Negative pressure wound therapy of an anal cancer to facilitate further treatment – case report.

A common treatment of bad healing wounds is vacuum assisted therapy (negative pressure wound therapy). The main clinical goal are: reduced time of wound healing, decreasing frequency of septic complications, and better functional and cosmetic effect. One of the main contraidications include a malignant process in the patient, however, it is reported that in some cases it has achieved possitive results. 68 years-old man was admitted to the hospital due to resection of giant anal cancer. Because of severe problems with passing stool, size of the lesions, sphincter infiltration and full dysfunction, according to the patient’s acceptation abdominoperineal rectal resection with end colostomy was performed. An open, non-healed wound was a contraindication for radiotherapy – the most advisable type of treatment in advanced anal cancer. Despite of potential malignancy in the wound, because the non-healed wound delaying the radiotherapy the negative pressure wound therapy was introduced to improve healing, close the wound and enable radiotherapy. Potential benefits and risks of npwt treatment should always be considered. In some selected cases of oncologic patients after the surgery npwt can be considered, especially when our treatment is used in palliative management or even when the proliferation of neoplastic tissues does not affect the duration of life (paliative treatment, morbidity, old age etc.)   &nbsp

Negative pressure wound therapy of an anal cancer to facilitate further treatment – case report.

A common treatment of bad healing wounds is vacuum assisted therapy (negative pressure wound therapy). The main clinical goal are: reduced time of wound healing, decreasing frequency of septic complications, and better functional and cosmetic effect. One of the main contraidications include a malignant process in the patient, however, it is reported that in some cases it has achieved possitive results. 68 years-old man was admitted to the hospital due to resection of giant anal cancer. Because of severe problems with passing stool, size of the lesions, sphincter infiltration and full dysfunction, according to the patient’s acceptation abdominoperineal rectal resection with end colostomy was performed. An open, non-healed wound was a contraindication for radiotherapy – the most advisable type of treatment in advanced anal cancer. Despite of potential malignancy in the wound, because the non-healed wound delaying the radiotherapy the negative pressure wound therapy was introduced to improve healing, close the wound and enable radiotherapy. Potential benefits and risks of npwt treatment should always be considered. In some selected cases of oncologic patients after the surgery npwt can be considered, especially when our treatment is used in palliative management or even when the proliferation of neoplastic tissues does not affect the duration of life (paliative treatment, morbidity, old age etc.)  

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline