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1.
Endokrynol Pol ; 73(3): 387-454, 2022.
Article in English | MEDLINE | ID: mdl-36059171

ABSTRACT

Continuous progress in the diagnostics and treatment of neuroendocrine neoplasms (NENs), the emerging results of new clinical trials, and the new guidelines issued by medical societies have prompted experts from the Polish Network of Neuroendocrine Tumours to update the 2017 recommendations regarding the management of neuroendocrine neoplasms. This article presents the general recommendations for the management of NENs, resulting from the findings of the experts participating in the Fourth Round Table Conference, entitled "Polish Guidelines for the Diagnostics and Treatment of Neuroendocrine Neoplasms of the gastrointestinal tract, Zelechów, June 2021". Drawing from the extensive experience of centres treating these cancers, we hope that we have managed to formulate the optimal method of treating patients with NENs, applying the latest reports and achievements in the field of medicine, which can be effectively implemented in our country. The respective parts of this work present the approach to the management of: NENs of the stomach and duodenum (including gastrinoma), pancreas, small intestine, and appendix, as well as large intestine.


Subject(s)
Endocrinology , Neuroendocrine Tumors , Pancreatic Neoplasms , Humans , Medical Oncology , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/therapy , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Poland , Stomach
2.
Endokrynol Pol ; 73(3): 491-548, 2022.
Article in English | MEDLINE | ID: mdl-36059173

ABSTRACT

In this paper, we present the current guidelines for the diagnostics and management of pancreatic neuroendocrine neoplasms (PanNENs) developed by Polish experts providing care for these patients in everyday clinical practice. In oncological diagnostics, in addition to biochemical tests, molecular identification with the use of NETest liquid biopsy and circulating microRNAs is gaining importance. Both anatomical and functional examinations (including new radiopharmaceuticals) are used in imaging diagnostics. Histopathological diagnosis along with immunohistochemical examination still constitute the basis for therapeutic decisions. Whenever possible, surgical procedure is the treatment of choice. Pharmacological management including biotherapy, radioisotope therapy, targeted molecular therapy and chemotherapy are important methods of systemic therapy. Treatment of PanNENs requires a multidisciplinary team of specialists in the field of neuroendocrine neoplasms.


Subject(s)
Endocrinology , Neuroendocrine Tumors , Humans , Medical Oncology , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/therapy , Poland
3.
Endokrynol Pol ; 73(3): 455-490, 2022.
Article in English | MEDLINE | ID: mdl-36059172

ABSTRACT

After another meeting of experts of the Polish Network of Neuroendocrine Tumours, updated recommendations for the management of patients with gastric and duodenal neuroendocrine neoplasms, including gastrinoma, have been issued. As before, the epidemiology, pathogenesis and clinical symptoms of these neoplasms have been discussed, as well as the principles of diagnostic procedures, including biochemical and histopathological diagnostics and tumour localisation, highlighting the changes introduced in the recommendations. Updated principles of therapeutic management have also been presented, including endoscopic and surgical treatment, and the options of pharmacological and radioisotope treatment. The importance of monitoring patients with gastric and duodenal NENs, including gastrinoma, has also been emphasised.


Subject(s)
Duodenal Neoplasms , Endocrinology , Gastrinoma , Neuroendocrine Tumors , Pancreatic Neoplasms , Duodenal Neoplasms/diagnosis , Duodenal Neoplasms/therapy , Gastrinoma/diagnosis , Gastrinoma/therapy , Humans , Medical Oncology , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/therapy , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Poland
4.
Endokrynol Pol ; 73(3): 584-611, 2022.
Article in English | MEDLINE | ID: mdl-36059175

ABSTRACT

Colorectal neuroendocrine neoplasm (CRNEN), especially rectal tumours, are diagnosed with increased frequency due to the widespread use of colonoscopy, including screening examinations. It is important to constantly update and promote the principles of optimal diagnostics and treatment of these neoplasms. Based on the latest literature and arrangements made at the working meeting of the Polish Network of Neuroendocrine Tumours (June 2021), this paper includes updated and supplemented data and guidelines for the management of CRNEN originally published in Endokrynologia Polska 2017; 68: 250-260.


