[A pilot study: correction of the levator hiatus using an anal sling as a surgical treatment of faecal incontinence].

Introduction: Faecal incontinence is a significantly depressing and mentally devastating disability. Surgical treatment, as a first choice method, is indicated for incontinence originating as a result of traumatic or iatrogenic infliction of the sphincter apparatus, particularly of the external sphincter. In case of idiopathic (neurogenic) incontinence, it is indicated very exceptionally, if ever.

[Micturition, sexual and defecation disorders in middle-aged women after pelvic fractures. A comparative study].

Purpose Of The Study: To present the results of a three-year study on micturition, defecation, gynecological and sexual disorders in middle-aged women who sustained pelvic fractures.

Material And Methods: A group of 33 female patients who were treated for unstable pelvic fractures (AO types B or C) in the 2004-2009 period were evaluated (treated group) and compared with 31 women who had given vaginal birth at least once and went to see a urologist because of urinary problems in the period from 2009 to 2010 (control group). The questionnaires used in the study included ICIQ, UIQ, UDI and PISQ12 instruments.

[Comparison of micturition, sexual and defecation disorders in females following type B and C pelvic fractures].

Introduction: The objective of this work is to present results obtained in a three-year study focussed on micturition, defecation and sexual disorders in women of active age.

Methods: The monitored set consisted of 33 female patients treated in 2004-2009 for unstable pelvic fracture (B-type or C-type according to AO classification). Out of them 25 patients suffered B-type fracture and 8 patients suffered C-type fracture.

[The spectrum of diaphragmatic injuries managed in a Prague traumatology centre].

Introduction: Diaphragmatic injuries may result from blunt or penetrating injuries. The symptomatology is usually overlaid by symptoms of associated abdominal or thoracic injuries or by symptoms of other systems injuries in polytraumas. Multidetector computer tomography (MDTC) facilitates the improvement of preoperative diagnostics in blunt injuries.

Peroperative optical autofluorescence biopsy--verification of its diagnostic potential.

The authors tested the diagnostic potential of the portable autofluorescence optical system that was developed in the preoperative evaluation of resection margins, and thus of the resection line safety in patients with low-positioned colorectal carcinoma. A total of 217 spectral measurements of the fluorescence properties of normal (117) and malignant (100) tissues in 19 patients with colorectal carcinoma were accomplished. The measured spectra thus acquired were then evaluated using logistic regression.

[Antimicrobial treatment of nosocomial intra-abdominal infections--new treatment options with tygecycline].

Introduction: Nosocomial, intra-abdominal infections are extremely serious conditions, considering possibilities for their early diagnosis, as well as for their effective therapy. Multiresistant bacteria (Enterobacteriacae producing extended-spectrum beta-lactamases - ESBL Escherichia coli, Klebsiella species, vancomycin-resistant enterococci [VRE], and methicillin-resistant Staphylococcus aureus [MRSA]) are frequently isolated as pathogens of these infections. Tygecycline is among the novel wide- spectrum antibiotics affecting multiresistant bacteria, which are being introduced in clinical practice.

[Damage control laparotomy in blunt abdominal injury].

Purpose Of The Study: Damage control surgery is one of the major advances in surgical techniques used in polytrauma patients in the past 25 years. It is based on a foreshortened pre-operative examination during ongoing resuscitation which includes surgical intervention in an injured patient with severe hypotension due to haemorrhage. In this seven-year retrospective study the authors evaluate the results of damage control laparotomy in patients with injury to the abdominal organs, retroperitoneum and pelvis.

Transrectal stent in endoscopic palliative therapy of malignant stenosis of the rectum.

Background/aims: To check the feasibility and safety of endoscopic stent introduction in colorectal cancer therapy.

Methodology: A total of 62 patients with inoperable tumors of the rectum and rectosigmoid were treated by introducing stents. Stents were also introduced in 3 patients with advanced prostate tumors obturating (narrowing) the rectum.

Photodynamic therapy of human colorectal carcinoma cell line.

Colorectal cancer is one of the most common cancers in Europe and North America and it is the most common gastrointestinal carcinoma. The population in the Czech Republic has a higher incidence of colorectal carcinoma compared to other countries. Efforts are underway to develop better screening strategies and novel therapies to improve patient survival rates.

[Surgical site infection following proximal GIT procedures].

Introduction: Surgical site infections (ICHM) remain a serious problem in the proximal GIT surgery, with incidence rates from 5% to 26% in planned procedures, and up to 40% in urgent procedures. Surgical site infections result in increased postooperative morbidity and mortality rates, prolonged hospitalization and increased treatment costs. Minimalization of the surgical site infection rates is an important epidemiological and therapeutical objective.

[Polytraumas in injured patients over 65 years of age].

Introduction: Geriatric trauma is most commonly defined as a trauma in patients of 65 years of age and over. These patients represent a specific problem due to their vulnerability, limited physiological response to the traumatic stress and high frequency of associated disorders, complicating the treatment. The aim of this report is to assess polytrauma patients of 65 years of age and older, compared to a group of younger patients.

[Postoperative nutritional support in liver surgery. Effects of specialized parenteral nutrition enriched with branched-chain amino acids following liver resections for colorectal carcinoma metastases].

