Results of Sentinel Lymph Node Biopsy in Patients with Breast Cancer in 10-Year Own Material of the 4th Military Teaching Hospital with Polyclinic in Wroclaw.

UNLABELLED: 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.

Laparoscopic appendectomy as an alternative to conventional procedure - results in our own material.

UNLABELLED: Appendectomies are the most common surgical procedures performed in the emergency surgery setting. Since more than one decade laparoscopic appendectomy appeared as an alternative procedure to commonly used conventional appendectomy as a recognized method of treatment of acute appendicitis. Despite multiple papers and studies comparing these techniques, still no clear indications and eligibility criteria exist for either of them. THE AIM OF THE STUDY: was to evaluate results of treatment of acute appendicitis using the laparoscopic method versus the conventional appendectomy, basing on parameters affecting treatment results and costs, such as duration of hospitalization, complications, use of medications. MATERIAL AND METHODS: The analysis included patients who underwent surgical treatment for acute appendicitis at the Department of Surgery of 4th Military Clinical Hospital in Wroclaw between 2006 and 2012. Since 2006, 128 laparoscopic appendectomies (group 1) were performed, while 189 patients underwent conventional procedure during this time (including 11 who underwent a diagnostic laparoscopy - group 2). The study was based on retrospective analysis of medical records of patients. Treatment results were evaluated basing on the following parameters: duration of hospitalization, amount of used analgesics, duration and type of antibiotic therapy, peri- and postoperative complications. RESULTS AND CONCLUSIONS: Results obtained at our Clinic, similar to results obtained at other sites, warrant use of laparoscopic appendectomy. Use of minimally invasive techniques provides better treatment results, mainly with regard to shorter duration of hospitalization, lower use of antibiotics and analgesics, which also contributes to lower overall treatment costs.

[Implantation of plastic and metal stents to biliary tract in obstructive jaundice in material of Surgery Department of 4th Military Clinical Hospital in Wroclaw]. / Zaopatrywanie dróg zólciowych protezami plastikowymi i metalowymi w nowotworowej zóltaczce mechanicznej w materiale Kliniki Chirurgicznej 4. WSKzP we Wroclawiu.

INTRODUCTION: A method of treatment for malignant bile duct strictures depends on early diagnosis, location and extent of tumor infiltration. Patients eligible for radical surgery should be operated. AIM OF THE STUDY: The authors used plastic and metal prostheses in the treatment of biliary tract cancer cholestasis. MATERIAL AND METHODS: Retrospective analysis was done in 2730 endoscopies performed in the Laboratory of the Department of Endoscopic Surgery, 4th Military Hospital in Wroclaw in 2008-2011. The authors analyzed 441 cases of prosthetic biliary cancer. RESULTS: 223 patients (51%) were treated for pancreatic head tumor, 98 pts (22%)--for papilla of Vater tumor, 85 pts (19%)--due to Klatskin tumor and 35 pts (8%)--due to tumor of the gallbladder. Plastic prostheses were inserted in 228 (65.4%) patients, self-expanding metal prostheses--in 21 patients (4.9%). Dilatation of the bile duct or the inserted prosthesis was performed in 48 (11.1%) pts. 27 patients (6.1%) had endoscopic treatment failure. 32 patients (7.3%) had following complications of biliary prosthesis: bleeding into the bile duct, into the digestive tract--4 cases (1%), the migration of the prosthesis--7 (1.6%), cholangitis--21 cases (4.7%). CONCLUSIONS: Palliative biliary stenting is a safe method that provides efficient drainage of bile. It shows a definitive advantage over percutaneous, biliary transhepatic drainage.