Magyar sebészet
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Anal fissure is a small linear tear in the lining of the distal anal canal below the dentate line. Treatment is aimed at reducing internal sphincter spasm. ⋯ This is a nitric oxide donor which reduces the increased anal canal pressure caused by the hypertonic internal anal sphincter, improving anodermal blood flow. Although headache is a frequent side-effect, it is usually transient and glyceryl trinitrate does not seem to have any long-term adverse effects.
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The authors present a case of enterobiasis of the appendix. Enterobius infection is an uncommon cause of acute appendicitis. ⋯ Careful observation of the appendix stump may lead to intraoperative diagnosis of enterobiasis. A quick diagnosis and appropriate treatment may prevent future complications.
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Review
[Oncoplastic approach in breast cancer surgery--a new challenge for the future breast surgeon?].
The future challenge of breast surgery, the so-called oncoplastic approach is reviewed in this article. The authors discuss the most frequently applied surgical techniques as well as their indications. Medline and pubmed search was carried out using the following keywords and cross-references: "oncoplastic breast surgery", "breast reconstruction", "breast conserving surgery" and "reduction mammoplasty". ⋯ Finally, carrying out free flap reconstructions after mastectomy should be assigned exclusively to plastic surgeons qualified in microsurgical techniques, and not to surgical oncologists. As conclusions oncoplastic approach will be an integral element of the surgical treatment of breast cancer in the future. Breast oncoplastic training is an interdisciplinary task, which combines surgical oncological management of breast cancers with aesthetic/reconstructive breast surgery.
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The authors describe two intraoperative fires during cardiac surgery. In both cases, in addition to the usual disinfection and isolation of the operating field, they wanted to reduce the infection hazard and to restore the partly ruined isolation by 70% alcoholic skin antiseptic solution. Soon after the disinfection, but before the evaporation of alcohol, diathermy was used and caused fire. In case of the first patient the fire spread over the isolation film and resulted second grade (5%) and third-grade (1%) burn injury which required plastic surgery. In the second case the patient's beard caught fire causing second-grade (1%) burn that was treated locally. Despite these burn injuries both patients recovered after the heart surgery. These two intraoperative fires are 0.003-0.004% of all surgical procedures. ⋯ Fires during surgery are rare and might have serious consequences. They can be prevented by keeping the discipline of work and instructions of fire protection. The best way of prevention is regular education of all the staff (doctors, nurses, etc.) working in the operating theatre.