Zbigniew Lorenc - Academia.edu (original) (raw)
Papers by Zbigniew Lorenc
Nowa Medycyna, 2019
Anal fistula is pathological tract lined by inflammatory granule connects bottom of the anal cryp... more Anal fistula is pathological tract lined by inflammatory granule connects bottom of the anal crypt with perianal skin. In most cases, anal fistula is a consequence of abscess developed due to infection of anal the glands. The most common symptoms of anal fistula are recurrent inflammation around the anus, pruritus and purulent leakage. In the treatment of fistulas mainly surgical methods are used, however, attempts of conservative treatment (tissue adhesives glues or plugs) are also undertaken. The goal of treatment is to choose a method that will be characterized by high radicality with the lowest possible risk of complications. Literature describes only few cases of perianal fistula caused by a foreign body. The paper presents a case of a 57-year-old man who was diagnosed with fistula-in-ano caused by a foreign body of unknown origin. The patient reported long-term purulent discharge only. Surgical treatment involved resection of the foreign body and fistula with subsequent uneven...
Nowa Medycyna, 2019
Introduction. Colorectal cancer is the third most common cancer worldwide. The introduction of no... more Introduction. Colorectal cancer is the third most common cancer worldwide. The introduction of novel diagnostic and treatment methods has resulted in decreasing mortality rates; however, an increase in morbidity is observed. Severe inflammation plays an important role in many aspects associated with carcinogenesis. Neoplasia and inflammatory response are mutually related. Aim. The aim of the study was to evaluate the association between preoperative serum C-reactive protein levels and total leukocyte count in colorectal cancer patients in comparison with postoperative histopathological findings depending on whether there was neoplastic infiltration of the local adipose tissue or not. Material and methods. The study population included 50 patients with colon cancer. Exclusion criteria were distant metastases, neoadjuvant therapy and a past history of cancer diagnosis. Blood findings were compared with histopathology. Patients were divided into two groups – with and without neoplastic...
Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z posta... more Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z postaci jest enteropatyczny chłoniak T-komórkowy (EATL), występujący z częstością 0,5–1/mln populacji. Znane są dwie postacie tego chłoniaka: EATL 1 — pleomorficzny, który jest ściśle związany z celiakią oraz EATL 2 — monomorficzny, rzadko lub wcale niezwiązany z chorobą trzewną. Enteropatyczny chłoniak T-komórkowy umiejscawia się głównie w jelicie czczym lub krętym, a znacznie rzadziej w żołądku czy też dwunastnicy. Rozpoznanie przedoperacyjne jest trudne, a przyczyną laparotomii u większości chorych są objawy niedrożności, badalnego guza, krwawienie itp. W niniejszym artykule przedstawiono jeden z przypadków EATL podtypu 2 u 36-letniej kobiety. Chłoniak enteropatyczny z komórek T umiejscowiony był w jelicie czczym, a zdiagnozowany został dopiero po operacji. Mimo ogromnego postępu diagnostyki chorób jamy brzusznej nie jesteśmy w stanie bez pobrania materiału do badania histopatologicznego p...
Metabolites
Colorectal cancer is one of the most prevalent cancers worldwide. There is a great interest and n... more Colorectal cancer is one of the most prevalent cancers worldwide. There is a great interest and need to find simple, inexpensive, and minimally invasive diagnostic tests. The aim of the study was to analyze the salivary concentrations of chemerin, α-defensin 1, and TNF-α in colorectal cancer (CRC) patients and in a healthy control group. The concentration of these proteins was simultaneously determined in the serum of subjects. We also aimed to assess the correlation of these results and selected clinicopathological features. This prospective study was comprised of 39 CRC patients and 40 control group patients. Salivary and serum concentrations were determined by enzyme immunoassays. The salivary and serum concentrations of chemerin, α-defensin 1, and TNF-α were significantly higher in cancer patients compared to the control group. No correlation was found between concentrations of the proteins and the clinical stage of cancer and tumor location. The ROC curve analysis showed that a...
INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related propert... more INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related properties have recently been emphasized. The aim of this study was to examine the concentrations of chemerin in the serum and saliva of healthy subjects and patients with colorectal cancer (CRC) in II and III stage of TNM (tumor, node, metastasis) classification as well as to assess the relationship between the results and the clinical and pathological parameters. MATERIAL AND METHODS: 52 persons were qualified to the study, divided into two equal groups – control and study with cancer in stage II N0 and in stage III N+ according to TNM classification. Inside the groups, subgroups of persons with normal body weight 18.5 ≤ BMI < 25 and obese and overweight persons with a BMI ≥ 25 were distinguished. Serum and saliva chemerin concentrations were determined by immunoenzymatic methods. RESULTS: The median concentrations of chemerin were significantly higher in the study group as compared to the...
The introduction of the first trocar, often following creation of the pneumoperitoneum is conside... more The introduction of the first trocar, often following creation of the pneumoperitoneum is considered as crucial, and the most dangerous step of a laparoscopic procedure. Throughout the years individual methods of laparoscopic entry were described. The first person to create the pneumoperitoneum was German surgeon Georg Kelling (1866-1945). He performed this procedure on dogs. Among the methods actually used, arguably the most popular method of the closed laparoscopic entry probably was introduced in 1947 by Raol Palmer (1904-1945) French gynaecologist, who was also the inventor of an insuflator, which was adapted from a colposcopy pressure measuring device. He was followed by Kurt Semm (1927-2003) German gynaecologist, who invented also an automated electronic insuflation device. They both used in this technique the needle formerly developed in 1938 by a Hungarian, Janos Veres1 (1903-1979) which had been primarly used for the creation of a pneumothorax. The last two, but not least t...
Inguinal herniorrhaphy is one of the most common operations in general surgery wards worldwide. T... more Inguinal herniorrhaphy is one of the most common operations in general surgery wards worldwide. Tension free techniques with mesh implantation (among Lichtenstein most common) reduced recurrence rate to less than 1%. Chronic pain comprising up to 40% of operated patients still remains a clinical problem. Laparoscopic (endoscopic) techniques avoid extensive preparation in the groin, what is more hernia mesh is placed in avascular space of Borgios which contribute to reduction in chronic pain level. Apart from mentioned advantages laparoscopy (endoscopy) have drawbacks as well, among which high cost and long learning curve has to be taken into account. Currently many authors are keen on preperitoneal non laparoscopic minimal incision hernioplasty which result in few recently published operation techniques. In the article we present new hernioplasty methods and discuss them.
Przeglad epidemiologiczny, 2017
INTRODUCTION In hospitals outbreaks of nosocomial infections are recorded i.e. the occurrence of ... more INTRODUCTION In hospitals outbreaks of nosocomial infections are recorded i.e. the occurrence of at least two clearly related cases of infections. In these outbreaks not only patients but also hospital staff are getting infected. Due to the fact, that nosocomial infections are inseparably related to the hospitalisation of the patients, there is a need to build a culture of active surveillance of emerging infections and their reporting to the authorities of the State Sanitary Inspection. MATERIAL AND METHODS This article was developed on the basis of the information gathered in the report about the occurrence of outbreaks in entities carrying out the medical activities. This report is the result of the analysis of the preliminary reports submitted by the hospitals in the cases where there was a suspicion of or an epidemic outbreak and the final reports of the epidemic outbreak suppressions. RESULTS In the years 2011-2015 in all hospitals in Poland a total number of 1 912 outbreaks of...
