Acta chirurgica Hungarica
-
A case of severe stricture and a case of tracheogastric fistula after laryngopharyngo-esophagectomy and pharyngogastrostomy for cervical esophageal cancer are described. Stricture is often seen but tracheogastric fistula is a rare complication, however, both are devastating conditions. According to the literature, the survival rate is poor in both cases. ⋯ The survival of the patient treated with free jejunal interposition exceeds 24 month. Unfortunately, the patient with tracheogastric fistula, treated with interpositioned sternocleidomastoideus muscular flap, lived two weeks after this operation. The surgical managements described in this report may provide palliation or definitive treatment for these devastating complications.
-
Acta chirurgica Hungarica · Jan 1997
Case ReportsSplenectomy and spleen autotransplantation due to splenic cyst.
Splenectomy is known to increase the risk of Overwhelming Postsplenectomy Infection (OPSI). Autotransplantation is one of the possibilities to preserve splenic functions. ⋯ Ten pieces from the intact spleens each sized 10 x 20 x 2 mm were implanted in between the plates of the great omentum according to Furka's spleen apron method. The function of the reimplanted splenic tissue was demonstrated by scintigraphic investigations.
-
Acta chirurgica Hungarica · Jan 1997
Comparative StudyAnaesthesiological indications and contraindications of minimally invasive surgery.
Spreading of laparoscopic techniques caused changes in anaesthesiological contraindications. In the first period laparoscopy was contraindicated in ischemic heart disease (IHD). Early mobilisation and short postoperative period are positive goals, IHD was taken out of contraindications. ⋯ TIVA with Propofol is better choice because of its favourable effects on circulation and acid-base balance. Using N2O caused higher grade of intestinal distension. The cardio-respiratory, blood gas parameters and acid-base balance have to be monitorised in perioperative period of laparoscopic surgery.
-
Acta chirurgica Hungarica · Jan 1997
The role of different tumor markers in the early diagnosis and prognosis of pancreatic carcinoma and chronic pancreatitis.
The examination of tumor markers in the diagnosis and in the evaluation of progression of tumors has got an increasing significance. The serum level changements of three tumor markers (CEA, CA 19-9, CA 125) were examined before and after the operation in 94 patients operated for pancreatic carcinoma (PC) and chronic pancreatitis (CP) between March 1994 and December 1996 at the 2nd Dept. of Surgery of Debrecen Medical University. From the patients 62 were operated for carcinoma, in 19 cases the tumor was resectable, 43 patients had palliative operation. ⋯ The authors evaluate the serum level changements of the three tumor markers examined in three groups of patients before and after the operation. In conclusion CA 19-9 is the most sensitive marker of PC, the sensitivity was 77.4%, the specificity was 87.5%. CEA and CA 125 are not as sensitive markers of PC as CA 19-9, while CEA and CA 125 serum levels are both increased in half of the patients with chronic pancreatitis.