Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
-
Blunt injury of the carotid artery is uncommon but serious injury with high mortality and morbidity. The symptomatology may be inconspicuous, in other case a neurological deficit is present. ⋯ The diagnosis is usually confirmed by CT scan, CT angiography, MRI. In the therapy in present prevail heparin anticoagulation and endovascular stent implantation in some cases.
-
The aim of this study was to assess the heterotopic ossification rate (HO), the range of motion of the operated, as well as the adjacent segments and the clinical condition of patients following cervical arthroplasty over a medium-term period. ⋯ 39-48 months following the Prodisc-C implantation, the below findings were demonstrated: 1. Statistically significant improvement in NDI by 48.13%, improvement in cervical pain VAS by 65.75% and radicular pain VAS improvement by 67.31%. 2. Arthroplasty resulted in improved sagittal balance of the cervical spine and the resulting lordosis of the operated segment was more pronounced. 3. HO was detected in 56.25% of the operated segments and resulted in a complete loss of the arthroplasty mobility in 18.75% of the segments. 4. No cases of the implant dislocation, subsidence or non-healing were observed, no subjects required surgical revisioning. 5. No cases of "adjacent segment diseases" were recorded.
-
Case Reports
[Case report: fat embolism syndrome--grave handicap after traumatic long-bones fractures].
Embolism of fat and bone marrow tissue is quite often due to bone fractures but it is seldom with signs of systemic involvement as a fat embolism syndrome. The main forming factor is late stabilization of fractures and hypovolemia too. Clinical image of fat embolism syndrome results from lung and systemic microembolism which leads to activation of inflammatory and thrombogenic cascades. ⋯ One year later he is able to walk alone, he has no visual failure, but he is still quadruspastic although able to manipulate with a mobile phone. We discuss diagnostic criteria and treatment. We also point out need of volumetherapy in prevention of fat embolism syndrome--this was underrated here because of primary missed out diagnose of co-existing tibia fracture at the same time (this was stabilised 18 hours after injury).
-
Laparoscopic surgery for rectal cancer is still debated. The aim of this study was to compare long-term results for patients undergoing laparoscopic or open surgery for rectal cancer. ⋯ In this nonrandomized single centre study the long-term oncologic outcomes were not significantly different in group of patients undergoing laparoscopic surgery for rectal cancer. The probability of survival in the laparoscopic group for stage III carcinoma was conversely significantly better.
-
Bedside ultrasonography is a modern and progressive examinating method. During the past two decades, performing of bedside ultrasonography has repeteadly shown its clinical and economical advantages. Bedside ultrasonography appears to be cost-effective method which provides minimall patient and staff stress. ⋯ Bedside USG had comparable sensitivity to CT in fluidothrorax and abdominal wall colections detection, in some cases even more. For intraabdominal fluid USG represent less accurate method to CT, benefit of CT should be then discussed in each patient individually considering general health condition and basic diagnosis.