Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Repairs of umbilical and epigastric hernias are common surgical procedures; the choice of the surgical method generally depends on the size of the hernial sac and fascial defect. ⋯ Early complications were slightly more frequent in epigastric hernia repairs with mesh implantation, but this was not the case of umbilical hernias. We recommend mesh implantation in larger and borderline sized hernias to reduce the risk of recurrence.
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The history of blood administration in injured patients in the prehospital care started early after the discovery of blood groups in the first decade of the 20th century. The first practical experiences were gained by army during World War I. During the 20th century blood products were not admini-stered in the civilian prehospital care due to the risk of infectious disease transmission, transfusion reactions and donor deficiency. ⋯ Prehospital blood administration is feasible and safe. However, what is the most beneficial blood product for a patient with severe hemorrhagic-traumatic shock during the prehospital phase? This question is now explored in ongoing studies. This paper provides an overview of current policies for pre-hospital blood products administration.
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Pectus excavatum is the most common congenital chest wall deformity. Aproximatelly 1 out of 400 to 1000 newborns are affected by this diagnosis. Surgical correction is indicated in patients that fulfil the indication criteria. The highly modified Ravitch correction (HMRR) and minimally invasive pectus excavatum repair (MIRPE) are by far the most popular methods of correction. MIRPE has been established as the method of choice amongst children. Feasibility of the minimally invasive approach in the funnel chest correction in adult population still remains controversial. ⋯ adult patients - MIRPE pectus excavatum.
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Irreversible electroporation (IRE) is a quite novel method of tissue ablation. Its mechanism of action that does not use thermal energy is the most important feature of the method. Current experience with IRE in animal studies and in clinical practice are summarized in the paper. In particular, the paper is focused on using IRE in locally advanced pancreatic carcinoma. ⋯ Irreversible electroporation is a safe method used to decrease tumour mass in pancreatic cancer. Further studies are needed to determine its therapeutic efficiency.
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The purpose was to identify 5-year survivors among a group of radically resected patients with pancreatic cancer and analyse the characteristics and factors associated with their 5-year survival. Single tertiary centre experience. ⋯ Factors associated with an improved overall survival included: the absence of lymph node infiltration, an uncomplicated postoperative course, absence of vascular invasion, no need of blood transfusions, and finally the use of postoperative chemotherapy. Vascular invasion, use of blood transfusions and postoperative adjuvant chemotherapy were significant independent prognostic factors of survival.