[New treatment approach in liver metastates: hand-assisted laparoscopic radiofrequency liver resection]. / Nový prístup k lécbe jaterních metastáz: manuálne asistovaná laparoskopická radiofrekvencní resekce jater.

BACKGROUND: Hand-assisted laparoscopic liver surgery, a newly developed technique based on an innovative concept, has proved useful and safe for a variety of less invasive hepatectomies. Radiofrequency assisted hepatic resection has been reported to be safe, associated with minimal morbidity and mortality and decreased intraoperative blood loss and transfusion requirements. METHOD: We describe how we perform hand assisted laparoscopic radiofrequency assisted hepatic resection using a bipolar radiofrequency device. RESULTS: The use of the hand port has allowed the surgeon to use his hand in direct liver manipulation, mobilization, and retraction. It was also useful for tactile tumor localization. Radiofrequency assisted hepatic parenchymal transaction was performed using bipolar device (Habib 4X) with minimal blood loss (35 ml), and reduced operative and resection times (75 min, 17 min respectively). CONCLUSION: This combined procedure seems to offer a safer, more effective, and less time-consuming means of resection of hepatic tumours. This might encourage surgeons to perform more frequently a laparoscopic approach for liver resection.

Virtual colonoscopy: a new promising technique.

OBJECTIVES: Virtual colonoscopy is less invasive than conventional colonoscopy and does not require a conscious sedation. BACKGROUND: Virtual colonoscopy using the abdominal spiral computed tomography scanning allows a total colonic evaluation with minimal invasiveness. METHODS: We studied 48 patients with a virtual colonoscopy using oral iodinated contrast. Colonic lavage was achieved with an oral polyethylene glycols preparation. We examined patients who had refused a colonoscopic examinations, or patients with a stenotic processes, in which it was not possible to examine the proximal colon using standard methods. RESULTS: Our indications for CT virtual colonoscopy were following: firstly, when colonic examination by other methods (colonoscopy, barium enema) failed or was not possible, and secondly, to exclude tumour duplicity in cases with an already verified colon tumour. 26 patients underwent a virtual colonoscopy examination based on the first indication, and 22 patients based on the second indication. CONCLUSION: In summary, our results show that virtual colonoscopy is a promising method in detecting individuals with significant colorectal lesions. The aim of the present study was to assess the ability of virtual colonoscopy using oral contrast to detect patients with colorectal lesions who need a colonoscopy (Tab. 2, Fig. 3, Ref. 4). Full Text (Free, PDF) www.bmj.sk.

Cystic adenomyoepithelioma of the breast.

Cystic adenomyoepithelioma of the breast is a rare tumor. We report a case of this entity in a 42-year-old woman who presented with a lump behind her left nipple. Clinical examination suggested the diagnosis of a cyst. Ultrasound showed a cyst with an intracystic mass. The lesion was biopsied and found to be a cystic adenomyoepithelioma.