Subject(s)
Colorectal Neoplasms , Endocrinology , Neuroendocrine Tumors , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/therapy , Humans , Medical Oncology , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/therapy , Poland
5.
Endokrynol Pol ; 73(3): 549-583, 2022.
Article in English | MEDLINE | ID: mdl-36059174

ABSTRACT

Updated Polish recommendations for the management of patients with neuroendocrine neoplasms (NENs) of the small intestine (SINENs) and of the appendix (ANENs) are presented here. The small intestine, and especially the ileum, is one of the most common locations for these neoplasms. Most of them are well-differentiated and slow-growing tumours; uncommonly - neuroendocrine carcinomas. Their symptoms may be untypical and their diagnosis may be delayed or accidental. Najczesciej pierwsza manifestacja ANEN jest jego ostre zapalenie. Typical symptoms of carcinoid syndrome occur in approximately 20-30% of SINENs patients with distant metastases. In laboratory diagnostics the assessment of 5-hydroxyindoleacetic acid concentration is helpful in the diagnosis of carcinoid syndrome. The most commonly used imaging methods are ultrasound examination, computed tomography, magnetic resonance imaging, colonoscopy and somatostatin receptor imaging. Histopathological examination is crucial for the proper diagnosis and treatment of patients with SINENs and ANENs. The treatment of choice is a surgical procedure, either radical or palliative. Long-acting somatostatin analogues (SSAs) are essential in the medical treatment of functional and non-functional SINENs. In patients with SINENs, at the stage dissemination with progression during SSAs treatment, with high expression of somatostatin receptors, radioisotope therapy should be considered first followed by targeted therapies - everolimus. After the exhaustion of the above available therapies, chemotherapy may be considered in selected cases. Recommendations for patient monitoring are also presented.


Subject(s)
Appendix , Carcinoid Tumor , Endocrinology , Neuroendocrine Tumors , Humans , Intestine, Small/diagnostic imaging , Medical Oncology , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/drug therapy , Poland
6.
Curr Oncol ; 29(5): 2887-2894, 2022 04 19.
Article in English | MEDLINE | ID: mdl-35621625

ABSTRACT

(1) Background: The purpose of the study was a retrospective, comparative assessment of complications of the surgical sentinel node biopsy (SNB) procedure in breast cancer using the radiotracer method and the SentiMag® method on groups of patients after 3.5 years of use. (2) Methods: The material was a group of 345 patients with primary surgical breast cancer who underwent the SNB procedure with the use of a radiotracer in combination with wide local excision (WLE), simple amputation (SA) with SNB and an independent SNB procedure in the period from May 2018 to January 2021 in the Department of Oncological Surgery. Of the patients who were monitored in the Hospital Outpatient Clinic, 300 were enrolled. The analyzed group was compared in terms of the occurrence of the same complications with the group of 303 patients also operated on in our center in the period from January 2014 to September 2017, in which SN identification was performed using the SentiMag® method. (3) Results: The most common complications found were sensation disorders in the arm, which occurred in 16 (14.1%) patients using the radiotracer method, SentiMag®-11 (9.9%). By comparing the complication rate between the methods with the radiotracer (n = 300) and SentiMag® (n = 303), no significant differences were found. (4) Conclusions: Sentinel node (SN) identification using the radiotracer method and the SentiMag® method are comparable diagnostic methods in breast cancer, with a low risk of complications.


Subject(s)
Breast Neoplasms , Lymphadenopathy , Breast Neoplasms/pathology , Female , Humans , Lymphadenopathy/surgery , Postoperative Complications , Retrospective Studies , Sentinel Lymph Node Biopsy/methods
8.
Med Sci Monit ; 26: e926977, 2020 Sep 30.
Article in English | MEDLINE | ID: mdl-32994388

ABSTRACT

BACKGROUND Contrast-enhanced spectral mammography (CESM) is digital mammography with contrast agent. This promising new breast imaging method can be used for planning surgical treatment. This study compared CESM versus digital mammography (MG) in evaluating tumor size in breast cancer. MATERIAL AND METHODS Comparison of tumor dimensions in CESM, MG, and histopathology was made. The correlation of these data was assessed by histopathological type, biological subtype, grading of the carcinoma, and patient age. RESULTS The average difference in tumor size between CESM and histopathological examination was 5 mm. The differences in size measurement between CESM and MG were significant (p=0.00). The Pearson's linear correlation coefficients of CESM versus HP and MG versus HP were -0.01 (p=0.79) and -0.25 (p=0.00), respectively, indicating no differences between CESM and HP based on the lesion size. A weak negative correlation between those values was observed on MG. No relationship was found between the tumor size in CESM and the biological subtype, carcinoma malignancy degree, or patient age. CONCLUSIONS CESM is a new diagnostic method in breast cancer. The accuracy of measurement of tumor size using CESM is independent of lesion size, but it overestimates the size by 5 mm on average. The difference is not dependent on grading, biological subtype of the carcinoma, or patient age. They concern the histopathological type, and values are significantly greater in pre­invasive carcinomas.


