Polski przeglad chirurgiczny
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Background - In December 2019 following an outbreak of Novel coronavirus infection (COVID-19) in Wuhan, China, it spread rapidly overwhelming the healthcare systems globally. With little knowledge of COVID-19 virus, very few published reports on surgical outcomes; hospitals stopped elective surgery, whilst emergency surgery was offered only after exhausting all conservative treatment modalities. This study presents our experience of outcomes of emergency appendectomies performed during the pandemic. ⋯ Our study shows that with careful planning and strict theatre protocols, emergency appendicectomy can be safely offered with minimal risk of spreading COVID-19 infection. These observations warrant further prospective randomised studies. Keywords - appendicectomy, COVID-19, Coronavirus, emergency surgery, laparoscopy.
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In the last several weeks we have been witnessing the exponentially progressing pandemic SARS-CoV-2 coronavirus. As the number of people infected with SARS-CoV2 escalates, the problem of surgical management of patients requiring urgent surgery is increasing. Patients infected with SARS-CoV2 virus but with negative test results will appear in general hospitals and may pose a risk to other patients and hospital staff. ⋯ Limited availability of the equipment, working under pressure and staff shortages in addition to a highly contagious pathogen necessitate a pragmatic management of human resources in health care. Instant synchronized action is needed, and clear uniform guidelines are essential for the healthcare system to provide citizens with the necessary surgical care while protecting both patients, and staff. This document presents current recommendations regarding surgery during the COVID-19 pandemic in Poland.
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It is extremely difficult to provide non-compressible torso hemorrhage control particularly in trauma setting. A vast majority of cases present inability of successful exsanguination arrest, leading to cardiovascular collapse, myocardial and cerebral hypoperfusion and death eventually. The only possible treatment for these patients is prompt bleeding control, either open or endovascular. ⋯ This method together with invasive endovascular and surgical procedures creates a new approach of choice for trauma patients. It is called Endovascular Hybrid Trauma and Resuscitation Management (EVTM) and introduces this concept to modern clinical practice. Through a detailed review, this article aims to introduce REBOA procedure to a broader recipient and present REBOA details, benefits and limitations.
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The most common complications after thyroidectomy are postoperative neck hematoma, recurrent laryngeal nerve injury and hypoparathyroidism [1]. However, iatrogenic cervical esophageal perforation is a very rare repercussion of this procedure. In literature there are a few reported cases concerning this complication. We want to report a case of a patient with severe esophageal injury resulting from thyroidectomy.
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Insertion of temporary and tunneled catheters for hemodialysis in the internal jugular vein is a "gold standard". On the other hand, the supraclavicular approach to the subclavian vein was described by Yoffa in 1965. Despite its old invention, the latter technique has been well forgotten for unknown reasons. The aim of this study is to present our experience with the usage of the supraclavicular approach for insertion of temporary and tunneled catheters as vascular access for hemodialysis treatment. ⋯ We conclude that the supraclavicular approach to the subclavian vein is an easier, safer and practically more convenient method than cannulation of the IJV. The revisit of this approach demonstrates that it should be used more widely.