A case of three synchronous primary lung cancers within the same lung lobe.

We present the case of a 74-year-old patient with three synchronous primary lung cancers within the same lung lobe. Computed tomography and positron emission tomography investigations revealed two suspicious nodular lesions in the upper lobe of the left lung. Fine-needle aspiration biopsy confirmed that one of the lesions was non-small cell lung cancer. The patient was qualified for surgical treatment, and left upper lobectomy plus lymphadenectomy was performed. Histopathological examination confirmed the presence of three primary cancers in the left lung: keratinizing squamous cell carcinoma, neuroendocrine carcinoma, and acinar adenocarcinoma, localized within the same lung lobe. The patient was classified as having stage T3N1M0 lung cancer (stage IIIA) according to the latest, 7(th) edition of the TNM classification.

A new technique of pulmonary hernia surgical repair using intramedullary titanium implants.

INTRODUCTION: In this paper we present a new method of pulmonary hernia surgical treatment. Pulmonary hernia is a rare pathology. The first description of pulmonary hernia was made by Roland in 1499. The world literature describes only a little more than 300 cases of pulmonary hernia. Pulmonary hernia is defined as the projection of the lung tissue covered by the parietal pleura beyond the normal boundaries of the pleural cavity, through the pathological holes in the chest wall. During our work as thoracic surgeons, we have used different ways of thoracic chest wall reconstructive operations and anastomoses of the broken ribs. AIM OF THE STUDY: To search for optimal methods of pulmonary hernia surgery and to evaluate a new technique of pulmonary hernia surgical repair using intramedullary titanium implants. MATERIAL AND METHODS: In 2013 in our clinic, we diagnosed and cured two patients with idiopathic pulmonary hernia. We performed a reconstructive operation of the chest wall with anastomosis of the broken ribs using titanium intramedullary stabilization implants - splints. RESULTS: To date, the annual observation has revealed no recurrence of pulmonary hernia or postoperative complications. At present, the patients demonstrate full life activity. CONCLUSIONS: So far, in the world literature, we have not encountered any information about using such methods to repair pulmonary hernia. We regard our method as safe, easy to use and giving good therapeutic results.

[Acute appendicitis masking adenocarcinoma of the cecum]. / Ostre zapalenie wyrostka robaczkowego jako maska gruczolakoraka katnicy.

Acute appendicitis can be the first symptom of the malignant tumour of the cecum. In the article we described case of 76 years old patient who came to the hospital on account pain in the right iliac hole, occurrent for 4 days with nausea and vomiting. Primarily patient classified to the appendectomy. The ultrasound examination showed the pathological mass in projection ileocecal valve and appendicitis. The computer tomography of the abdomen confirmed this diagnosis. The patient became classified to the right-sides hemicolectomy. The result of histopathological examination is adenocarcinoma of the ileocaecal valve and the appendicitis phlegmonous. Patient became classified to the adiuvant chemotherapy in the regional oncological centre.

Repair of postpneumonectomy bronchopleural fistula using pedicled pericardial flap supported by fibrin glue.

Effective closure of the postpneumonectomy bronchopleural fistula (PBF) with the use of different techniques still remains a challenge for thoracic surgeons. The aim of this study was to evaluate the efficacy of modified method of PBF closure using pedicled pericardial flap (PPF) supported by fibrin glue (FG). The efficacy of the late PBF closure with the use of two surgical methods was compared. In 10 patients, the edges of the PBF were covered with FG and PPF. In the second group of nine patients, myoplasty was used to close the bronchial fistula. Postsurgical follow-up was for 1 year. In the first group, the healing of the fistula was achieved in 100% of the cases, whereas in the second, myoplasty group, healing was achieved in only 66·67% of the cases. The number of complications was similar in both groups. Pericardial flap supported by fibrin glue can be an effective method adjunctive to the treatment of PBF in selected patients.

Strangulation of a Meckel's diverticulum in a femoral hernia (Littre's hernia).

Femoral hernia is usually presented as a flexible, round, domed shape lying on the medial side of the thigh about 2-3 cm below the inguinal ligament. Among the external hernias, femoral hernia is the second most common inguinal hernia. Its prevalence reaches 20%. Among all inguinal hernias, femoral hernias are characterised by a high level of incarceration and strangulation. This can be as high as 60%. We would like to present a case of 71-year-old patient who was admitted to the Clinic urgently due to strangulation of Meckel's diverticulum in a right-sided femoral hernia. Strangulation of Meckel's diverticulum in femoral hernia is an extremely rare entity. It was described for the very first time in 1700 by Littre.