Subject(s)
Breast Neoplasms/diagnostic imaging , Contrast Media/administration & dosage , Mammography , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Neoplasm Grading , Retrospective Studies
9.
Med Sci Monit ; 25: 3154-3160, 2019 Apr 29.
Article in English | MEDLINE | ID: mdl-31032820

ABSTRACT

BACKGROUND The objective of this paper was to assess the complications following sentinel lymph node biopsy (SLNB) in breast cancer patients using the SentiMag® method. MATERIAL AND METHODS The study material consisted of 368 patients who had received the SLNB procedure in combination with wide local excision (WLE), simple mastectomy or who had an autonomous SLNB procedure in the period from January 2014 to September 2017. The final study group consisted of 303 patients who attended follow-up consultations. RESULTS Sensory disturbances in the arm occurred in 12 patients (9.9%), including 3 patients (1.5%) after WLE and 9 patients (8.4%) after simple mastectomy. Restricted mobility in the upper limb was experienced by 9 patients (7.1%), including 3 patients (1.5%) after WLE and 6 patients (5.6%) after simple mastectomy. Minimal-degree lymphedema developed in 9 patients (7.5%), including 2 patients (1%) after WLE and 7 patients (6.5%) after simple mastectomy. A significant correlation was demonstrated between the incidence of these complications and the number of lymph nodes dissected. A significantly higher incidence of paresthesia and lymphedema was revealed for simple mastectomy with SLNB when compared to WLE with SLNB. Discolorations upon tracer administration were observed in 47 patients (15.5%). CONCLUSIONS SentiMag® is a safe sentinel lymph node identification method used in breast cancer and has a low risk of complications. The rate of complications increases together with the number of dissected lymph nodes and the extent of the surgery. The possibility of temporary discolorations on the skin should be communicated to the patients explicitly prior to surgery.


Subject(s)
Breast Neoplasms/pathology , Sentinel Lymph Node Biopsy/adverse effects , Sentinel Lymph Node/pathology , Adult , Aged , Aged, 80 and over , Axilla , Breast Neoplasms/surgery , Female , Humans , Lymph Node Excision/methods , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Mastectomy , Middle Aged , Postoperative Complications/etiology , Sentinel Lymph Node/cytology , Sentinel Lymph Node Biopsy/methods
10.
Endokrynol Pol ; 69(4)2018.
Article in English | MEDLINE | ID: mdl-29952408

ABSTRACT

INTRODUCTION: The aim of this study was to compare hormonal stress responses (changes in adrenaline, noradrenaline, and cortisol concentrations) to surgical injury during total intravenous propofol anaesthesia and volatile anaesthesia with sevoflurane in patients subjected to anterior resection of the rectum. MATERIAL AND METHODS: The prospective randomised study included 61 patients qualified for anterior resection of the rectum. The subjects were randomised into two groups, based on the type of anaesthesia: 1) Group I (TIVA, n = 31), administered total intravenous propofol anaesthesia, and 2) Group II (VIMA, n = 30), administered volatile induction and maintenance sevoflurane anaesthesia. Serum concentra-tions of adrenaline, noradrenaline, and cortisol were determined prior to surgery, during assessment of abdominal cavity, after resection of the rectum, and 30 min and one day post-surgery. RESULTS: The two groups did not differ significantly in terms of their haemodynamic parameters: heart rate and arterial blood pressure. Compared to individuals subjected to TIVA, patients from the VIMA group presented with significantly higher concentrations of adrenaline during evaluation of the abdominal organs. No significant intergroup differences were found in terms of intra- and postoperative serum concentrations of noradrenaline and cortisol. CONCLUSIONS: TIVA and VIMA induce similar hormonal stress responses during anterior resection of the rectum. The increase in serum adrenaline concentration during evaluation of the abdominal organs in the VIMA group implies that the dose of sevoflurane should be escalated at this time point.


