Risk factors predicting acute postoperative pain immediately after minimally invasive inguinal hernia repair.

Introduction: Acute postoperative pain remains one of the most common problems, even after laparoscopic or endoscopic hernia repair. Avoiding predictive factors for acute pain after surgery or prescribing additional analgesia for a patient who has risk factors that cannot be removed can be one of the options to reduce acute postoperative pain. However, there is a lack of clinical studies that evaluate the predictive factors of postoperative pain after transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) surgeries.

A scan of all coding region variants of the human genome, identifies 13q12.2-rs9579139 and 15q24.1-rs2277598 as novel risk loci for pancreatic ductal adenocarcinoma.

Coding sequence variants comprise a small fraction of the germline genetic variability of the human genome. However, they often cause deleterious change in protein function and are therefore associated with pathogenic phenotypes. To identify novel pancreatic ductal adenocarcinoma (PDAC) risk loci, we carried out a complete scan of all common missense and synonymous SNPs and analysed them in a case-control study comprising four different populations, for a total of 14 538 PDAC cases and 190 657 controls.

Evaluation of Mobility Status after Inguinal Hernia Surgery.

Background: Many different studies have compared open and laparoscopic-endoscopic inguinal hernia repair techniques according to intraoperative and postoperative complications, recurrence rates, postoperative inguinal chronic pain, quality of life, and costs. Most of the researchers have compared these different inguinal hernia repair techniques using a visual analog scale, a short-form survey instrument, or patients' return-to-normal-activity time, but there is a lack of objective data concerning pelvic function recovery after these procedures.

Aim: To evaluate and compare real hip and leg function recovery times after the application of different inguinal hernia repair techniques using hip and leg mobility, strength, and stability testing for the first time.

Coagulation System Disorders and Thrombosis Prophylaxis During Laparoscopic Fundoplications.

Background: The aim of this study was to assess and recommend the optimal deep vein thrombosis (DVT) prophylaxis regimen during and after laparoscopic fundoplication according to the blood coagulation disorders and the rate of DVT in 2 patient groups, receiving different DVT prophylaxis regimens.

Materials And Methods: This was a prospective randomized, single-center clinical study. The study population, 121 patients, were divided into 2 groups: group I received low-molecular-weight heparin 12 hours before the operation; group II received low-molecular-weight heparin only 1 hour before the laparoscopic fundoplication.

Long-term follow-up results of umbilical hernia repair.

Introduction: Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery.

Aim: To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence.

Material And Methods: A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed.

The choice of optimal antireflux procedure after laparoscopic cardiomyotomy: two decades of clinical experience in one center.

Introduction: Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated.

Thromboelastographic changes during laparoscopic fundoplication.

Introduction: Thromboelastography (TEG) is a technique that measures coagulation processes and surveys the properties of a viscoelastic blood clot, from its formation to lysis.

Aim: To determine the possible hypercoagulability state and the effect of antithrombotic prophylaxis on thromboelastogram results and development of venous thrombosis during laparoscopic fundoplication.

Material And Methods: The study was performed on 106 patients who were randomized into two groups.

Plexiform angiomyxoid myofibroblastic tumor of stomach: A rare case.

Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge to gastroenterologists, pathologists and surgeons when encountering such patients and differentiating PAMT from other gastric intramural tumors. We report a case of 28-year-old woman, who presented with epigastric pain after meals, iron-deficiency anaemia and weight loss.

Trends and results in treatment of gastric cancer over last two decades at single East European centre: a cohort study.

Background: A steady decline in gastric cancer mortality rate over the last few decades is observed in Western Europe. However it is still not clear if this trend applies to Eastern Europe where high incidence rate of gastric cancer is observed.

Methods: This was a retrospective non-randomized, single center, cohort study.

The influence of operation technique on long-term results of achalasia treatment.

Unlabelled: Currently, the most effective therapy for achalasia is laparoscopic Heller myotomy with partial fundoplication. The aim of this study was to compare the long-term results between 2 different laparoscopic operation techniques in achalasia treatment.

Material And Methods: This was a retrospective study, where 46 achalasia patients were examined: 23 patients underwent laparoscopic Heller myotomy followed by the full gastric fundus mobilization, total hiatal dissection, and posterior Toupet (270°) fundoplication (group 1); other 23 patients underwent laparoscopic Heller myotomy with limited surgical cardia region dissection, not dividing the short gastric vessels and performing anterior partial Dor fundoplication (group 2).

Analysis of intracorporeal knotting with invaginating suture versus endoloops in appendiceal stump closure.