Moulded calculus of common bile duct mimicking a stenosis.

Bile duct stenosis, in most cases, appears to be the consequence of pancreatic head, ampulla of Vater and bile duct tumours, cholangitis sclerosans, as well as iatrogenic damages, which may all be diagnosed during endoscopic retrograde cholangiopancreatography (ERCP). In very rare cases the restriction may result from an atypically shaped wedged stone. This situation creates many diagnostic problems, which in the majority of cases can be solved using imaging studies. However, in some patients even a significant extension of diagnostic procedures may not lead to a correct diagnosis. We present a diagnostically difficult case of a deposit imitating restriction. We present a 70-year-old woman with common bile duct restriction undiagnosed despite several ultrasound examinations (USG), computed tomography (CT), double magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). Only after the third ERCP examination a fragmented, by formerly introduced prosthesis, deposit, imitating narrowing, was revealed. Identification of bile duct deposits depends on their composition, localisation and the imaging techniques used. Pigment calculi with atypical shape, bile density, air density or surrounding tissue density are very difficult to diagnose. Thus, the sensitivity of common bile duct stone detection in USG, CT, MRCP and endoscopic ultrasound (EUS) is 5-88%; 6-88%; 73-97%; and 84-98%, respectively. Moreover, ERCP may not diagnose the character of the restriction even in 5.2% up to 30% of the patients. Consequently, assessment of diagnosis in a number of patients is difficult. A deposit imitating common bile duct (CBD) restriction is a rare, difficult to diagnose phenomenon, which should be taken into account during differential diagnosis of CBD restrictions.

Pericardial flap: an effective method of surgical repair of late post-pneumonectomy fistula.

BACKGROUND: We report our experience with the surgical closure of late post-pneumonectomy bronchopleural fistula (PBF) using our own method of coverage of the bronchial stump: Pedicled pericardial flap in combination with fibrin glue. METHODS: We reviewed the surgical results of 33 patients who underwent surgical closure of PBF by thoracotomy access using three methods: Myoplasty (MYO)-12, omentoplasty (OMT)-10, and pedicled pericardial flap (PPF) with fibrin glue-11. Post-operative follow up was six months. RESULTS: The patients' demography was comparable among the groups. The diameter of the fistulas ranged from 5 mm to total dehiscence. The mean time of the fistula manifestation (in weeks) was 21.5 in the MYO group, 19.50 in the OMT, and 20.1 in the PPF group. The shortest period of hospital drainage of the pleural space was noted in the PPF group. Healing of the fistula was obtained in 66.67% in the MYO group, 80% in the OMT, and 100% in the PPF group. The number of complications was similar in all groups. The hospitalization time was significantly shorter in the PPF group (13.00 d) versus the MYO group (19.58 d) and the OMT (20.01 d). Overall mortality rate was 18.18%; 33.33% of the patients in the MYO group and 20% in the OMT group died. There were no hospital deaths in the PPF group. CONCLUSION: Pericardial flap supported by fibrin glue can be an effective method adjunctive to the treatment of postpneumonectomy PBF in selected patients. Compared with other methods of bronchial stump coverage (omentopasty and myoplasty), this one showed a higher percentage of healing of the fistulas and shorter duration of hospital drainage and hospitalization.

The own method and program of isotope quantitatively assessment of perfusion in muscles of upper limbs (initial report).