Chirurgia Polska, 2013
Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z posta... more Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z postaci jest enteropatyczny chłoniak T-komórkowy (EATL), występujący z częstością 0,5-1/mln populacji. Znane są dwie postacie tego chłoniaka: EATL 1-pleomorficzny, który jest ściśle związany z celiakią oraz EATL 2-monomorficzny, rzadko lub wcale niezwiązany z chorobą trzewną. Enteropatyczny chłoniak T-komórkowy umiejscawia się głównie w jelicie czczym lub krętym, a znacznie rzadziej w żołądku czy też dwunastnicy. Rozpoznanie przedoperacyjne jest trudne, a przyczyną laparotomii u większości chorych są objawy niedrożności, badalnego guza, krwawienie itp. W niniejszym artykule przedstawiono jeden z przypadków EATL podtypu 2 u 36-letniej kobiety. Chłoniak enteropatyczny z komórek T umiejscowiony był w jelicie czczym, a zdiagnozowany został dopiero po operacji. Mimo ogromnego postępu diagnostyki chorób jamy brzusznej nie jesteśmy w stanie bez pobrania materiału do badania histopatologicznego postawić rozpoznania. Brakuje też jednoznacznych zaleceń co do metody leczenia. Wydaje się, że standardem pozostaje chemioterapia CHOP, której skuteczność nie jest zadawalająca. Mimo to leczenie operacyjne powinno ograniczać się do przypadków powikłań EATL (krwawienia z przewodu pokarmowego lub do jamy otrzewnej, niedrożności jelit, perforacji czy też dużych rozmiarów guza). Rokowanie u pacjentów z wykrytym chłoniakiem enteropatycznym z komórek T jest złe, dużo gorsze niż w przypadku chłoniaków z komórek B. Przeżycie całkowite w tego typu przypadkach szacuje się na około 7 miesięcy.
Wiadomości Lekarskie, 2002
Neoplastic metastases in the small intestine are rare - only 2% of the metastases are localized i... more Neoplastic metastases in the small intestine are rare - only 2% of the metastases are localized in the small intestine. It is important to remember that colorectal metastases are the most frequent, though metachronous cancer of the small intestine is the rare cause of ileus or bleeding in patients who underwent resection of the colorectal cancer. The challenge is to select among those patients, the ones with metachronous tumor in the other parts of the small and large bowel. The diagnostics in these situations is often difficult and only the operative management is an optimal way of treatment. We present the case of the patient with metachronous cancer of the small intestine after the sigmoid resection and the diagnostic difficulties concerned.
Chirurgia Polska, 2014
Operacja przepukliny pachwinowej jest jedną z najczęściej wykonywanych na oddziałach chirurgii og... more Operacja przepukliny pachwinowej jest jedną z najczęściej wykonywanych na oddziałach chirurgii ogólnej. Obecnie stosowane metody beznapięciowe z wszczepieniem materiału syntetycznego (najczęściej operacja Lichtensteina) pozwoliły zredukować liczbę nawrotów poniżej 1%. Problemem natomiast pozostają przewlekłe dolegliwości bólowe, które dotyczą nawet 40% operowanych pacjentów. Techniki laparoskopowe (endoskopowe) pozwoliły zmniejszyć odsetek powikłań bólowych. W metodach tych unika się uszkodzenia nerwów powstające przez rozległe preparowanie w pachwinie, a siatkę umieszcza się w beznaczyniowej przestrzeni przedotrzewnowej. Mimo opisanych korzyści laparoskopia (endoskopia) ma również swoje wady, spośród których należy wymienić wysoką cenę instrumentarium używanego podczas operacji oraz długą krzywą uczenia. Obecnie wielu autorów wiąże duże nadzieje z przedotrzewnowym umieszczaniem siatki poprzez małe otwarte cięcia. W ostatnim czasie pojawiło się kilka propozycji takich operacji. W artykule autorzy dokonali przeglądu najnowszych metod pod kątem używanych technik oraz osiąganych rezultatów. Słowa kluczowe: plastyka przepukliny pachwinowej, przepuklina pachwinowa, przestrzeń przedotrzewnowa, chirurgia minimalnie inwazyjna
World Journal of Gastroenterology, 2007
with rectal cancer at the stage of cT3NxM0. There is no unequivocal relationship between "T-downs... more with rectal cancer at the stage of cT3NxM0. There is no unequivocal relationship between "T-downstaging" and TRG and NG. There is some concordance in the assessment of lymph node status with ypT, TRG and NG. TRG and NG are of limited value for the risk assessment of the lymph node involvement.
Polish Journal of Surgery, 2015
Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Pl... more Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery.The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors.Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year...
