PURPOSE OF THE STUDY The purpose of this study is to reveal the waste of water by medical staff hand scrubbing preoperatively in the operation theatre, draw attention to the water consumption with small precautions. The study compares motion-sensitive sensor tap with an uncensored classic tap, to assess the difference of water consumption during hand scrubbing. MATERIAL AND METHODS The presented study compared two groups; hand scrubbing with sensory tap was enrolled as group A and classic tap with running water was enrolled as group B. Three participants were included in each group. Operation faucets with a motion-sensitive sensor and timekeeper were used in group A. Running water from a tap in 10 seconds was measured with the help of a measuring cup. The water amount after 3 minutes of washing was also measured. The difference between the two obtained data was compared. The obtained data were also multiplied to the global surgical data. RESULTS Measurements were performed with a measuring cup and it was measured that 1,250 ml of water is running from faucets in 10 seconds. In group A, faucets were open for 23 seconds whereas in group B faucets were open for 180 seconds. In group A, water utilization was 2,875 ml per person (8,625 ml for three), in group B was the water utilization of 22,500 ml per person (67,500 ml for three). Regarding this data for a single operation, the consumption difference between the two groups was measured as 58,875 ml. The total count of major surgery worldwide per year is reported to 321,500,000. When this number is multiplied with the obtained data, it is calculated that the total amount of water to be saved between the two groups is 18,928,313 m3. That is equal to one year of water consumption of a city with 125,000 inhabitants. CONCLUSIONS In conclusion, as healthcare professionals, it is possible to save enough water as a medium-sized city by changing our handwashing habits in the operation rooms. As a result, water-conserving systems and hand scrubbing education can be very effective in using the natural resources economically and protecting these resources. Key words: water, operation theatre, washing.

• MeSH
• dezinfekce rukou * MeSH
• lidé MeSH
• operační sály MeSH
• ruka * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In the present study we examined the positive effects of a healthcare clown intervention on children undergoing surgeries, and the role parent-child relationships may play in their effectiveness. Children between 5 and 12 years, who were scheduled to undergo elective surgical procedures in a large university hospital, were randomly assigned to an intervention group (IG; n = 35) that was visited by a healthcare clown, and a control group (CG; n = 27) that received treatment as usual (i.e., company of parents before the surgery). Children in both groups were videotaped and the videos were later used to rate their activity, arousal, emotional expressivity, and vocalizations. Additionally, children and parents rated their mood and perceived quality of life at several points during the procedure, and parents reported their perceptions of the relationship with their children. Results showed that children in the IG showed more positive emotions and vocalizations than children in the CG. Parents of children in the IG also reported more positive mood than parents of children in the CG. In contrast, children in the CG reported higher quality of life than children in the IG. Importantly, analyses showed considerable effects of the parent-child relationship on all outcome measures. Results of the present study demonstrate that a healthcare clown intervention had some positive effects on behaviors and mood of hospitalized children and their parents. Importantly, our findings also suggest that we need to consider the pre-existing "relationship microcosmos" that the clowns enter when assessing their effectiveness in the hospital.

• Klíčová slova
• healthcare clowns, humor, parent-child relationship, pediatric surgery, positive emotions, well-being,
• MeSH
• dítě hospitalizované MeSH
• dítě MeSH
• kvalita života * MeSH
• lidé MeSH
• operační sály * MeSH
• poskytování zdravotní péče MeSH
• úzkost MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

This editorial discusses the recent study conducted by Macias et al., revealing that anesthesiologists' case volume history has only a marginal impact on improving operating room efficiency, resulting in minimal clinical significance. The idea that a specific anesthesia team or type of anesthesia could enhance productivity has been previously investigated, yielding similar conclusions. Although the study primarily focuses on the time from patient arrival to the completion of anesthesia induction, excluding the latter part of anesthesia-controlled time, Macias et al. have made a valuable contribution by challenging the prevalent notion that less experienced anesthesiologists adversely affect operating room efficiency.