BACKGROUND: The issue of blood flow in muscles has been dealt with for many years. However, most often it was assessed qualitatively with standard vascular examinations. The quantitatively perfusion assessment is indispensable in the normal and pathological conditions. Some diseases impair the perfusion mainly in the area of upper limbs. It can be observed in Raynaud's disease, vascular occlusive diseases, neurological disturbances, and thermal injuries. Hyperhidrosis of upper limbs after sympathectomy of thoracic part of sympathetic trunk may bring closer the diagnosis statement. Nuclear medicine has the markers and methods that allow for the assessment of the volume of perfusion in muscles. The aim for creating this method and program was the development of radioisotope method allowing for quantitative assessment of perfusion in muscles of upper limbs. This should lead to calculating the perfusion index and its range of normal values in a greater group of patients and to using this method both in the healthy and pathological conditions. MATERIAL AND METHODS: 20 patients, age 30.4 ± 7.1 years, who underwent following examinations: qualification to the group, medical history, subject examinations, USG of upper limb vessels, anthropometric examinations, biochemical and hormonal blood tests, the assessment of upper limbs with USG Doppler and FMD (flow mediated dilatation), radioisotope examinations with gamma camera BrightView XCT by own program RAPUL (Radioisotope Assessment Perfusion of Upper Limb). Acquisitions were started five minutes after intravenous injection of 99mTc-MIBI (metoxyisobutylnitrite). The whole body scintigram and scintigrams of arm and forearm muscles in A-P projections were taken. RESULTS: In the examined patients, the results of anthropometric, biochemical and hormonal test were within the range of normal values. In radioisotope quantitative assessment of perfusion, perfusion indexes of left arm were 20 < PI(_left) < 11.90 and of the right arm 7.00 < PI(_right) <12.30. The dependency correlation PI(_left) vs. PI(_right) was strong r = 0.92036.The values of perfusion symmetry index (IPS) had a normal distribution and were within the following range: 0.9231 < IPS < 1.1019. CONCLUSIONS: The RAPUL method and program allow for quantitative assessment of perfusion in muscles of upper limbs. Developed program has a high repeatability of results. The results in the bigger group will allow for defining the range of normal values of perfusion index in muscles of upper limbs at rest. These will be diagnostically used both in healthy (sports medicine, military services) and pathological conditions.

Comparison of effectiveness of electrocautery and phenol application in partial matricectomy after partial nail extraction in the treatment of ingrown nails.

UNLABELLED: Ingrowing nail also known as onychocryptosis is a common health problem. This disease mostly affects young people, often carrying a considerable amount of socio-economic implications. It's foot problem that usually manifests as inflammation of tissue along the side of a toenail. The aim of the study was to asses and to compare effectiveness of electrocautery and phenol application in partial matrixectomy after partial nail extraction in the treatment of ingrown toenails. MATERIAL AND METHODS: The group of 60 patients with ingrowing toenail which was randomized into two groups underwent partial matrixectomy in surgical outpatient clinic between 2009-2013. This group of patients was under surgical observation for 100 days in outpatient clinic. RESULTS: In all operated patients we obtained surgical success however we had 13 recurrences during the follow up period, 5 in the phenolization group and 8 in the electrocoagulation group. CONCLUSIONS: There was statistically significant difference between these two techniques, which indicated that matrix phenolization is connected with shortened healing time vs the matrix electrocoagulation.

Efficacy assessment of the drainage with permanent airflow measurement in the treatment of pneumothorax with air leak.

AIM: The aim of this study was to compare the efficacy of the treatment of patients with spontaneous pneumothorax with air leak (AL) using two different chest drainage systems. METHODS: Patients were randomized into two groups: group A included 30 patients (23 males and 7 females, mean age 41.1 ± 16.29 y, range 17-71 y) in which digital drainage system was used, group B with 30 patients (22 males and 8 females, mean age 40.3 ± 15.74 y, range 18-72 y) in which traditional suction drainage system was applied.The following variables were evaluated: intensity of AL, duration of the chest tube drainage, delay in surgery, length of stay, and the overall hospitalization costs. RESULTS: In group A the mean drainage duration was 47.63 hours, the hospitalization time was about 5.10 days, and the cost of hospitalization was €1,495. In group B the mean drainage duration was 84.93 hours, the hospitalization time was 6.97 days, and the hospitalization cost was €1,925. CONCLUSION: The digital drainage system applied in the treatment of AL in patients with pneumothoraces reduced the duration of the drainage, the length of hospital stay, and overall hospitalization costs.

Application of biochemical markers CA 19-9, CEA and C-reactive protein in diagnosis of malicious and benign pancreatic tumors.