Polski przeglad chirurgiczny, 2015
World journal of gastroenterology : WJG, Jan 7, 2014
To demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric can... more To demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric cancer (GAC) tissues. The study involved 84 surgically treated patients with gastric adenocarcinoma, regardless of the clinical stage of the disease. The presence of HPV DNA of high oncogenic risk types in formalin-fixed, paraffin-embedded tumor samples was determined using quantitative polymerase chain reaction analysis. A stringent protocol of prevention of cross- and environmental contamination was applied during DNA isolation, and amplification, as well as confirmation of the biological activity of the virus in tumor cells, was implemented. The study utilized the Real-time High Risk HPV test, which detects the DNA of 14 HPV subtypes that are considered to have high oncogenic potential. The overexpression of the p16(INK4a) protein assessed immunohistochemically was considered confirmation of the HPV infection. Among the 89 patients initially included in the study group, diagnostic result...
Hepato-gastroenterology
Closed entry technique using the Veress needle is currently most commonly used and is reported to... more Closed entry technique using the Veress needle is currently most commonly used and is reported to be associated with a high rate of complications. The open entry technique, requiring tissue preparation prior to insertion of the first trocar, is less popular despite being regarded as safer. The aim of the study was to objectively compare the two techniques with regard to the risk of complications when introducing the pneumoperitoneum. The evaluation was based on Evidence Based Medicine (EBM) criteria. Data were obtained from the Medline database, sources of Silesian University of Medicine and directly from the Google website at Internet. Thirty-one studies were accepted for inclusion. Open approach was found to be the safest in 17 studies (54.84%) and closed approach in 3 only (9.68%). It is noteworthy that none of the 20 studies showing a clearcut advantage of either of the two techniques was in the grade A recommendation category. Our literature survey identified the open technique...
Wiadomości lekarskie (Warsaw, Poland : 1960), 2006
The authors present a rare case of ileus caused by unusual cecum mobility. The 31-years old femal... more The authors present a rare case of ileus caused by unusual cecum mobility. The 31-years old female patient was diagnosed ineffectively several times due to abdominal pain. The diagnostics, an attempt of a conservative treatment, along with surgical and postoperative treatment are discussed.
Nowa Medycyna, 2019
Anal fistula is pathological tract lined by inflammatory granule connects bottom of the anal cryp... more Anal fistula is pathological tract lined by inflammatory granule connects bottom of the anal crypt with perianal skin. In most cases, anal fistula is a consequence of abscess developed due to infection of anal the glands. The most common symptoms of anal fistula are recurrent inflammation around the anus, pruritus and purulent leakage. In the treatment of fistulas mainly surgical methods are used, however, attempts of conservative treatment (tissue adhesives glues or plugs) are also undertaken. The goal of treatment is to choose a method that will be characterized by high radicality with the lowest possible risk of complications. Literature describes only few cases of perianal fistula caused by a foreign body. The paper presents a case of a 57-year-old man who was diagnosed with fistula-in-ano caused by a foreign body of unknown origin. The patient reported long-term purulent discharge only. Surgical treatment involved resection of the foreign body and fistula with subsequent uneven...
Nowa Medycyna, 2019
Introduction. Colorectal cancer is the third most common cancer worldwide. The introduction of no... more Introduction. Colorectal cancer is the third most common cancer worldwide. The introduction of novel diagnostic and treatment methods has resulted in decreasing mortality rates; however, an increase in morbidity is observed. Severe inflammation plays an important role in many aspects associated with carcinogenesis. Neoplasia and inflammatory response are mutually related. Aim. The aim of the study was to evaluate the association between preoperative serum C-reactive protein levels and total leukocyte count in colorectal cancer patients in comparison with postoperative histopathological findings depending on whether there was neoplastic infiltration of the local adipose tissue or not. Material and methods. The study population included 50 patients with colon cancer. Exclusion criteria were distant metastases, neoadjuvant therapy and a past history of cancer diagnosis. Blood findings were compared with histopathology. Patients were divided into two groups – with and without neoplastic...
Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z posta... more Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z postaci jest enteropatyczny chłoniak T-komórkowy (EATL), występujący z częstością 0,5–1/mln populacji. Znane są dwie postacie tego chłoniaka: EATL 1 — pleomorficzny, który jest ściśle związany z celiakią oraz EATL 2 — monomorficzny, rzadko lub wcale niezwiązany z chorobą trzewną. Enteropatyczny chłoniak T-komórkowy umiejscawia się głównie w jelicie czczym lub krętym, a znacznie rzadziej w żołądku czy też dwunastnicy. Rozpoznanie przedoperacyjne jest trudne, a przyczyną laparotomii u większości chorych są objawy niedrożności, badalnego guza, krwawienie itp. W niniejszym artykule przedstawiono jeden z przypadków EATL podtypu 2 u 36-letniej kobiety. Chłoniak enteropatyczny z komórek T umiejscowiony był w jelicie czczym, a zdiagnozowany został dopiero po operacji. Mimo ogromnego postępu diagnostyki chorób jamy brzusznej nie jesteśmy w stanie bez pobrania materiału do badania histopatologicznego p...
Metabolites
Colorectal cancer is one of the most prevalent cancers worldwide. There is a great interest and n... more Colorectal cancer is one of the most prevalent cancers worldwide. There is a great interest and need to find simple, inexpensive, and minimally invasive diagnostic tests. The aim of the study was to analyze the salivary concentrations of chemerin, α-defensin 1, and TNF-α in colorectal cancer (CRC) patients and in a healthy control group. The concentration of these proteins was simultaneously determined in the serum of subjects. We also aimed to assess the correlation of these results and selected clinicopathological features. This prospective study was comprised of 39 CRC patients and 40 control group patients. Salivary and serum concentrations were determined by enzyme immunoassays. The salivary and serum concentrations of chemerin, α-defensin 1, and TNF-α were significantly higher in cancer patients compared to the control group. No correlation was found between concentrations of the proteins and the clinical stage of cancer and tumor location. The ROC curve analysis showed that a...
INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related propert... more INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related properties have recently been emphasized. The aim of this study was to examine the concentrations of chemerin in the serum and saliva of healthy subjects and patients with colorectal cancer (CRC) in II and III stage of TNM (tumor, node, metastasis) classification as well as to assess the relationship between the results and the clinical and pathological parameters. MATERIAL AND METHODS: 52 persons were qualified to the study, divided into two equal groups – control and study with cancer in stage II N0 and in stage III N+ according to TNM classification. Inside the groups, subgroups of persons with normal body weight 18.5 ≤ BMI < 25 and obese and overweight persons with a BMI ≥ 25 were distinguished. Serum and saliva chemerin concentrations were determined by immunoenzymatic methods. RESULTS: The median concentrations of chemerin were significantly higher in the study group as compared to the...
The introduction of the first trocar, often following creation of the pneumoperitoneum is conside... more The introduction of the first trocar, often following creation of the pneumoperitoneum is considered as crucial, and the most dangerous step of a laparoscopic procedure. Throughout the years individual methods of laparoscopic entry were described. The first person to create the pneumoperitoneum was German surgeon Georg Kelling (1866-1945). He performed this procedure on dogs. Among the methods actually used, arguably the most popular method of the closed laparoscopic entry probably was introduced in 1947 by Raol Palmer (1904-1945) French gynaecologist, who was also the inventor of an insuflator, which was adapted from a colposcopy pressure measuring device. He was followed by Kurt Semm (1927-2003) German gynaecologist, who invented also an automated electronic insuflation device. They both used in this technique the needle formerly developed in 1938 by a Hungarian, Janos Veres1 (1903-1979) which had been primarly used for the creation of a pneumothorax. The last two, but not least t...
Inguinal herniorrhaphy is one of the most common operations in general surgery wards worldwide. T... more Inguinal herniorrhaphy is one of the most common operations in general surgery wards worldwide. Tension free techniques with mesh implantation (among Lichtenstein most common) reduced recurrence rate to less than 1%. Chronic pain comprising up to 40% of operated patients still remains a clinical problem. Laparoscopic (endoscopic) techniques avoid extensive preparation in the groin, what is more hernia mesh is placed in avascular space of Borgios which contribute to reduction in chronic pain level. Apart from mentioned advantages laparoscopy (endoscopy) have drawbacks as well, among which high cost and long learning curve has to be taken into account. Currently many authors are keen on preperitoneal non laparoscopic minimal incision hernioplasty which result in few recently published operation techniques. In the article we present new hernioplasty methods and discuss them.
