Gallbladder carcinoma - when to use laparoscopic approach?

Aim: To assess how laparoscopy has altered the presentation of patients with gallbladder cancer and determine whether radical resection in patients with gallbladder cancer is beneficial.

Method: 47 patients underwent surgery because of suspected gallbladder cancer. Cancer was found incidentally in 29 patients (61.

Predicting venous insufficiency in flaps raised on the deep inferior epigastric system using computed tomography (CT) angiography.

Computed Tomography Angiogram (CTA) has become a routine part of pre-operative assessment of vascular anatomy and design in perforator flaps. We conducted a retrospective cohort study of flap raised on the deep inferior epigastric system (DIES) at our institution in order to identify CTA signs that might predict venous congestion in these flaps. 98 consecutive patients who had 124 DIES flaps raised from 2008 to 2012 were studied.

[Arterial embolisms in the extremities].

The authors discuss the causes of development of embolism into the peripheral vessels. The most frequent site of embolism in the lower extremity is the a. femoralis communis and a.

[Surgical treatment of acute diverticulitis of the large intestine].

The authors analyze in this paper covering a ten-year period (1990-1999) a group of patients with acute perforated diverticulitis. The patients were classified according to Hinchey's classification. During this period 35 patients were operated with a high preoperative morbidity.

[The "open abdomen" as one of the possible therapeutic alternatives in postoperative complications].

The authors discuss the important problem of healing, infection of surgical wounds and causes of healing per secundam. Despite efforts on the part of surgeons to close the surgical wound, in particular in old people with polymorbidity, hypoproteinaemia and anaemia, disintegration of the surgical wound may occur which cannot be closed and healing must proceed while the abdomen is open.

[True aneurysms of the popliteal artery--surgical treatment].

The authors discuss the history of treatment of popliteal aneurysm, causes of its development and its surgical treatment. They recommend surgery of an asymptomatic aneurysm with a diameter greater than 2 cm because of possible development of thrombosis with subsequent embolization into the periphery and development of gangrene of the extremity which may end by amputation. Early thrombolysis of a thrombotized aneurysm can be successful and combined with subsequent surgery can save the extremity.

[Transverse laparotomy closed with continuous absorbable loop sutures].

The authors emphasize the advantages of a transverse incision which are beyond doubt, because they provide the surgeon not only with an excellent bilateral view of the operated area, but what is most important, they have the significantly least negative effect on respiratory functions and the composition of blood gases, which is of major importance in patients with chronic respiratory failure. Due to the much smaller retraction forces the incidence of postoperative dehiscences and hernias is smaller. It is an incision which interferes least with the innervation of the abdominal wall and thus is not only less painful but has also better healing parameters.

Urgent proctocolectomy in ulcerative colitis.

UC being a typical medical disease is encountered by the surgeon only in the stage of toxic megacolon or in case of severe complication during conservative treatment such as perforation, haemorrhage, obstruction or malignity. The authors operated urgently 6 young women with all these complications performing total proctocolectomy, constructing ileal pouch with complete stapling technique. In spite of high rate of complications the results are promising.

[Comprehensive prevention of postoperative thrombosis].

Thromboembolic disease with its high mortality and morbidity is currently one of the most serious postoperative complications. Its occurrence in high-risk patients in surgical wards is 25-50%. Since 1979, the authors have examined 160 risk patients in whom no prevention had been performed.

[Myxoma embolizing into both lower extremities].

Authors refer about an extremely rare embolisation of a myxoma into the both lower limbs. Despite of late diagnosis an embolectomy after 28 hours was successful.