INTRODUCTION: We would save many lives and spare a lot of suffering if we could only detect and accurately determine the character and TMN staging of pancreatic tumors (PTs). With improved diagnosis, we could offer specific treatment that would result in better treatment outcome. The aim of study was to determine the significance of neoplastic markers CA 19-9 and CEA for prognosis in inflammatory and carcinomatous PTs. MATERIAL AND METHODS: We based our research upon a group of 170 patients. The patients were treated in our Oncologic Surgery Department from January 2007 to December 2010 for PTs. The patients were divided into four groups depending on the character of the tumor and underwent the following treatments: group 1 - 34 patients with carcinoma of the ampulla of Vater, group 2 - 64 patients with PTs at different stages (1, 2, 3) according to TMN classification, group 3 - 62 patients with PTs at stage 4 on the TMN scale (unresectable tumors), group 4 - 28 patients with inflammatory PTs. RESULTS: The results of Ca 19-9 in group 2 were 736.00 (25-75% 220.40-4285.00) ng/ml before surgery, 53.00 (25-75% 12.60-84.00) ng/ml in the 7 days after surgery, 29.4 (25-75% 7.90-113.00) ng/ml at day 30, and 119.00 (25-75% 96.30-621.00) ng/ml 3 months after the operation. These results were significantly higher than the control group but were significantly lower than the results for group 3 (unresectable tumors). The highest average concentration and median for CA 19-9 and CEA were noted in patients with unresectable PTs (the 3(rd) group). The average concentration for CEA was lowest in group 4, but much higher than the lab limits. CONCLUSIONS: The sensitivity of the CA 19-9 marker may be as high as 88%. Values of CA 19-9 above 852 U/ml may indicate TNM stage 4, consistent with an unresectable PT. In the cases where CA 19-9 is within normal limits but C-reactive protein is above normal limits (often thirty times the upper limit), in comparison to the control group and to patients with pancreatic neoplasms, strong consideration should be given towards the inflammatory characteristics of the pancreatic changes and conservative treatment should be applied.

Assessment of adhesion formation after laparoscopic intraperitoneal implantation of Dynamesh IPOM mesh.

INTRODUCTION: Formation of adhesions after laparoscopic hernia repair using the intra-peritoneal onlay mesh (IPOM) procedure can lead to intestinal obstruction or mesh erosion into intestinal lumen. The aims of this study included: measurement of adhesion formation with Dynamesh IPOM after laparoscopic intraperitoneal implantation, and assessment of the occurrence of isolated adhesions at the fastening sites of slowly absorbable sutures. MATERIAL AND METHODS: Twelve healthy pigs underwent laparoscopic implantation of 2 Dynamesh IPOM mesh fragments each, one was fastened with PDSII, and the other with Maxon sutures. An assessment of adhesion formation was carried out after 6 weeks and included an evaluation of surface area, hardness according to the Zhulke scale, and index values. The occurrence of isolated adhesions at slowly absorbable suture fixation points was also analyzed. RESULTS: Adhesions were noted in 83.3% of Dynamesh IPOM meshes. Adhesions covered on average 37.7% of the mesh surface with mean hardness 1.46 and index value 78.8. In groups fixed with PDS in comparison to Maxon sutures adhesions covered mean 31.6% vs. 42.5% (p = 0.62) of the mesh surface, mean hardness was 1.67 vs.1.25 (p = 0.34) and index 85.42 vs. 72.02 (p = 0.95). CONCLUSIONS: The Dynamesh IPOM mesh, in spite of its anti-adhesive layer of PVDF, does not prevent the formation of adhesions. Adhesion hardness, surface area, and index values of the Dynamesh IPOM mesh are close to the mean values of these parameters for other commercially available 2-layer meshes. Slowly absorbable sutures used for fastening did not increase the risk of adhesion formation.

Isolated retroperitoneal mixed germ cell tumor presenting as acute abdomen - case report.

Extragonadal germ cell tumors are an uncommon clinical entity. Their prevalence varies between 1 and 5% of all germ cell tumors. Approximately 85-90% of cases have metastatic changes at the time of diagnosis. In our article we would like to present a case of an 18-year-old patient who was admitted to the hospital due to acute abdominal symptoms. A day earlier, the patient suffered blunt abdominal trauma during workout. Post-traumatic changes, which were described after admission in computed tomography, intraoperatively proved to be masses of extraperitoneal tumor.

The estimation of metaloproteinases and their inhibitors blood levels in patients with pancreatic tumors.

BACKGROUND: The aim of the study was to evaluate the concentration of proteolytic enzymes, MMP-2 and MMP-9, and their tissue inhibitors, TIMP-1 and TIMP-2, in the blood of patients with benign and malignant pancreatic tumors. METHODS: MMP-2, MMP-9, TIMP-1, and TIMP-2 were evaluated in the patients with benign and malignant pancreatic tumors before surgery and in the 30-day follow-up. The study covered 134 patients aged 54 to 76 years, who were divided into groups by TNM staging. RESULTS: Before the operation, the highest mean concentration of MMP-2 was found in patients with unresectable cancer, whereas the highest level of MMP-9 was in patients with resectable cancer. The highest level of TIMP-1 was noted in patients with inflammatory tumors. In 1 month following the operation, the highest level of MMP-2 was also in patients with unresectable cancer and the highest level of TIMP-2 in patients with inflammatory tumors. CONCLUSIONS: The evaluation of the level of the studied cytokines in the pancreatic tumor patients can be diagnostically significant in the differentiation of benign and malignant changes. The changes in the levels of the studied enzymes and their inhibitors can have a prognostic value in the clinical severity of pancreatic cancer.

