Morbidity, mortality and long term survival in patients with vascular resection in pancreatic cancer - single center experience.

Although venous resection in pancreatic cancer is widely used method, recently published data about its safety and survival benefit showed conflicting results. A retrospective case matched study was performed to compare the results of patients who underwent venous resection to those with no venous resection during radical surgery in pancreatic cancer.From January 2010 to December 2015, 297 pancreatic resections due to pancreatic tumor were performed in the National Cancer Institute (NCI). Fifty-three patients with venous resection were identified and enrolled into the study and matched with 66 patients without vascular resection during radical resection of pancreatic head/body cancer. Both groups matched for age, ASA score, need for preoperative biliary drainage and clinical staging of the tumor. Morbidity was determined according Clavien and Dindo classification [1] and was similar in both groups of patients (p = 0.48). Thirty day postoperative mortality was also equal in both groups 5.6 vs 4.5% (p > 0.99) and long term survival was with no significant difference. Median overall survival was 18.8 vs 20.7 months (p = 0.33) for patients with/without venous resection.Therefore we consider venous resection in pancreatic cancer safe procedure with equal morbidity and perioperative mortality as in patients with no need for vascular resection and with the same long term survival if R0 resection is achieved.

[Rare complication after stapled hemorrhoidectomy]. / Raritná komplikácia po staplerovej hemoroidektómii.

Statistics show that more than half of the population suffers from hemorrhoids at different clinical stages. Only a small percentage of them (5 to 10%) require surgical treatment. The gold standard is open hemorrhoidectomy (most commonly Milligan-Morgan operation). Circular stapled hemorrhoidopexy by Longo is an alternative to conventional hemorrhoidectomy. The main advantages of this procedure are: less postoperative pain, earlier return to work and to social life. The complication rate is similar to open hemorrhoidectomy. This method, however, also brings new kinds of complications, some of them potentially life-threatening. Our case report presents one of these rare complications.

Portomesenteric vein gas and pneumatosis intestinalis--a rare complication after neoadjuvant radiochemotherapy in oesophageal cancer.

Portomesenteric vein gas and pneumatosis intestinalis is most commonly caused by mesenteric ischemia and bowel necrosis but may have a variety of other causes. The etiology is multifactorial and the clinical presentation is variable. The diagnosis is based on a combination of clinical suspicion and radiographic findings. The finding of hepatic portal venous gas alone is not an indication for emergent exploration. We report portomesenteric venous gas as a rare complication after neoadjuvant radiochemotherapy of the oesophageal cancer (Fig. 3, Ref. 12).