Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Urgent abdominal disorders are a daily work routine at surgical departments. Therefore, all surgeons are familiar with the problematics, including all its pitfalls, e.g. high morbidity rates and mortality rates of the patients managed. The authors record urgent abdominal disorders mortality rates as well as rates of serious surgical complications requiring re-operations and their effect on the patients' prognosis. ⋯ Peritonitis in some form (50%), dehiscence of the laparotomy (31.2%), necrosis of the intestine, ileus, bleeding and some less frequent complications, were the most frequent indications for re-laparotomies. The thirty-day mortality rate in patients, operated for urgent abdominal disorders, was 4.8%. In the re-operated group, the mortality rate reached 19.4%.
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Mesenteric artery embolisation is serious complication of heart diseases. Its mortality is almost 95%. ⋯ This sign can be very helpful in diagnostics and consequently in treatment of this disease. Late diagnostics and treatment of vascular ileus has fatal prognosis.
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Case Reports
[A postoperative bronchopleural fistule--a success of the conservative treatment (a case review)].
Disintegration of the bronchial stub following the lung resection procedures together with development of the bronchopleural fistule and the postoperative empyema of the thorax, remain a feared complication following all lung resections, but especially pneumonectomies. In this case review, the authors report on a successful conservative management case, which followed an unsuccessful surgical revision and an attempt for the endobronchial stent introduction. 20 months following the closure of the fistule, the patient shows no signs of a relapse of the disorder.
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Perioperative optimalization of haemodynamics is associated with improved post-operative development, as presented in most published studies. This study has confirmed that intra-operative correction of cardiac output back to it's physiological level is associated with improved post-operative course in the group of patients undergoing major elective intraabdominal surgery. Statistically significant decreasing of post-operative complications (4.7% vs 17.7%), decreased length of stay (LOS) in the ICU by 33% and decreased LOS in the hospital by 24% was recorded. Interpretation of the study could be limited by using non-indexed cardiac output values and higher female presentation in the group of patients (although statistically not significant).