Acute mediastinitis: evaluation of clinical risk factors for death in surgically treated patients.

BACKGROUND: Acute mediastinitis (AM) is the most lethal form of infection within the thorax. The authors of this study, using statistical tools, made an attempt to determine the most important clinical risk factors in retrospective material of patients treated surgically due to AM. METHODS: A total of 44 consecutive patients with AM were subjected to surgery. The aetiology was differentiated: iatrogenic (19), traumatic (11), descending mediastinitis (9) and neoplastic (5). A statistical analysis was performed using chi-square test with Yates correction and analysis of variance test to investigate the correlation between mortality and selected risk factors such as age, gender, aetiology, microbiology, delay between the diagnosis and surgery, coexisting diseases and the kind and number of post-operative complications. RESULTS: The general death rate was 31.82%. Aetiology was associated with mortality: neoplastic (100%), descending (33.3%), iatrogenic (26.3%) and post-traumatic (9.1%). The following types of bacteria were isolated: aerobes (65.9%), anaerobes (25%) and mixed flora (9.1%). The prognosis was not related to age, gender or the kind of the pathogen. The risk of death increased depending on the number of preoperative co-morbidities (P = 0.0446), particularly on the occurrence of a neoplasm (P = 0.0104). Early qualification for surgery (<24 h) resulted in lower death rate (P = 0.085). Manifestation of more than two post-operative complications (P = 0.0007) should be listed as one of the most negative risk factors. CONCLUSIONS: The knowledge of negative prognostic factors can appear to be a crucial tool enabling one to work out a better therapeutic strategy for high-risk patients with AM.

Giant mesentery fibromatosis presenting as acute abdomen - case report.

Mesentery fibromatosis, also called abdominal desmoid, is a rare clinical entity. It is part of the clinical-pathologic spectrum of so-called deep fibromatoses. The deep fibromatoses encompass a group of benign fibroproliferative processes that are locally aggressive; they may infiltrate the adjacent organs or recur, but do not create distant metastatic lesions. The small bowel mesentery is the most common site of intraabdominal fibromatosis. However, the omentum, ileocolic mesentery, transverse or sigmoid mesocolon, or ligamentum teres may be the site of origin for intraabdominal fibromatosis. Mesenteric fibromatosis occurs in a wide age range of patients, and has no gender or race predilection. Most cases of abdominal fibromatosis occur sporadically. In this article we would like to present a case report of a patient who was admitted to the clinic due to severe abdominal pain with clinically advanced peritoneal signs. The intraoperative findings were astonishing; we found a giant desmoid which originated in the mesentery. The tumor oppressed the ileum, leading to its obstruction.

A case of upper gastrointestinal acute bleeding as a complication of renal carcinoma metastases to the papilla Vateri.

Acute bleeding from metastatic tumour of the papilla Vateri is an extremely rare case. In this report the case of a woman who suffered from complications after a metastatic tumour of the papilla is described. Seventeen years following resection of the kidney due to clear cell carcinoma the patient was admitted to the clinic because of massive bleeding (Forrest IB) to the upper digestive tract in the form of sanguineous vomiting. The conducted diagnostics revealed a bleeding tumour of the papilla Vateri. Endoscopic treatment could not effectively stop the bleeding. A surgical procedure was performed by Whipple's method. A histopathological examination showed a metastatic clear cell tumour of the kidney. The patient was discharged from hospital on the 8(th) day following her admission and was also referred for further oncological treatment. The discussion is based on other cases of rare bleeding from the digestive tract within tumours of the bile duct and papilla Vateri.

Evaluation of the effectiveness of thoracic sympathectomy in the treatment of primary hyperhidrosis of hands and armpits using the measurement of skin resistance.