Przeglad epidemiologiczny, 2017
INTRODUCTION In hospitals outbreaks of nosocomial infections are recorded i.e. the occurrence of ... more INTRODUCTION In hospitals outbreaks of nosocomial infections are recorded i.e. the occurrence of at least two clearly related cases of infections. In these outbreaks not only patients but also hospital staff are getting infected. Due to the fact, that nosocomial infections are inseparably related to the hospitalisation of the patients, there is a need to build a culture of active surveillance of emerging infections and their reporting to the authorities of the State Sanitary Inspection. MATERIAL AND METHODS This article was developed on the basis of the information gathered in the report about the occurrence of outbreaks in entities carrying out the medical activities. This report is the result of the analysis of the preliminary reports submitted by the hospitals in the cases where there was a suspicion of or an epidemic outbreak and the final reports of the epidemic outbreak suppressions. RESULTS In the years 2011-2015 in all hospitals in Poland a total number of 1 912 outbreaks of...
Chirurgia Polska, 2013
Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z posta... more Chłoniaki z komórek T stanowią grupę rzadkich chorób o niezwykle ciężkim przebiegu. Jedną z postaci jest enteropatyczny chłoniak T-komórkowy (EATL), występujący z częstością 0,5-1/mln populacji. Znane są dwie postacie tego chłoniaka: EATL 1-pleomorficzny, który jest ściśle związany z celiakią oraz EATL 2-monomorficzny, rzadko lub wcale niezwiązany z chorobą trzewną. Enteropatyczny chłoniak T-komórkowy umiejscawia się głównie w jelicie czczym lub krętym, a znacznie rzadziej w żołądku czy też dwunastnicy. Rozpoznanie przedoperacyjne jest trudne, a przyczyną laparotomii u większości chorych są objawy niedrożności, badalnego guza, krwawienie itp. W niniejszym artykule przedstawiono jeden z przypadków EATL podtypu 2 u 36-letniej kobiety. Chłoniak enteropatyczny z komórek T umiejscowiony był w jelicie czczym, a zdiagnozowany został dopiero po operacji. Mimo ogromnego postępu diagnostyki chorób jamy brzusznej nie jesteśmy w stanie bez pobrania materiału do badania histopatologicznego postawić rozpoznania. Brakuje też jednoznacznych zaleceń co do metody leczenia. Wydaje się, że standardem pozostaje chemioterapia CHOP, której skuteczność nie jest zadawalająca. Mimo to leczenie operacyjne powinno ograniczać się do przypadków powikłań EATL (krwawienia z przewodu pokarmowego lub do jamy otrzewnej, niedrożności jelit, perforacji czy też dużych rozmiarów guza). Rokowanie u pacjentów z wykrytym chłoniakiem enteropatycznym z komórek T jest złe, dużo gorsze niż w przypadku chłoniaków z komórek B. Przeżycie całkowite w tego typu przypadkach szacuje się na około 7 miesięcy.
Wiadomości Lekarskie, 2002
Neoplastic metastases in the small intestine are rare - only 2% of the metastases are localized i... more Neoplastic metastases in the small intestine are rare - only 2% of the metastases are localized in the small intestine. It is important to remember that colorectal metastases are the most frequent, though metachronous cancer of the small intestine is the rare cause of ileus or bleeding in patients who underwent resection of the colorectal cancer. The challenge is to select among those patients, the ones with metachronous tumor in the other parts of the small and large bowel. The diagnostics in these situations is often difficult and only the operative management is an optimal way of treatment. We present the case of the patient with metachronous cancer of the small intestine after the sigmoid resection and the diagnostic difficulties concerned.