Subject(s)
Anesthesia/psychology , Propofol/therapeutic use , Rectum/surgery , Sevoflurane/therapeutic use , Stress, Psychological , Adult , Aged , Anesthetics/administration & dosage , Anesthetics/therapeutic use , Epinephrine/blood , Female , Hemodynamics , Humans , Hydrocortisone/blood , Male , Middle Aged , Norepinephrine/blood , Propofol/administration & dosage , Prospective Studies , Random Allocation , Sevoflurane/administration & dosage
11.
Endokrynol Pol ; 67(1): 74-107, 2016.
Article in English | MEDLINE | ID: mdl-26884119

ABSTRACT

Revised Guidelines of Polish National Societies Prepared on the initiative of the Polish Group for Endocrine Tumours approved in their final version between November 16th and 28th, 2015 by the Scientific Committee of the V Conference "Thyroid Cancer and other malignancies of endocrine glands" organised between November 14th and 17th, 2015 in Wisla, Poland; called by the following Societies: Polish Endocrine Society, Polish Society of Oncology, Polish Thyroid Association, Polish Society of Pathologists, Society of Polish Surgeons, Polish Society of Surgical Oncology, Polish Society of Clinical Oncology, Polish Society of Radiation Oncology, Polish Society of Nuclear Medicine, Polish Society of Paediatric Endocrinology, Polish Society of Paediatric Surgeons, Polish Society of Ultrasonography Gliwice-Wisla, 2015 DECLARATION: These recommendations are created by the group of delegates of the National Societies, which declare their willingness to participate in the preparation of the revised version of the Polish Guidelines. The members of the Working Group have been chosen from the specialists involved in medical care of patients with thyroid carcinoma. Directly before the preparation of the Polish national recommendations the American Thyroid Association (ATA) published its own guidelines together with a wide comment fulfilling evidence-based medicine (EBM) criteria. ATA Guidelines are consistent with National Comprehensive Cancer Network (NCCN) Recommendation. According to the members of the Working Group, it is necessary to adapt them to both the specific Polish epidemiological situation as well as to the rules referring to the Polish health system. Therefore, the Polish recommendations constitute a consensus of the experts' group, based on ATA information. The experts analysed previous Polish Guidelines, published in 2010, and other available data, and after discussion summed up the results in the form of these guidelines. It should be added that Part II, which constitutes a pathological part, has been available at the website of the Polish Society of Pathologists for acceptance of the members of the Society, and no essential comments have been proposed. The Members of the Group decided that a subgroup elected from among them would update the Guidelines, according to EBM rules, every year. The Revised Guidelines should help physicians to make reasonable choices in their daily practice; however, the final decision concerning an individual patient should be made by the caring physician responsible for treatment, or optimally by a therapeutic tumour board together with the patient, and should take into consideration the patient's health condition. It should be emphasised that the recommendations may not constitute a strict standard of clinical management imposed on medical staff. The data from clinical trials concerning numerous clinical situations are scarce. In such moments the opinion of the management may differ from the recommendations after considering possible benefits and disadvantages for the patient.


Subject(s)
Thyroid Neoplasms/diagnosis , Consensus , Evidence-Based Medicine , Humans , Poland , Societies, Medical , Thyroid Neoplasms/pathology , Thyroid Neoplasms/therapy
13.
Int J Colorectal Dis ; 29(3): 387-93, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24343275

ABSTRACT

BACKGROUND: Microencapsulated sodium butyrate (MSB) has been previously associated with anti-inflammatory and regenerative properties regarding large bowel mucosa. We aimed to examine a role of MSB in patients with diverticulosis, hypothesizing its potential for reduction of diverticulitis episodes and diverticulitis prevention. METHODS: Seventy-three patients with diverticulosis (diagnosed in colonoscopy or/and barium enema or/and CT colography) were recruited for the study and randomized. The investigated group was administered MSB 300 mg daily; the control group was administered placebo. After 12 months, a total of 52 patients completed the study and were subject to analysis (30 subjects and 22 controls). During the study, the number of episodes of diverticulitis (symptomatic diagnosis with acute pain, fever, and leukocytosis), hospitalizations, and surgery performed for diverticulitis were recorded. Additionally, a question regarding subjective improvement of symptoms reflected changes in quality of life during the analysis. RESULTS: After 12 months, the study group noted a significantly decreased number of diverticulitis episodes in comparison to the control group. The subjective quality of life in the study group was higher than in the control group. There were no side effects of the MSB during the therapy. CONCLUSIONS: MSB reduces the frequency of diverticulitis episodes, is safe, and improves the quality of life. It can play a role in the prevention of diverticulitis.