INTRODUCTION: Hyperhidrosis is excessive sweating beyond the needs of thermoregulation. It is disease which mostly affects young people, often carrying a considerable amount of socio-economic implications. Thoracic sympathectomy is now considered to be the "gold standard" in the treatment of idiopathic hyperhidrosis of hands and armpits. AIM: Assessment of early effectiveness of thoracic sympathectomy using skin resistance measurements performed before surgery and in the postoperative period. MATERIAL AND METHODS: A group of 20 patients with idiopathic excessive sweating of hands and the armpit was enrolled in the study. Patients underwent two-stage thoracic sympathectomy with resection of Th2-Th4 ganglions. The skin resistance measurements were made at six previously designated points on the day of surgery and the first day after the operation. RESULTS: In all operated patients we obtained complete remission of symptoms on the first day after the surgery. Inhibition of sweating was confirmed using the standard starch iodine (Minor) test. At all measurement points we obtained a statistically significant increase of skin resistance, assuming p < 0.05. To check whether there is a statistically significant difference in the results before and after surgery we used sequence pairs Wilcoxon test. CONCLUSIONS: Thoracic sympathectomy is an effective curative treatment for primary hyperhidrosis of hands and armpits. Statistically significant increase of skin resistance in all cases is a good method of assessing the effectiveness of the above surgery in the early postoperative period.

[Influence of the shift work on circadian-rhythms compare survey on health service employees and policemen]. / Wplyw pracy zmianowej na rytmy okolodobowe--badania porównawcze na pracownikach sluzby zdrowia i policjantach.

It has been estimating that about 20% working persons works in the shift system. It concerns health service employees and policemen among others. The shift work causes permanent conflict "of biological clock" with required working hours. The work in the night hours is less effective, it is held with greater expensive and triggering the increased tiredness.The aim of overtaken by the authors questionnaire survey amongst the population working in shifts, was to determining the influence of the shift work on the length and the quality of the dream and the tiredness and the sleepiness during day in comparison to group working only on the day shift. MATERIAL AND THE METHOD: The survey was conducted in the group of employees of the Health Service (30 persons) and policemen (20 persons) working in shifts. Healthy volunteers working in the system of the daily work constituted the control group (30 persons). The examination consisted of questionnaire forms which were filled in anonymously, the duration of examining one person lasted 4 weeks. RESULTS: Age and sex of the examined and control group were similar. In the examined period of time the number of night shift was averaged 6. During holidays 47 persons had night changes. Average time of dream was approximately 7 hours, for those who was working only at daily shift. On the following day after the night shift examined slept additionally average about 3 hours. Those who didn't work in shifts slept average 7.5 hour/24. Clinically significant sleeplessness was developed: examined group--18 persons, control group--3 persons. Amongst respondents we measured level of sleepiness during night shift using carolain scale of the sleepiness. Increase of sleepiness and decrease of activity appeared between 2:00 and 6:00 a.m. In the process of the examination a measurement of appearing the indications of exaggerated sleepiness and tiredness was also conducted using the ATS scale. The frequency of appearing was two or even three times bigger in the examined group. In examined group most common was reduction of psychophysical activity and difficulty in maintaining opened eyes. We have noted most often reduction of psychophysical activity and the problem with concentrating the eyesight on the object in the examined group. CONCLUSIONS: 1. The shift work is connected with a substantial effect to the clinical insomnia. 2. Insufficiency of sleep is a frequent occurrence in those who works in shifts especially having above 6 night shift monthly and also having children below 7 years.

Comparison of early results of surgical treatment in patients with pancreatic cancer.

UNLABELLED: Pancreatic tumours are a serious medical and social issue. Patients come to the doctor too late, when the disease is well advanced. The most frequently applied method of surgical treatment is pancreatoduodenectomy (Whipple procedure). The most frequently used technique of pancreatoduodenectomy is the Child-Waugh method. The procedure can be performed in a classic way or as modified by Traverso (with preservation of the pylorus). MATERIAL AND METHODS: Between August 2008 and June 2011, in the Department of Thoracic, General and Oncologic Surgery of Medical University in Lódz, a total of 79 patients with pancreatic tumours were hospitalized. In 61, pancreatoduodenectomy was performed. The patients were divided into two groups, depending on the diagnosis and the procedures performed: group 1 comprised patients in whom the pylorus was resected (n = 43); group 2 comprised patients in whom the pylorus was preserved (Traverso-Longmire procedure; n = 18). RESULTS: Mean duration of surgery was about 3 hours and 50 minutes in both groups. Mean duration of hospitalization after the procedure was 15.6 days in group 1 and 12.2 days in group 2 (p < 0.05). Early complications (within 30 days of the procedure) were observed in 33.2% of patients in both groups. Blood transfusion was necessary in 21% of patients in group 1 and 28% of patients in group 2 (p>0.05). CONCLUSIONS: There are specific indications for each method of surgical treatment, however, it seems that both techniques of pancreatic resection can be recommended as standard surgical treatment, and the number of complications after both procedures is similar.