• Klíčová slova
• Anesthesia, Anesthesia-controlled time, Case volume, Operating group,
• MeSH
• anesteziologie * MeSH
• anesteziologové * MeSH
• celková anestezie MeSH
• lidé MeSH
• operační sály MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH

INTRODUCTION: Near-infrared (NIR) fluorescence angiography (FA) is an augmented reality (AR) technique. When used in the operating room, it allows colorectal surgeons to visualize and evaluate intestinal blood flow in real time, identify lymph nodes, ureters, or peritoneal metastases. Evaluation of perfusion with FA in augmented reality mode has an impact on reducing the ALR (anastomotic leakage rate) in rectal resections. METHODS: Data analysis of patients after minimally invasive surgery (MIS) for middle and lower rectal adenocarcinoma with total mesorectal excision (TME) using fluorescent angiography (FA) with indocyanine green (ICG) (100 patients, 20152019) were subsequently compared with a historical control group (100 patients) operated on for the same diagnosis before the introduction of the FA-ICG method (20122015) using minimally invasive approach (MIS). The patients were operated on consequently at one workplace. RESULTS: In fifteen patients (15%), the resection line was shifted due to insufficient perfusion detected by FA-ICG. The incidence of AL was lower in the group with FA compared to the group without FA (9% vs. 19%, p=0.042, χ test). A retrospective analysis of the group revealed a significant risk factor (RF) for the anastomotic leak, namely diabetes (p=0.036) and, among others, a protective factor, application of the transanal drain (NoCoil) (p=0.032). CONCLUSION: The introduction of new procedures and the use of new technologies, such as the use of the FA method in the AR mode in resections of the rectum with TME for cancer can lead to a reduction in the incidence of anastomotic leakage.

• Klíčová slova
• anastomotic leakage − rectal resections − fluorescence angiography − augmented reality,
• MeSH
• anastomóza chirurgická škodlivé účinky   MeSH
• augmentovaná realita * MeSH
• fluoresceinová angiografie MeSH
• indokyanová zeleň MeSH
• kolorektální chirurgie * MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• netěsnost anastomózy etiologie   MeSH
• operační sály MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• indokyanová zeleň MeSH

• MeSH
• chování zvířat * MeSH
• krysa rodu Rattus MeSH
• lidé MeSH
• obranné mechanismy MeSH
• operantní podmiňování MeSH
• skupinové procesy * MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Is it better to treat popliteal aneurysms as elective operations when their diameter is above 2 cm? MATERIALS AND METHODS: Between 1985 and 2004, 76 operations for popliteal artery aneurysm were performed in 67 patients. RESULTS: 58 operations were elective (76.32%) and 18 were emergencies [13 procedures and 5 urgent amputations] (23.68%). For reconstruction, autologous saphenous vein was used in 53 cases (69.74%), vascular prosthesis in 15 cases (19.74%), and a cryo-preserved vein allograft in 3 cases (3.95%). In 5 cases (6.58%), amputation for advanced lower limb ischaemia was performed without arterial reconstruction. In our patient group there were 62 men (92.53%) and 5 women (7.47%). Patient age ranged from 49 to 80 years, with a mean age of 69 years. Elective operation was indicated in most of the patients with popliteal artery aneurysm, because it was associated with a relatively low risk for the patient. In fact, it was a preventive operation. In the acute stage, there was a higher risk of complications and (potential) amputation. CONCLUSIONS: Popliteal aneurysms should be surgically treated as soon as possible after their diagnosis, preferably before ischaemic complications occur.

