[Role of manometry in evaluating long-term outcomes of the surgical treatment of functional esophageal diseases]. / Bedeutung der Manometrie bei der Bewertung von Langzeitergebnissen der chirurgischen Behandlung funktioneller Erkrankungen der Speiseröhre.

In the years 1979-1986, 73 patients with esophageal achalasia, 110 patients with the reflux disease of esophagus and paraesophageal herniae, 17 patients with esophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in esophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of esophagus it can contribute to the decision between a conservative and surgical therapy. The postoperative control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

[Long-term follow-up of patients with diffuse colonic polyps]. / Langzeitige Beobachtung der Kranken mit diffuser Dickdarmpolypose.

During the years from 1968 to 1984, at the First Department of Surgery in Olomouc, 10 patients with diffuse polyposis of the colon were treated. In 5 of them, a familial occurrence of polyposis was dealt with. In three of them, malignity developed. In five unfamilial polyposes, malignity occurred only once. In one patient, the occurrence of malignity was found present immediately with the first manifestation of the disease. In the other patients, it was after an interval of 3 to 17 years after the onset of the disease. Three patients died from generalization of the malignant process. In two of them, carcinoma developed in the remaining part of the colon, once after previous hemicolectomy and once after colectomy. One patient with an advanced disease died one year after proctocolectomy. Two other operated on patients survive after proctocolectomy 12 and 13 years. The other patients who had been operated on before the development of malignity are healthy. The choice of an adequate radicalintervention is of importance. Optimal is the performance of colectomy with ileorectal anastomosis and the regular endoscopic and bioptic follow-up of the stump of the intestine. When proctocolectomy is necessary, it is of advantage to apply Kock's continent ileostomy.

Oesophageal diverticula.

The classification and etiopathogenesis of oesophageal diverticula is discussed, based on the experience with the treatment of 91 (68 Zenker's, 7 parabronchial, and 16 epiphrenic) diverticulectomies performed at the First and Second Departments of Surgery in Olomouc from 1948 to 1987. The tactics and technique of surgical management and its results in the single groups of diseases are analyzed in detail. Parapharyngeal diverticula represent typical true diverticula associated with hypertonia of the upper oesophageal sphincter. No causal relationship could be proved to exist between the origin of this diverticulum and the gastrooesophageal reflux. Thoracic diverticula are probably rather of congenital than traction origin. Epiphrenic diverticula arise most often from hypertonia of the lower oesophageal sphincter. They can also be of congenital origin. Traction etiology could be observed in the presence of a leiomyoma in the diverticulum. The surgical management of Zenker's diverticulum consists in the excision of the diverticulum and cricopharyngeal myotomy. Excision of parabronchial diverticulum is seldom indicated for causing little discomfort, as a rule only when it is very large. Epiphrenic diverticula are usually associated with hypertonia of the lower oesophageal sphincter. In such cases, myotomy after Heller is performed and, as a rule, the diverticulum is excised.

[The importance of manometry in the evaluation of long-term results after surgical therapy of functional disorders of the esophagus]. / Význam manometrie pri hodnocení dlouhodobých výsledku chirurgické lécby funkcních poruch jícnu.

In the years 1979-1986, 73 patients with oesophageal achalasia, 110 patients with the reflux disease of oesophagus and paraoesophageal herniae, 17 patients with oesophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. There were 446 examinations performed on the whole. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in oesophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of oesophagus it can contribute to the decision between a conservative and surgical therapy. The postoperation control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

[Report of experiences in the surgical treatment of functional disorders of the esophagus]. / Erfahrungsbericht bei der chirurgischen Behandlung der Funktionsstörungen der Speiseröhre.

Operations were performed on 1,275 patients for various oesophageal disorders at the First Surgical Department of Olomouc University, between 1948 and 1985. Most of these functional disorders were of benign nature, including simple or complicated reflux disease of the oesophagus, achalasia of the cardia, para-oesophageal and mixed hiatus hernia, and diverticulum. The group of these benign cases included 826 patients. Their lethality amounted to 2.8 percent. Surgical techniques and tactical approaches to various types of functional disorders of the oesophagus are described in some detail. Also reported are lethality, complications, and long-time results.

Etiopathogenesis and classification of esophageal diverticula.

The classification and etiopathogenesis of esophageal diverticula is discussed on the basis of our experience with the surgical management of 74 such diverticula (51 parapharyngeal, 7 thoracic, 167 epiphrenic). Parapharyngeal diverticula always represent true diverticula, their walls comprising muscular tissue as well as mucosa and submucosa. A causal relationship between esophageal reflux disease and Zenker's diverticulum has not yet been proved. Thoracic diverticula are probably more often of a congenital than traction origin. Epiphrenic diverticula result either from hypertonia of the lower esophageal sphincter (esophageal achalasia) or, if the latter functions normally, are of congenital origin. Traction etiology can in special cases be due to the presence of a leiomyoma in the esophageal wall.

[EMG method in assessing diaphragmatic paralysis in a miner as an occupational disease]. / Beitrag der EMG-Methode zur Beurteilung der Zwerchfellparese bei einem Bergarbeiter als Berufserkrankung.

A diaphragmatic palsy of a miner as an occupational accident happened during backdrawing pit props out of a low seam. For this trauma an excessive stretching of the spinal roots of the n. phrenicus with simultaneous presence of osteoarthrotic alterations in the area of the cervical vertebra was held responsible. The investigation of the cervical muscles on the side of palsy demonstrated a depressed activity corresponding to the radicular phrenicus palsy.