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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Heart disease during pregnancy necessitating cardiac surgery is potentially increasing maternal and fetal morbidity and mortality. Most patients know about their heart disease long before conception however the relation between the deteriorating cardiac function and the perinatal complications is not emphasized. Best possible results can be achieved by providing preconception counseling for cardiac patients. ⋯ Fetal monitoring is inevitable for prompt correction of operative conditions in case of impending hypoxemia. The perioperative fetal risk can be reduced by applying normothermia, high mean arterial pressure and cardiac index during the intentionally shortest intervention. Cardiac operation with cardiopulmonary bypass during pregnancy has become a relatively safe procedure for the mother but not for the baby.