Subject(s)
Butyric Acid/therapeutic use , Diverticulitis, Colonic/prevention & control , Diverticulosis, Colonic/drug therapy , Histamine Antagonists/therapeutic use , Butyric Acid/administration & dosage , Capsules , Diverticulosis, Colonic/complications , Double-Blind Method , Female , Histamine Antagonists/administration & dosage , Humans , Male , Middle Aged , Prospective Studies , Quality of Life
14.
Travel Med Infect Dis ; 12(2): 183-8, 2014.
Article in English | MEDLINE | ID: mdl-24063909

ABSTRACT

INTRODUCTION: Travellers' diarrhoea (TD) remains a considerable concern among international travellers. Known methods of prevention include dietary precautions, administration of vaccines and antibiotic agents. AIM: To assess the efficacy of sodium butyrate (SB) and short-chain fatty acids (SCFA) in prevention of TD. MATERIAL AND METHODS: 67 adult patients planning to travel to subtropical countries were originally enrolled in the study. After eliminating 7 patients for not fulfilling the inclusion criteria, 60 patients were randomized into a study group receiving SB with SCFA and a placebo group. Patients were requested to complete previously distributed questionnaire daily. After elimination of 18 patients who did not return questionnaires, 42 patients completed the study (22 study, 20 placebo). RESULTS: In comparison to the control arm, the study arm noted significantly reduced occurrence of TD (4.5% vs. 40%, p = 0.008), was associated with a significant decrease in number of stools per day in travellers (1.9 vs. 4.2, p = 0.04), as well as a decrease in gastrointestinal symptoms including pain, bloating and nausea with fevers (0.7 vs. 1.4, p = 0.01). We recorded a trend towards decrease in diarrhoea related utilization of medical care in subjects from the study arm. There were no adverse effects noted regarding the use of SB and SCFA. CONCLUSIONS: Administration of SB with SCFA decreases occurrence of travellers' diarrhoea. It is safe and may constitute a new method of travellers' diarrhoea prevention.


Subject(s)
Butyric Acid/therapeutic use , Diarrhea/prevention & control , Fatty Acids, Volatile/therapeutic use , Travel , Diarrhea/drug therapy , Humans , Surveys and Questionnaires , Travel Medicine
15.
Pol Przegl Chir ; 85(8): 433-7, 2013 Aug.
Article in English | MEDLINE | ID: mdl-24009053

ABSTRACT

UNLABELLED: Over the last decade, gastric cancer treatment has changed from extensive multiorgan resections towards less invasive approaches with limited resections and a more selective lymphadenectomy. Despite all available trials, the conclusions on the extent of necessary resections still remain debatable. The aim of the study was to assess the short term outcomes (morbidity and mortality) of a total gastrectomy depending on the simultaneous splenectomy status. MATERIAL AND METHODS: We performed a retrospective analysis of the records of all patients treated with a curative intent using a total gastrectomy for gastric cancer between 1997 and 2003. 49 patients fulfilled the inclusion criteria. Patients were divided into two groups: S(+) gastrectomy with splenectomy group (29 patients) and S(-) total gastrectomy with spleen preservation (20 patients). RESULTS: Survival analysis at one year showed that there was no difference in survival between the two groups (p=0.84). There were six recurrences, one in the group S(+) and five in group S(-) (p>0.05). Dissemination was observed in three patients in group S(-) (p>0.05). Other complications including infectious complications, exenteration, subileus, cardiovascular insufficiency, multiorgan failure were more frequent in the S(+) group (31% v 15%) although the difference was not significant (p=0.17). CONCLUSIONS: Splenectomy during gastrectomy for cancer has no statistically significant impact on short-term morbidity and mortality. Even though it does not show benefit in terms of 5-year overall survival rates it might be performed when needed in more advanced cases in properly selected patients (e.g. upper gastric T3/4 gastric cancer).