Introduction: Laparoscopic appendectomy is a well-described surgical technique and has gained wide clinical acceptance. Laparoscopic appendectomy offers fewer wound infections, faster recovery and an earlier return to work in comparison to open surgery. However, concerns still exist regarding the appendiceal stump closure.

Influence of wrap length on the effectiveness of Nissen and Toupet fundoplications: 5-year results of prospective, randomized study.

Background: Long-term results in antireflux surgery may depend on fundoplication type and wrap length. We compared the outcome of two different wrap lengths among the patients undergoing partial or total fundoplications. This study is the next part of a prospective 5-year follow-up assessment.

Surgical treatment of metastatic tumors of the femur.

Objective: To evaluate the patients functional outcome and pain control after resection of metastatic femoral tumors.

Material And Methods: A prospective randomized clinical study was conducted, which included 26 cases of metastatic tumors of the femur with an associated pathologic fracture. These selected cases were randomly divided into two groups based upon the using of methylmethacrylate cement in fracture fixation.

A combinative effect of low-molecular-weight heparin and intermittent pneumatic compression device for thrombosis prevention during laparoscopic fundoplication.

BACKGROUND. Venous thromboembolism is known to be an important social and health care problem because of its high incidence among patients who undergo surgery. For instance, 20-30% of patients develop this problem after general surgical operations, while 5.

[Surgical treatment of humeral metastatic tumors].

Objective: To evaluate the functional outcome and pain control in patients after resection of humeral metastases.

Material And Methods: A prospective randomized study of 24 cases of metastatic disease of the humerus with an associated pathologic fracture was carried out. The selected cases were divided into two groups based on the using methylmethacrylate cement for fracture fixation.

[Adjuvant therapy after curative resection with D2 lymphadenectomy for gastric cancer: results of a prospective clinical trial].

Objective: Adjuvant chemoradiation for gastric cancer is used more frequently, but there is no general opinion about the effect of this treatment. The aim of this study was to compare adjuvant chemoradiation with adjuvant chemotherapy after radical operation for stomach cancer.

Material And Methods: A total of 133 patients were included in this prospective study.

Umbilical hernia: factors indicative of recurrence.

Unlabelled: Umbilical hernia has gained little attention from surgeons in comparison with other types of abdominal wall hernias (inguinal, postoperative); however, the primary suture for umbilical hernia is associated with a recurrence rate of 19-54%. The aim of this study was to analyze the results of the umbilical hernia repair and to assess the independent risk factors influencing umbilical hernia recurrence.

Materials And Methods: A retrospective analysis of patients who underwent surgery for umbilical hernia in the Hospital of Kaunas University of Medicine in 2001-2006 was performed.

Influence of wrap length on the effectiveness of Nissen and Toupet fundoplication: a prospective randomized study.

Background: Incontinence or hypercontinence of the fundic wrap depends primarily on the length of the valve or the type of procedure. Much less attention has been paid to the fundic wrap length. This study aimed to compare the effectiveness of two different wrap lengths among the patients undergoing partial or total fundoplication.

Long-term results of incisional hernia treatment.

Unlabelled: Ventral hernia is a common problem in general surgery practice. Incisional hernia can develop in 15-25% of patients after abdominal surgery. The aim of this study was to compare two different methods of incisional hernia surgery.

Hiatal hernia recurrence after laparoscopic fundoplication.

Objectives: To determine the influence of hiatal hernia size and the laparoscopic fundoplication technique on the rate of hernia recurrence.

Patients And Methods: The preoperative, operative, and postoperative observational data of 381 patients operated on at the Department of Surgery of Kaunas University of Medicine during the period of 1998-2004 for hiatal hernia complicated with gastroesophageal reflux were analyzed. The surgery technique (Nissen or Toupet operation) was chosen independently of the hernia size.

The effect of passive foot flexion on blood circulation in sports and clinical medicine.

Unlabelled: The aim of the study was to analyze the effect of the passive foot flexion on peripheral and systemic blood circulations in the state of rest of persons adapted to endurance physical loads, and on patients during surgery.

Methods: In the first series of experiments which included 16 males in recumbent supine position adapted to endurance physical loads, the effect of the passive foot flexion by applying a leg muscle activator on the systemic and peripheral blood circulations was analyzed. In the second series of experiments conducted with 6 males and 12 females, the passive foot flexion was aimed at preventing thromboembologenesis during the intraoperative period.

[Hiatal hernia and gastroesophageal reflux: possibilities and results of surgical treatment].

In this article we analyze our experience of surgical treatment of hiatal hernia, complicated with gastroesophageal reflux. We operated 134 patients with hernia hiatus esophagi, complicated with gastroesophageal reflux, from 03.1998 till 10.