[Hemorrhagic complications of warfarin therapy].

Introduction: Introduction of warfarin use in prevention and treatment of thromboembolic diseases resulted in lower rates of thromboembolic complications, however, on the other hand, it has been associated with increased incidence of hemorrhagic complications,which often require surgical management. AIM, MATERIAL, METHODS: The aim of the study was a retrospective analysis of hemorrhagic complications in 184 patients, hospitalized in the FNKV (Královské Vinohrady Faculty Hospital) Surgical Clinic during 2000-2008, following warfarin overdose. The following diagnostic or treatment methods were used: endoscopy of the upper or lower GIT in GIT hemorrhages and spiral CT when peritoneal bleeding was suspected.

[The harmonic scalpel and surgery of the thyroid gland].

Unlabelled: The objective of the investigation was to test the effects and properties of a harmonious scalpel in operations of the thyroid gland. During a three-year period (1999-2001) for this indication at the Surgical Clinic of the Third Medical Faculty Charles University Prague on account of this indication 306 patients were operated, 133 with a harmonious scalpel and 173 by the classical technique. In the experimental part the authors made sure first that the necrotic changes in tissues surrounding the thyroid gland caused by the ultrasonic blade do not reach further than 1 mm from the line of resection.

[Laparoscopic surgery of gastric diverticula with secondary adhesiolysis].

The authors present the case-history of a rare cause of gastric diverticulum. On account of a very painful symptomatology and X-ray evidence of a diverticulum the authors decided on laparoscopic excision of the diverticulum. The resection was made using a Endo GIA II stapler.

[Infiltration of local anesthetics into the thyroid gland capsule for surgery and the postoperative period].

In a prospective randomized study the hypothesis was tested whether infiltration of the thyroid capsule by a local anaesthetic will reduce the haemodynamic response to surgical trauma, consumption of anaesthetics and opioids during surgery and will shorten the time of arousal. A total of 64 patients indicated for planned goitre surgery were divided at random into a control group (C, n = 32) and experimental group (LA, n = 32). The preoperative medication and anesthesia did not differ in the two groups.

[Traumatic rupture of the diaphragm in blunt injuries].

The authors present a group of 12 casualties operated on account of a traumatic rupture of the diaphragm. The rupture of the diaphragm was part of an associated thoracoabdominal injury or multiple injury. The casualties were examined within the framework of the diagnostic algorithm, in 11 of them rupture of the diaphragm was proved by spiral computed tomography.