Subject(s)
Gastrectomy/mortality , Neoplasm Recurrence, Local/epidemiology , Splenectomy/mortality , Stomach Neoplasms/surgery , Female , Gastrectomy/adverse effects , Humans , Length of Stay , Lymph Node Excision , Male , Middle Aged , Neoplasm Seeding , Neoplasm Staging , Prognosis , Retrospective Studies , Splenectomy/adverse effects , Stomach Neoplasms/pathology , Survival Analysis , Survival Rate
16.
Hered Cancer Clin Pract ; 11(1): 4, 2013 Jun 01.
Article in English | MEDLINE | ID: mdl-23724922

ABSTRACT

Hamartomas are tumour-like malformations, consisting of disorganized normal tissues, typical of the site of tumour manifestation. Familial manifestation of hamartomatous polyps can be noted in juvenile polyposis syndrome (JPS), Peutz-Jeghers' syndrome (PJS), hereditary mixed polyposis syndrome (HMPS) and PTEN hamartoma tumour syndrome (PHTS). All the aforementioned syndromes are inherited in an autosomal dominant manner and form a rather heterogenous group both in respect to the number and localization of polyps and the risk of cancer development in the alimentary tract and other organs. Individual syndromes of hamartomatous polyposis frequently manifest similar symptoms, particularly during the early stage of the diseases when in several cases their clinical pictures do not allow for differential diagnosis. The correct diagnosis of the disease using molecular methods allows treatment to be implemented earlier and therefore more effectively since it is followed by a strict monitoring of organs that manifest a predisposition for neoplastic transformation.

17.
Acta Biochim Pol ; 60(2): 195-8, 2013.
Article in English | MEDLINE | ID: mdl-23741719

ABSTRACT

Detection of mutations in families with a hereditary predisposition to colon cancer gives an opportunity to precisely define the high-risk group. 36 patients operated on for colon cancer, with familiar prevalence of this malignancy, were investigated using the DNA microarrays method with the potential detection of 170 mutations in MLH1, MSH2, MSH6, CHEK2, and NOD2 genes. In microarrays analysis of DNA in 9 patients (25% of the investigated group), 6 different mutations were found. The effectiveness of genetic screening using the microarray method is comparable to the effectiveness of other, much more expensive and time-consuming methods.


Subject(s)
Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , DNA Mismatch Repair/genetics , Genetic Testing/methods , Oligonucleotide Array Sequence Analysis/methods , Adaptor Proteins, Signal Transducing , Humans , MutL Protein Homolog 1 , MutS Homolog 2 Protein/genetics , Nuclear Proteins , Pilot Projects
18.
Pol Przegl Chir ; 85(4): 216-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23640930

ABSTRACT

Diffuse cavernous hemangioma of the rectum (DCHR) is a rare benign tumor of vascular origin. Approximately 200 such cases have been reported in the literature. Here we present a case of a 49-year old female patient who underwent a surgical procedure due to a mass of the rectum with a history of recurrent, painless gastrointestinal bleeding and anemia in whom DCHR was diagnosed postoperatively. This paper is intended as a metaanalysis of available diagnostic and therapeutic methods to be used in patients with DCHR.


Subject(s)
Hemangioma, Cavernous/diagnosis , Hemangioma, Cavernous/surgery , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Colonoscopy , Female , Humans , Magnetic Resonance Angiography , Middle Aged , Tomography, X-Ray Computed , Treatment Outcome
19.
Pol Przegl Chir ; 85(3): 141-4, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23612622

ABSTRACT

For many years, laparoscopic cholecystectomy remains the method of choice for both the treatment of symptomatic cholelithiasis, and chronic and acute cholecystitis (1). The experience of the surgeon grows with each laparoscopic procedure, which enables to operate in case of difficult anatomical conditions and associated anatomical variants. The aim of the study was to present a case of a 47-year old male patient with total situs inversus and several months history of recurrent left epigastric pain, radiating to the left scapula, being accompanied by nausea and vomiting. The study presented the operative technique of laparoscopic cholecystectomy and postoperative period data. In conclusion, laparoscopic cholecystectomy in a patient with total situs inversus is possible and safe, providing relevant precautions. The main issues certainly include a good and feasible plan of the operation, discussion concerning the possible intraoperative and postoperative complications, a good plan considering the localization of the trocars, as well as an experienced surgical team. One should also not forget that early conversion to classical cholecystectomy is not considered as failure, but might prevent accidental damage of the biliary ducts and long-term complications.


Subject(s)
Cholecystectomy, Laparoscopic , Situs Inversus/surgery , Humans , Male , Middle Aged , Situs Inversus/diagnosis , Treatment Outcome
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