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Andrzej Litarski, Jerzy Pawełczyk, Jarosław Majcherek, Dawid Janczak, Lech Pawłowski, Zuzanna Rucińska and Dariusz Janczak

Abstract

Laparoscopic surgery has become a well approved method of abdominal hernias treatment in recent years. Due to the advancement of laparoscopy and the use of improved synthetic materials laparoscopic surgery is characterized not only by low complication but also by a short period of recovery after surgery.

The aim of the study was a retrospective analysis of the results of laparoscopic abdominal hernia surgeries (IPOM).

Material and methods. Between year 2007 and 2012, 65 patients aged between 29 to 76 underwent laproscopic abdominal hernia surgeries due to either primary or postoperative abdominal hernias. All patients were examined in perioperative period, after 12 and 24 months after surgery in search of complications, pain and reccurence. Recovery period was also estimated.

Results. In most cases postoperative pain was estimated from 1 to 4 on VAS scale. The most frequent complications were seromas that occured in 3 patients. The other complications were pneumothorax, wound hematoma and wound infection that occured once each. One patient required reoperation due to wound hematoma. Chronic postoperative pain was diagnosed in 3 patients and 4 recurrences were stated.

Conclusions. Laparoscopic therapy of abdominal hernias is a safe operative method characterized by low recurrence and complication rates as well as short hospital stay and quick recovery. This technique is restricted by high material costs and the lack of full refund for the procedure.

Open access

Mariusz Chabowski, Adam Paszkowski, Jerzy Skotarczak, Tadeusz Dorobisz, Michał Leśniak, Dawid Janczak and Dariusz Janczak

Abstract

The study presented a case of a patient with a glomus tumor of the stomach, a mesenchymal neoplasm manifesting with upper gastrointestinal bleeding (Forrest IB). The patient was operated twice. First, he underwent elective laparotomy, during which Billroth I (Rydygier’s method) gastric resection was performed. This his was followed by Billroth II resection with Braun’s anastomosis. Histopathological examination revealed glomus tumor tissue. Literature data on the glomus tumor of the stomach are presented.

Open access

Dariusz Janczak, Wiktor Pawłowski, Agnieszka Ziomek, Tadeusz Dorobisz, Dawid Janczak, Werner Janus and Mariusz Chabowski

Abstract

The study presented a case of a gastrocutaneous fistula, as a result of bariatric sleeve gastrectomy. The discussion considered the main pathogenesis, etiology, diagnostics and endoscopic treatment using the implantation of covered esophageal stents. Special attention was placed upon the multifactorial origin of this life-threatening clinical condition, typical for bariatric surgery

Open access

Piotr Kabziński, Jacek Rac, Tadeusz Dorobisz, Wiktor Pawłowski, Agnieszka Ziomek, Mariusz Chabowski, Dawid Janczak, Michał Leśniak and Dariusz Janczak

Abstract

At present, sentinel lymph node biopsy is a standard procedure to assess the advancement of breast cancer and cutaneous melanoma.

The aim of the study was to assess the role of the sentinel lymph node biopsy in the treatment of patients with breast cancer in our own material.

Material and methods. Analyzed was medical documentation of 258 patients with initially operable breast cancer, qualified for operation with sentinel lymph node biopsy in 2004-2014 in the Department of Surgery of the 4th Military Teaching Hospital. A few hours prior to the planned surgery, radioisotope (technitium-99 sulfur colloid) was applied in the area of tumor or under the areola. 1-2 hours after administering the tracer, the lymphoscintigraphy with the labelling of the sentinel lymph node on the skin was performed.

Results. On the basis of the gathered material, obtained were the following parameters: sensitivity - 100%, and specificity - 94.6%. Four cases were false negative (5.5%).

Conclusions. 1. Marking the sentinel lymph node in breast cancer, based on the single visualisation method with the use of radioisotope, is a useful and effective technique. 2. The factor influencing the results of the sentinel lymph node biopsy (true positive and negative results and false negative result) was the number of the excised lymph nodes except for the sentinel lymph node. 3. Patients with estrogen receptor expression had often metastases to sentinel lymph node (145 cases - 56%). 4. The false negative rate, i.e. 5.5% in our material, is within the limits of acceptability given in the literature. 5. The sentinel lymph node biopsy performed by the experienced surgical team is a reliable diagnostic tool with a low complication rate.