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Papers by Zsolt Szentkereszty

Metabolites

Acute pancreatitis still means a serious challenge in clinical practice. Its pathomechanism is co... more Acute pancreatitis still means a serious challenge in clinical practice. Its pathomechanism is complex and has yet to be fully elucidated. Rheological properties of blood play an important role in tissue perfusion and show non-specific changes in acute pancreatitis. An increase in blood and plasma viscosity, impairment of red blood cell deformability, and enhanced red blood cell aggregation caused by metabolic, inflammatory, free radical-related changes and mechanical stress contribute to the deterioration of the blood flow in the large vessels and also in the microcirculation. Revealing the significance of these changes in acute pancreatitis may better explain the pathogenesis and optimize the therapy. In this review, we give an overview of the role of impaired microcirculation by changes in hemorheological properties in acute pancreatitis.

Magyar sebészet, Mar 24, 2022

European Journal of Surgical Oncology, 2019

Introduction: In the current study we analyzed the follow-up and survival data of our patients un... more Introduction: In the current study we analyzed the follow-up and survival data of our patients undergoing rectal surgery in the Institute of Surgery, University of Debrecen between 2011 and 2012. using our previously developed computed data registry Patients and results: In 2011 and 2012 a total of 101 and 111 patients underwent elective surgery for rectal cancer, respectively. The overall 5year postoperative survival rate was 53.5% in 2011, and 54.1% in 2012. In both years the tumor-specific survival 5 years after the surgery was 68%. The mean age of patients was 64.5 years (34-85) in 2011 and 65.3 years (37-88) in 2012. During the first analyzed year more than 60% of the patients received neoadjuvant treatment, this ratio was 44% in 2012. The surgical complication rate was less than 20% and 22,5%, in 2011 and 2012, respectively; the proportion of non-surgical complications was lower. We found 5 cases (4.9%) of suspected local recurrence from 2011, while in 2012 recurrence was confirmed in 7 cases (6.3%). During the 5-year follow-up period the most frequent tumor-related event was the discovery of hepatic metastases. Unfortunately, less than half of these patients underwent metastasis surgery, survival rate was markedly better in the operated cases. Conclusions: Our results matched the expectations based on international standards. Regular analysis of the follow-up and survival data is vital, since it can provide invaluable feedback regarding our quality of work and show the steps where we must improve. Conflict of interest: No conflict of interest.

Hepato-gastroenterology

We have compared the effects of glutamine-rich Stresson Multi Fibre and of Nutrison Fibre nutrien... more We have compared the effects of glutamine-rich Stresson Multi Fibre and of Nutrison Fibre nutrients on the changes of some immunological parameters of 16 patients with acute pancreatitis. Laboratory parameters included: total protein, albumin, prealbumin, retinol binding protein, IgG, IgA, IgM, IgE, complement components: C3, C4, acute phase proteins: C-reactive protein, transferrin, CD-markers of peripheral lymphocytes and activity of peripheral phagocytes. Nine patients were supplied with Stresson Multi Fibre and 7 patients with Nutrison Fibre, using a nasojejunal tube. The levels of serum proteins were measured with laser nephelometry, the CD markers of lymphocytes with flow cytometry and the phagocytic activity with chemiluminescence. The treatment with glutamine-rich Stresson resulted in significant elevations in the serum levels of IgG, retinol binding protein, compared to the effects of Nutrison Fibre. In addition, the recovery of treated patients was significantly shorter in...

Zeitschrift für Gastroenterologie, 2004

Surgical Endoscopy, 2006

Background: We present our experience with laparoscopic deroofing of nonparasitic hepatic cysts. ... more Background: We present our experience with laparoscopic deroofing of nonparasitic hepatic cysts. Methods: Laparoscopic deroofing was performed due to a solitary hepatic cyst in 21 patients and polycystic liver in four patients. Laparoscopy was indicated when a cyst was larger than 5 cm (the general size of cysts was 6.9 cm) and caused complaints and was in a superficial position. In eight patients in whom the cyst was larger than 10 cm, omentoplasty was performed. Results: Intraoperative complications were not detected. Two conversions were performed because of the deep position of the cyst. Postoperative bile leakage was detected in one case that was treated conservatively. The average hospital stay was 4.7 days. Relapse occurred in two patients (8%), but only one of them required a second operation. Conclusion: We recommend laparoscopic deroofing for treatment of nonparasitic liver cysts. This operation causes only slight discomfort for the patients, the intra-and postoperative morbidity is low, and relapses are rare.

BMJ Open, 2019

Introduction According to the literature, early cholecystectomy is necessary to avoid complicatio... more Introduction According to the literature, early cholecystectomy is necessary to avoid complications related to gallstones after an initial episode of acute biliary pancreatitis (ABP). A randomised, controlled multicentre trial (the PONCHO trial) revealed that in the case of gallstone-induced pancreatitis, early cholecystectomy was safe in patients with mild gallstone pancreatitis and reduced the risk of recurrent gallstone-related complications, as compared with interval cholecystectomy. We hypothesise that carrying out a sphincterotomy (ES) allows us to delay cholecystectomy, thus making it logistically easier to perform and potentially increasing the efficacy and safety of the procedure. Methods/Design EMILY is a prospective, randomised, controlled multicentre trial. All patients with mild ABP, who underwent ES during the index admission or in the medical history will be informed to take part in EMILY study. The patients will be randomised into two groups: (1) early cholecystectom...

Negative Pressure Wound Therapy Journal, 2020

Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced re... more Recent SARS-CoV-2 pandemic leading to a rapidly increasing number of hospitalizations enforced reevaluation of wound management strategies. The optimal treatment strategy for patients with chronic wounds and those recovering from emergency and urgent oncological surgery should aim to minimize the number of hospital admissions, as well as the number of surgical procedures and decrease the length of stay to disburden the hospital staff and to minimize viral infection risk. One of the potential solutions that could help to achieve these goals may be the extensive and early use of NPWT devices in the prevention of wound healing complications. Single-use NPWT devices are helpful in outpatient wound treatment and SSI prevention (ciNPWT) allowing to minimize in-person visits to the health care center while still providing the best possible wound-care. Stationary NPWT should be used in deep SSI and perioperative wound healing disorders as soon as possible. Patient’s education and telemedica...

Hernia, 2006

The intercostal hernia of the lung is a very rare extraordinary disease that requires operation b... more The intercostal hernia of the lung is a very rare extraordinary disease that requires operation because of the complaints and potential complications. The authors review cases of their operations and analyze the subsequence and treatment. Three patients have been treated for intercostal lung hernia in our treatment. The causes of this disease were a previous thoracotomy in one case and fits of coughing in the other two cases. The diagnosis was set up on the grounds of the specific clinical symptoms, thoracic X-ray and CT scan. The hernia was dissolved with percostal stitches and with the suture of the thoracic musculature in two cases. Plastic operation of the thoracic wall by implanting a polypropylene surgical mesh (Prolen, Ethicon, Johnson & Johnson) was performed in the case of the third patient and later in the first two patients due to recrudescence. In one case the authors were constrained to resect the dystelectasial lung in the hernial sac. The three patients had been operated five times. Relapse of hernia was detected in two patients, in whom the intercostal space had been reconstructed with percostal stitches. We did not detect any relapsing in those two patients at 33 and 66 months after the second operation with mesh implantation. The third patient who got mesh implant immediately did not relapse 12 months after the operation. Intercostal lung hernia is an indication of operation. A plastic operation of the thoracic wall combined with the implantation of a surgical mesh is recommended to close the hernial orifice, which is suitable for treating both primary and relapsed hernias. Recurrence is rare in those patients treated with this method.