Introduction: Perioperative nutritional support in liver surgery remains specific regarding the role of the liver in the metabolism regulation. The loss of functional liver tissue following resection procedures may result in significant metabolic disorders, particularly in patients with preoperative liver impairment in chronic conditions. Perioperative nutritional support is indicated in patients suffering from malnutrition, chronic liver disorders and also following liver resections with limiting residual parenchyma.

Comparison of photodynamic therapy with phthalocyanine and photofrin in human colorectal carcinoma.

Photodynamic therapy (PDT) has been developed in recent years as a new modality for the treatment of various neoplastic and non-neoplastic lesions. Although the method of combining light with photosensitizers for treatment has been around for a century, further understanding has been evolved over the past decades. The method is based on the phenomenon involving the combination of photosensitizer and light.

[Technical aspects of the liver resection procedure--options for combinations of individual methods].

Introduction: The liver resection procedure as a treatment method of benign and malignant hepatobiliary disorders grows more important due to the fact, that its postoperative morbidity and mortality rates have been reduced, a result of the patients selection method, surgical techniques and perioperative care improvements. The aim of this report was to assess combinations of recent liver transsection techniques, based on the authors' own experience and results of recent studies.

Material, Methods And Results: From 1999 to May 2005, in the Surgical Clinic of the Faculty Hospital Královské Vinohrady in Prague, the liver resection procedure was completed in 133 patients with benign or primary and secondary malignant tumors.

[Diverticulosis of the small intestine--the authors study group and a case review].

Our case review describes an unusual case of an acute GIT haemorrhaging, caused by multiple diverticulosis of the proximal jejunum. The disorder is rare, rarely reported in literature worldwide. The typical course of the disease is asymptomatic, manifesting itself late as acute complications, most commonly urgent abdominal disorders.

[Anatomical resection for liver metastases of the carcinoma of the large intestine and the rectum].

Unlabelled: Resection of the colorectal carcinoma liver metastases is an effective therapeutical procedure with a five-year survival rate in 20-50% of the operated. Opinions on the most optimal type of the resection procedure remain to be controversial. The aim of this study was to assess all indication criteria for anatomical resections of the colorectal carcinoma liver metastases.

[Non-surgical aproach in blunt injuries to the liver and spleen].

Introduction: Non-surgical approach in blunt injuries of the liver and spleen in patients haemodynamically stable, is widely accepted as their therapeutical method of choice. Based on a retrospective analysis, the aim of this study is to assess the injured patients with blunt injuries of the liver and spleen who were treated non-surgically.

Subjects And Methodology: 75 injured patients with blunt intraabdominal injuries were hospitalized from 2001 to 2003.

[What are indications for hepatic resection in metastases?].

Introduction: In the last 20 years the resection of liver metastases became the method of choice in the therapy of malignant tumors, particularly of colorectal cancer. The study was aimed at evaluating indication criteria and operation tactics in liver metastases resection.

Materials And Methods: The authors retrospectively analyzed a group of 154 patients subjected to liver resection for metastases, having been operated on since 1980 to May 2003.

[Current diagnostic and therapeutic approaches in liver injuries].

Purpose Of The Study: The recent improvements in hospital care system (centralized specialized care) and the use of new imaging methods and modern technologies in surgical treatment have greatly enhanced successful outcomes of therapy in liver injury. The aim of the study was to evaluate the contribution of procedures included in the diagnostic-therapeutic algorithms to the treatment of blunt injury to the liver in our patient population.

Material: Our group consisted of 43 patients with blunt injury to the liver who were treated at the Emergency Department between 1998 and 2002.

[Liver transection with the harmonic scalpel in elective liver surgery].

More procedures used in transection of the liver parenchyma include also resection by means of a harmonious scalpel with an enhanced haemostatic effect. Based on analysis of 51 patients operated on account of liver disease using a harmonious scalpel, the authors evaluate its asset to the liver resection technique. The harmonious scalpel was used in transection of the liver in seven patients with benign liver disease (inborn cysts, follicular nodular hyperplasia, haemangioma, hepatocellular adenoma) and in 44 with malignant disease (hepatocellular carcinoma, metastases, most frequently, i.

[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.

[When is resection indicated in primary liver tumors?].

The development of hepatic surgery involved also definition of indications for resection in primary liver tumours. Based on an analysis of a group of 76 patients with primary liver tumours operated in 1978-2001 (up to the end of October) the authors evaluated the indication criteria for resection of primary hepatic tumours. As to benign tumours most frequently haemangiomas were resected (in 35 patients) and follicular nodular hyperplasia in 10 patients.

[Treatment of the agitated patient in surgical practice].

The authors discuss in their paper treatment of amented delirious conditions as a complication after an urgent or elective surgical operation. Contrary to hitherto applied practice, where treatment is started only at the onset of the mental disorder, the authors administered treatment in selected patients immediately after surgery. The results revealed a marked decrease of amented delirious conditions in the group of patients where treatment was started immediately after surgery.

[Amputation of the lower extremities, contribution of collaboration with a vascular surgeon].

In 1990 due to collaboration with a vascular surgeon the care of patients with diseases of the peripheral vessels of the lower extremities improved. As compared with previous years, the rate of amputations of the thigh changed markedly as well as the rate of reoperations and the period of hospitalization was reduced.