Chirurgia Polska, 2014
Operacja przepukliny pachwinowej jest jedną z najczęściej wykonywanych na oddziałach chirurgii og... more Operacja przepukliny pachwinowej jest jedną z najczęściej wykonywanych na oddziałach chirurgii ogólnej. Obecnie stosowane metody beznapięciowe z wszczepieniem materiału syntetycznego (najczęściej operacja Lichtensteina) pozwoliły zredukować liczbę nawrotów poniżej 1%. Problemem natomiast pozostają przewlekłe dolegliwości bólowe, które dotyczą nawet 40% operowanych pacjentów. Techniki laparoskopowe (endoskopowe) pozwoliły zmniejszyć odsetek powikłań bólowych. W metodach tych unika się uszkodzenia nerwów powstające przez rozległe preparowanie w pachwinie, a siatkę umieszcza się w beznaczyniowej przestrzeni przedotrzewnowej. Mimo opisanych korzyści laparoskopia (endoskopia) ma również swoje wady, spośród których należy wymienić wysoką cenę instrumentarium używanego podczas operacji oraz długą krzywą uczenia. Obecnie wielu autorów wiąże duże nadzieje z przedotrzewnowym umieszczaniem siatki poprzez małe otwarte cięcia. W ostatnim czasie pojawiło się kilka propozycji takich operacji. W artykule autorzy dokonali przeglądu najnowszych metod pod kątem używanych technik oraz osiąganych rezultatów. Słowa kluczowe: plastyka przepukliny pachwinowej, przepuklina pachwinowa, przestrzeń przedotrzewnowa, chirurgia minimalnie inwazyjna
World Journal of Gastroenterology, 2007
with rectal cancer at the stage of cT3NxM0. There is no unequivocal relationship between "T-downs... more with rectal cancer at the stage of cT3NxM0. There is no unequivocal relationship between "T-downstaging" and TRG and NG. There is some concordance in the assessment of lymph node status with ypT, TRG and NG. TRG and NG are of limited value for the risk assessment of the lymph node involvement.
Polish Journal of Surgery, 2015
Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Pl... more Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery.The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors.Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year...
Polski przeglad chirurgiczny, 2015
World journal of gastroenterology : WJG, Jan 7, 2014
To demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric can... more To demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric cancer (GAC) tissues. The study involved 84 surgically treated patients with gastric adenocarcinoma, regardless of the clinical stage of the disease. The presence of HPV DNA of high oncogenic risk types in formalin-fixed, paraffin-embedded tumor samples was determined using quantitative polymerase chain reaction analysis. A stringent protocol of prevention of cross- and environmental contamination was applied during DNA isolation, and amplification, as well as confirmation of the biological activity of the virus in tumor cells, was implemented. The study utilized the Real-time High Risk HPV test, which detects the DNA of 14 HPV subtypes that are considered to have high oncogenic potential. The overexpression of the p16(INK4a) protein assessed immunohistochemically was considered confirmation of the HPV infection. Among the 89 patients initially included in the study group, diagnostic result...
Hepato-gastroenterology
Closed entry technique using the Veress needle is currently most commonly used and is reported to... more Closed entry technique using the Veress needle is currently most commonly used and is reported to be associated with a high rate of complications. The open entry technique, requiring tissue preparation prior to insertion of the first trocar, is less popular despite being regarded as safer. The aim of the study was to objectively compare the two techniques with regard to the risk of complications when introducing the pneumoperitoneum. The evaluation was based on Evidence Based Medicine (EBM) criteria. Data were obtained from the Medline database, sources of Silesian University of Medicine and directly from the Google website at Internet. Thirty-one studies were accepted for inclusion. Open approach was found to be the safest in 17 studies (54.84%) and closed approach in 3 only (9.68%). It is noteworthy that none of the 20 studies showing a clearcut advantage of either of the two techniques was in the grade A recommendation category. Our literature survey identified the open technique...
Wiadomości lekarskie (Warsaw, Poland : 1960), 2006
The authors present a rare case of ileus caused by unusual cecum mobility. The 31-years old femal... more The authors present a rare case of ileus caused by unusual cecum mobility. The 31-years old female patient was diagnosed ineffectively several times due to abdominal pain. The diagnostics, an attempt of a conservative treatment, along with surgical and postoperative treatment are discussed.