• MeSH
• aneurysma diagnostické zobrazování   chirurgie   MeSH
• arteria poplitea * diagnostické zobrazování   MeSH
• cévy - implantace protéz MeSH
• elektivní chirurgické výkony MeSH
• lidé středního věku MeSH
• lidé MeSH
• průchodnost cév MeSH
• rentgendiagnostika MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• urgentní zdravotnické služby MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Comparison of duration of surgery, blood loss, complications, lenght of post-operative hospitalisation and post-operative morbidity in a group of patient operated for the diagnosis FtM transsexualism. DESIGN: Retrospective clinical study. MATERIAL: In our set of patients were 163 FtM transsexuals with caryotype 46 XX and normal gynecological finding (81 virgins). They were operated on from 1998-2012 at Department of Obstetrics and Gynecology The First Faculty of Medicine Charles University in Prague and Hospital Na Bulovce after at least of 12 months of hormonal preparation. METHODS: We used following types of hysterectomy and bilateral adnexectomy: total abdominal hysterectomy from infraumbilical median laparotomy (AHL) or from suprapubic transverse incision - Pfannenstiel (AH), laparoscopically assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH). In two patients TLH and colpectomy was performed in one setting. RESULTS: In the 23 AHL group the duration of the surgery was 54 minute, blood loss was 226 ml and the length of post-operative hospitalisation was 6.7 days. In the 22 individualy of AH group the duration of the surgery was 60 minute, blood loss was 240 ml and the length of post-operative hospitalisation was 6.1 days. In 4 patients of LAVH group the duration of the surgery was 73 minute, blood loss 200 ml and the length of post-operative hospitalisation was 5 days. In the TLH group (112 pts) the duration of the surgery was 91 minutes, blood loss was 121 ml and the length of post-operative hospitalisation was 4.4 days. In the 2 TLH with colpectomy group the duration of the surgery was 152 minute, blood loss was 250 ml and the length of post-operative hospitalisation was 5.5 days. In one case a peroperative lesion of urinary bladder occured and once a conversion TLH to AH for a strong vaginal bleeding was necessary. Among postoperative complication in one case subileus in AH group was diagnosed, once vaginal bleeding, once haematoma in the suture and one case of secondary healing. Postoperative complication after TLH included 4 times bleeding from vaginal suture, once haematoma in Douglas pouch, once seroma in the place of trocar insertion, once subileus. Once ureter was injured and treated by the ureteral stent insertion. Complication after AHL and LAVH were not recognised. CONCLUSION: Total laparoscopic hysterectomy is the method of choice in the group of FtM transsexuals. This technique could be used also in nuliparous women with long and narrow vagina. Compared with laparotomic approach lower blood loss and shorter hospital stay was proved. Earlier restitution of full activity is another advantage. Musculus rectus abdominis flap can be used for phallus construction. The only significant disadvantage is a longer duration of surgery.

• MeSH
• délka operace MeSH
• dospělí MeSH
• hysterektomie metody   MeSH
• laparoskopie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• postupy změny pohlaví metody   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• transsexualismus chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

The aim of this paper is to evaluate the prevalence of subjective symptoms and signs related to vibration syndrome in various groups of subjects exposed to hand-arm vibration (HAV). In 9 groups of subjects occupationally exposed to HAV, one group of subjects previously exposed to HAV, one control group, and 2 groups of general population (males and females), the prevalence of finger blanching, numbness in the hands, stiffness in the hands, and pain in the hands were investigated. The age of subjects ranged from 25 to 59 years. In subjects exposed to HAV, hand-transmitted vibration levels (HTVLs) were measured by means of vibration dosimeters, and the frequency-weighted acceleration levels [(Lh,w)eq,t] were determined as the vibration levels. The prevalence of vibration-induced white finger (VWF) in the exposed subjects was in the range of 0.0-9.6%, and that in subjects who were previously exposed to HAV was 4.1%. The prevalence rates of finger blanching in males and females of the general population were 2.7 and 3.4%, respectively. The highest prevalence rate of VWF was observed among subjects exposed to HTVLs of 2.7-5.1 m/s2. The prevalence of numbness of the hands fluctuated among the groups; i.e., in the exposed groups: in the range of 6.5-30.4%; in those previously exposed to HAV: 16.4%; and was 13.4% in males and 29.5% in females of the general population. The prevalence rates of stiffness in the hands were in the range of 7.6-65.2% in the exposed workers, 13.7% in those previously exposed to HAV, and was 5.5% in males and 20.9% in females of the general population. The prevalence of pain in the hands was between 7.4 and 17.4% in the exposed groups, 1.4% in those who stopped exposure to vibration, and 1.2% in subjects without segmental vibration exposure. Among the subjective symptoms, only VWF showed a significant positive correlation with the measured vibration acceleration; Y = -0.9 + 1.9 X, r = 0.8, P = 0.01. It was concluded that VWF is the most appropriate signs in decisions concerning quantitative recommendations for segmental vibration exposure.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci z povolání epidemiologie   MeSH
• prevalence MeSH
• Raynaudova nemoc epidemiologie   MeSH
• rizikové faktory MeSH
• ruka * MeSH
• studie případů a kontrol MeSH
• úžinové syndromy epidemiologie   MeSH
• vibrace škodlivé účinky   MeSH
• zaměstnání MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Japonsko epidemiologie   MeSH

