Malignant tumours of colon and rectum from the blood clotting view.

OBJECTIVES: The relationship between malignant tumours and blood coagulation disorders is generally well known. BACKGROUND: The authors notice blood coagulation in patients with colorectal cancer and evaluate prothrombotic markers. METHODS: The authors analyzed a group of 137 patients with malignant tumour of colon and rectum, drew attention to the relationship between level of D-dimer, PAI-1, F 1+2, Protein C and the progress of malignant tumour, its localization, clinical stage, histopathology type, method of surgery considering the stapling use. RESULTS: Very aggressive and advance tumours have high level of D dimer, plasminogen activator inhibitor I (PAI-1). Prothrombotic fragments 1+2 were significantly higher by anastomotic dehiscence. Protein C level was lower by age from sixty to seventy and in advanced clinical stage. CONCLUSION: Pre-operative surveys of D dimer, PAI-1, prothrombotic fragments and Protein C give informations abaout risk of thrombosis, far gone of malignant diseases, they clinical stage and histological type. D dimer and PAI-1 have the most clinical value (Fig. 5, Ref. 11).

[Laparoscopic splenectomy--our experience]. / Laparoskopická splenektómia--nase skúsenosti.

AIM: Comparison laparoscopic (LS) and conventional splenectomy (OS). MATERIAL AND METHODS: Evaluation results of 22 patients after LS and 22 patients after open splenectomy for idiopathic trombocythopenic purpura (ITP)--complications, operational time, hospital stay, dynamics of coagulating parameters, mainly plattelets. RESULTS: We provided longer operational time, shorter hospital stay, earlier regression of trombocytopenia at patients after laparoscopic splenectomy and all at once the same complications then at patients after open splenectomy. CONCLUSION: The laparoscopic splenectomy is considere for advantages of miniinvasive approach as appropriate alternative of surgical treatment of ITP.

[Crural arteries PTA in patients with diabetes]. / PTA krurálnych tepien u diabetikov.

AIM: The authors analyse the patients hospitalized with a neuroischemic diabetic foot. They evaluate experiences and results of the crural arteries percutaneous transluminal angioplasty (PTA) in the diabetic patients. METHOD: It is a retrospective analysis of the patients hospitalized during years 2005-2008 at the Department of Vascular Surgery of the Teaching Hospital J. A. Reiman Presov with the diabetic foot. During the study period 265 hospitalization in 205 patients were registered for complications of the diabetic foot. PTA of the crural arteries was performed on 74 lower extremities in 68 patients. 133 crural arteries were revascularized in this group of the patients. Indication for execution of the crural arteries PTA in the diabetic patients was critical limb ischemia on 68 revascularized lower extremities (91.9%). RESULTS: Technical success (residual stenosis no more than 30%, unobstructed revascularized crural artery to periphery) was achieved on 93 revascularized crural arteries (69.92%). They have control examination minimally 12 months after PTA in 54 revascularized lower extremities of the 68 patients with the neuroischemic diabetic foot. From this subset of the patients 28 lower extremities (51.85%) are healed according to clinical examination, on 7 lower extremities (12.96%) clinical signs of critical limb ischemia remain, 10 times (18.52%) low amputation was performed and 9 times (16.67%) high amputation was executed. CONCLUSION: The authors believe that PTA of the crural arteries is safe and effective method of critically ischemic diabetic foot revascularization. If revascularization is successful, it can effectively contributes to the lower extremity salvage of the patient with neuroischemic diabetic foot.

[Colorectal malignancies with respect to hemocoagulation]. / Malignómy kólonu a rekta z pohl'adu hemokoagulácie.

AIM: Relationship between malignants tumors and damage of hemocoagulation is known. The aim is analyse this damage and evaluate the thrombotic markers. MATERIAL AND METHODICS: Authors analyses group of 137 patients with colorectal malignants tumors. They notifyes to relationship between plasmatic preoperative D dimer, PAI-1, F 1+2, Protein C level with controll group. RESULTS: Especially aggressive forms of colorectal tumours have increased levels of D dimer and PAI-1. Protrombin fragments 1+2 were enhanced in the course of anastomotic dehiscence. Protein C level was reduced in 6.-7. decade and in advanced clinical stage. CONCLUSION: Praeoperative thrombotic markers assays inform about risk of thrombosis and clinical diseases stage. They prefere mini-invasive operations procedures. The maximall validity provides D dimer and PAI-1.

[Treatment of thrombotic complications of surgical infrainguinal revascularizations]. / Liecba trombotických komplikácií chirurgických infrainguinálnych revaskularizacných výkonov.

AIM: Authors in the work analyse the patients hospitalized with thrombosis of the surgical infrainguinal reconstruction. They evaluate the causes of reconstructions occlusions, therapeutic options in the treatment and their experiences with treatment of these patients. METHOD: It is the retrospective analysis of the patients hospitalized during years 2001-2006 at the Department of Vascular Surgery of the Teaching Hospital J. A. Reimana in Presov with thrombosis of the surgical infrainguinal reconstruction. During the study period 723 surgical infrainguinal revascularization procedures were performed. The basic therapeutic approach in the care of these patients is anticoagulation and digital subtraction angiography, then they decide between percutaneous endovascular treatment, surgical thrombectomy, reoperation with implantation of the new reconstruction or conservative treatment. In the phase of irreversible ischemia high amputation is indicated. RESULTS: Thrombosis of the reconstruction was occured in 109 subjects (15.8%). Prothesis was thrombosed in 71 subjects (65.14%), vein in 38 subjects (34.86%). Percutaneous endovascular treatment was indicated in 3 subjects (2.8%), surgical thrombectomy with correction of the stenosis in 23 subjects (21.1%), reoperation with implantation of the new reconstruction in 53 subjects (48.6%),conservative approach in 21 subjects (19.3%), high amputation in 9 subjects (8.2%). The secondary patency after 12 months according to the life table method analysis after percutaneous endovascular treatment was 75%, after surgical thrombectomy of the graft with correction of stenosis 37% and after reoperation with implantation of the new reconstruction 72%. CONCLUSION: Authors believe that the best treatment in the care of the patients with thrombosis of the surgical infrainguinal reconstruction and critical limb ischemia is implantation of the new secondary reconstruction with autologous vein.

[The isolated internal iliac artery aneurysms]. / Izolované aneuryzmy arteria iliaca interna.

The isolated iliac artery aneurysm is a rare disease. Diagnosis and treatment of these aneurysms according to their anatomic location is difficult. Authors describe diagnostic-therapeutic approach in the care of three patients at the vascular unit of the Surgical Clinic of the Teaching Hospital in Presov. They analyze different methods of treatment with emphasis on endovascular therapeutic methods mainly in the therapy of polymorbid high risk patients.

Detection of Philadelphia chromosome in patients with chronic myeloid leukemia from the Presov region in Slovakia (1995-2004).

Philadelphia chromosome (Ph) is a characteristic chromosomal marker that is associated with chronic myelogenous leukemia (CML). Philadelphia chromosome in bone marrow cells in patients with suspected diagnosis of CML in the Presov region (1995-2004) was detected in 94.4 % of cases. In one patient a complex translocation involving the chromosomes 8, 9 and 22 was identified. One patient has showed extra numerical and structural chromosomal aberrations. The mosaic karyotype of Ph chromosome was found in 5.9 % of cases. The conventional cytogenetic analysis remains the standard method for the purpose of diagnosis and monitoring of the therapeutic response and minimal residual disease in patients with chronic myeloid leukemia (Tab. 1, Fig. 1, Ref. 18). Full Text (Free, PDF) www.bmj.sk.