insufficiency affects a considerable proportion of the population and, commonly, is not considered a disease, but a disease process presenting as a wide range of clinical findings. The commonest findings include stages C2 and C3 according to the CEAP classification. Recently, modern miniinvasive surgical methods have come forth. AIM: The aim is to present the authors intitial experience with endoluminal bipolar radiofrequency thermotherapy of varices (RFITT). MATERIAL, METHODOLOGY: 48 extremities operated in 35 subjects from January to June 2007. VSM (Vena saphaena magna) was operated in 47 cases and VSP (Vena saphaena parva) in a single case. Where terminal VSM valve insufficiency was detected, additional crossectomy was performed. In all subjects, the procedure was followed by mimiphlebectomy and foam sclerotherapy. RESULTS: Obliteration of the operated vein using RFITT immediately after the procedure rated 100%. Subsequent recanalization was performed in a single subject after Day 140. Complications included irritation of the saphenous nerve in three subjects, in one case following miniphlegectomy and in the other two cases following RFITT. In all the subjects, the clinical findings recovered spontaneously within 14 days. Duration of their hospitalization was 5-24 hours. CONCLUSION: RFITT is a safe and effective miniinvasive surgical technique in the varicose veins management. It can be considered another alternative to other miinvasive procedures, such as laser endoluminal photocoagulation or conventional procedures, including stripping.
- MeSH
- dospělí MeSH
- katetrizační ablace * škodlivé účinky přístrojové vybavení MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- varixy chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
The authors present ethiology and aethilogy-based surgical techniques of the disorder on a group of 3458 patients operated for varices of lower extremities. Crossectomy is flashed out as a key moment of the procedure in cases of sapheno-phemoral junction insufficiencies. The results are presented on two patient groups comparing relaps rates of the disorder following completion of partial selective and radical complete crossectomies. A subject of neovascularization and its relation to the procedure and relapses is discussed.
- MeSH
- bérec krevní zásobení MeSH
- lidé MeSH
- recidiva MeSH
- varixy chirurgie MeSH
- výkony cévní chirurgie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
[Surgical therapy of the ductal carcinoma in situ]
AIM: Rates of the newly-detected DCIS reach up to 20% in developed countries. There is no unified therapeutic scheme to deal with the disorder. The aim of this work is to assess the author's own therapeutic results. METHODOLOGY: From 1999 until 2003, 11 female patients suffering from the DCIS were treated and 2 DCIS female patients were treated using microinvasion. The diagnosis was established 5x by the core-cut and 8x by the surgical excision. RESULTS: The size of the tumors varied from 0.5 cm to 6.0 cm. Conservative procedures were performed 11 times, a simple mastectomy once and a mastectomy with reconstruction once, as well. The sentinel lymphonodes were examined in all cases and once the examination was accompanied by the axilla dissection. The number of the sentinel lymphonodes was 29. All of the lymphonodes were negative. Seven female patients were given a complementary therapy. All female patients have had no local relapse in the breast and have had no signs of the disease process since. The average follow-up time is 13.5 months. CONCLUSION: The conservative procedures sufficiently provide treatment of early forms of the DCIS of the breast. The sentinel lymphonode biopsy is a patient- kind method, giving exact information on the status of the axillary lymphonodes and it is considered a suitable part of the DCIS therapy.
AIM: The method of extended lymphadenectomy in the early gastric carcinoma treatment remains controversial. The aim of this prospective study is to assess the above method feasibility with acceptable rates of complications, in our conditions. METHODOLOGY: From 2000 to 2003, 11 patients with early carcinomas of the stomach were treated using the method of extended lymphadenectomy. The study group included 7 males and 4 females. RESULTS: In 6 cases, the tumors were located in the distal, in 4 cases in the middle and once in the proximal third of the stomach. In a single case, the IIIA stadium was concerned, the other cases were rated lower. In total, 205 lymphonodes measuring 18.6 on average (median of 16) were examined. The total of 5 lymphonodes were malignant, all of them were found in one patient. The method of the sentinel lymphonode biopsy was applied once. A cardiopulmonary complication was reported once, a punction of the subphrenic absces was reported once, a primary disorder causing a death was reported once and the patient concerned exited after a 14-month-period of his follow-up. Once, a local relaps of the disorder was reported 43 months after the procedure. The follow-up median was 27 months. CONCLUSION: The method of extended lymphadenectomy can be conducted even in our conditions with acceptable rates of complications.
AIM: The aim of this study is to evaluate the lymphatic mapping method during the colorectal carcinoma surgery and to increase a number of the detected lymphonodes up to the level of the internationally recommended standards. METHODOLOGY: In the group collected in 2002 and 2003, the lymphatic mapping method was applied in cases of 32 patients suffering from the colorectal carcinoma, according to the protocol. RESULTS: In the group of 32 patients suffering from all stages of the colorectal carcinoma, a total number of 408 lymhonodes was examined, which is 12.75 lymphonodes per patient, on average. Out of this, in the rectal carcinoma cases--7.85 lymphonodes per patient were detected on average, and in the group of the colon tumors--13.72 lymphonodes per patient. CONCLUSIONS: The retrospective evaluation of the patients who underwent surgery for the colorectal carcinoma proved the method of the lymphatic mapping to increase the number of the detected lymphonodes from 6-8 up to nearly 13. Thus, the average number of the examined lymphonodes already complied with the international oncosurgical criteria. The lymphatic mapping technique proved to significantly increase the number of the examined lymphonodes and to improve the colorectal carcinoma patients staging.
- MeSH
- barvicí látky MeSH
- biopsie sentinelové lymfatické uzliny * MeSH
- kolorektální nádory patologie chirurgie MeSH
- lidé MeSH
- lymfadenektomie MeSH
- lymfatické metastázy diagnóza MeSH
- rosanilinová barviva MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- barvicí látky MeSH
- rosanilinová barviva MeSH
- sulfan blue MeSH Prohlížeč
The authors made one thousand thyroidectomies in the course of five years. In the submitted paper they discuss indications, for surgery, the extent of the operations, the results of the histological findings. They describe the surgical procedure, required preoperative examinations and postoperative monitoring. They analyze different postoperative complications incl. their frequency in the discussed group. They emphasize a physiological surgical technique, verifications of the recurrent nerve, care of the parathyroid bodies and collaboration with endocrinologists.
- MeSH
- lidé MeSH
- nádory štítné žlázy diagnóza chirurgie MeSH
- pooperační komplikace MeSH
- struma diagnóza chirurgie MeSH
- tyreoidektomie * metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
The authors present a review on the development of views on breast cancer from the beginning of the century and contemporary views on the problem, its solution world-wide and in the Czech Republic. They base on their own group of 475 patients of 1991-1998, they analyze the development of possible solutions of early breast cancer and their view on the discussed problem. With regard to favourable results they advocate progressive breast preserving operations associated with postoperative radiotherapy and the use of the method of sentinel nodes.
- MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory prsu diagnóza patologie chirurgie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