BACKGROUND: We sought to report the frequency, types, and outcomes of left-sided reoperations (LSRs) after an arterial switch operation (ASO) for patients with D-transposition of the great arteries (D-TGA) and double-outlet right ventricle (DORV) TGA-type. METHODS: Seventeen centers belonging to the European Congenital Heart Surgeons Association (ECHSA) contributed to data collection. We included 111 patients who underwent LSRs after 7,951 ASOs (1.4%) between January 1975 and December 2010. Original diagnoses included D-TGA (n = 99) and DORV TGA-type (n = 12). Main indications for LSR were neoaortic valve insufficiency (n = 52 [47%]) and coronary artery problems (CAPs) (n = 21 [19%]). RESULTS: Median age at reoperation was 8.2 years (interquartile range [IQR], 2.9-14 years). Seven patients died early after LSRs (6.3%); 4 patients with D-TGA (5.9%) and 3 patients with DORV TGA-type (25%) (p = 0.02). Median age at last follow-up was 16.1 years (IQR, 9.9-21.8 years). Seventeen patients (16%) required another reoperation, which was more frequent in patients with DORV- TGA type (4 of 9 [45%]) than in patients with D-TGA (13 of 95 [14%]). Late death occurred in 4 patients (4 of 104 [3.8%]). The majority of survivors were asymptomatic at last clinical examination (84 of 100 [84%]). CONCLUSIONS: Reoperations for residual LSRs are infrequent but may become necessary late after an ASO, predominantly for neoaortic valve insufficiency and CAPs. Risk at reoperation is not negligible, and DORV TGA-type anatomy, as well as procedures on the coronary arteries, were significantly associated with a higher morbidity and a lower overall survival. Recurrent reoperations after LSRs may be required.

• MeSH
• aortální insuficience epidemiologie   etiologie   chirurgie   MeSH
• dítě MeSH
• dvojvýtoková pravá komora chirurgie   MeSH
• incidence MeSH
• kojenec MeSH
• korekce transpozice velkých arterií škodlivé účinky   MeSH
• lidé MeSH
• míra přežití trendy   MeSH
• mladiství MeSH
• následné studie MeSH
• pooperační komplikace epidemiologie   etiologie   chirurgie   MeSH
• předškolní dítě MeSH
• prognóza MeSH
• reoperace metody   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• transpozice velkých cév chirurgie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

Background: Minimally invasive parathyroidectomy is the preferred treatment for primary hyperparathyroidism. Despite relatively accurate preoperative information, minimally invasive parathyroidectomy can be challenging, especially in the case of small and ectopic adenomas. Radio guidance aids in both in vivo identification and ex vivo confirmation of adenoma. In vivo accuracy is currently not satisfactory. The present study evaluated whether a beneficial effect (increased sensitivity, specificity, accuracy) is obtained with individualised timing of minimally invasive radio-guided parathyroidectomy (MIRGP) using preoperative multi-phase 99mTc-MIBI single photon emission computed tomography (SPECT)/computed tomography (CT). Methods: This randomised clinical trial was conducted from May 2016 to January 2020 in a tertiary referral hospital. Adult patients with primary hyperparathyroidism sent for 99mTc-MIBI SPECT/CT were included consecutively and randomly assigned to conventional (dual-phase) SPECT/CT and conventional MIRGP (group I) or multi-phase SPECT/CT and individualised MIRGP (group II). One hundred of 106 eligible patients were included, and 83 patients underwent complete intervention. Results: A total of 47 patients in group I and 35 patients in group II were analysed. Group II had a shorter operating time (p = 0.003). The in vivo sensitivity and accuracy of radio guidance was 85.1% in group I and 100% in group II (p = 0.046), and 90.4% in group I and 100% in group II (p = 0.021), respectively. We found no difference in the in vivo specificity and ex vivo parameters between groups. Conclusion: Individualised timing increased the in vivo sensitivity and accuracy of radio guidance and reduced operating time, as some parathyroid adenomas rapidly wash out the radionuclide.

• Klíčová slova
• individualised timing, minimally invasive parathyroidectomy, multi-phase SPECT/CT, superior in vivo results,
• Publikační typ
• časopisecké články MeSH