Single Incision Laparoscopic Cholecystectomy – A New Advantage of Gallbladder Surgery

In this study is demonstrated our experience in single incision laparoscopic cholecystectomy (SILS), compared to standard laparoscopic cholecystectomy. There were 48 single incision laparoscopic cholecystectomies (SILS) performed during one-year period (A group) and results have been compared with a group of 50 patients who underwent standard laparoscopic cholecystectomy (B group). Outcome measures included operative time, need for conversion, complications, additional analgesia for pain control after procedure, hospital stay and cosmetic outcome. The mean operative time was 46+/–3.5 min in A group, and 43+/–4 min in B patients group. Early postoperative complications were not detected. The mean hospitalization period was 2 days in both groups. Our experience suggests that SILS cholecystectomy can be performed with outcome similar to standard laparoscopic surgery while affording better cosmesis

Two-Incision Laparoscopic Cholecystectomy – Our Experience

Cilj: Članak opisuje tehniku i rezultate izvođenja laparoskopske kolecistektomije kroz dvije incizije, primijenjene na 42 bolesnika, te ju uspoređuje sa standardnom laparoskopskom kolecistektomijom. Metode: Učinjena je laparoskopska kolecistektomija kroz dvije incizije (skupina A) u 42 bolesnika. Rezultati su uspoređeni s rezultatima standardne laparoskopske kolecistektomije (skupina B – 50 bolesnika). Rezultati: Srednje operacijsko vrijeme bilo je 45 ± 3,5 min (skupina A) i 43 ± 4 min (skupina B). Nisu zabilježene unutaroperacijske ili poslijeoperacijske komplikacije. Srednje vrijeme hospitalizacije bilo je jednako u objema skupinama. Zaključak: Laparoskopska kolecistektomija kroz dvije incizije jednako je siguran postupak kao standardna laparoskopska kolecistektomija kroz tri incizije, ali s boljim estetskim rezultatom te bez dodatnih troškova.Objective: This article describes the technique and the results of two-incision laparoscopic cholecystectomy performed on 42 patients, and compares it with standard cholecystectomy. Methods: Two-incision laparoscopic cholecystectomy (group A) was performed on 42 patients. Results were compared with standard laparoscopic cholecystectomy (group B) – 50 patients. Results: Mean operative time was 45 ± 3.5 min (group A), and 43 ± 4 min (group B). No intraoperative or postoperative complications were observed. Average hospital stay was equal in both groups. Conclusion: Two-incision laparoscopic cholecystectomy is equally safe as standard laparoscopic cholecystectomy with three incisions but with better cosmetic results and without the extra cost

Laser Treatment in Hemorrhoidal Disease - Our Experience

Cilj: U ovome se članku iznose iskustva, tehnika i rezultati u 21 bolesnika s hemoroidalnom bolešću, koji su operirani diodnim laserom. Metode: Učinjena je hemoroidektomija diodnim laserom u 21 bolesnika s verificiranim II.-III. stupnjem hemoroidalne bolesti. Rezultati: Prosječno trajanje operacije bilo je 15 ± 2 minute, a prosječna hospitalizacija 24 sata. Tijekom 12-omjesečnoga praćenja nije zabilježen ni jedan neželjeni događaj u vidu krvarenja, infekcije ili recidiva bolesti u svih operiranih bolesnika. Dodatna analgezija bila je potrebna u četvero bolesnika. Zaključak: Uporaba diodnoga lasera predstavlja dodatnu metodu u liječenju hemoroidalne bolesti te je potrebna daljnja evaluacija u budućim studijama, koja će potvrditi uspješnost te metode.Objective: This article brings experiences, technique and results in 21 patients with haemorrhoidal disease treated with diode laser. Methods: In this study, 21 patients with II-III grade haemorrhoidal disease were included and treated with diode laser. Results: Average operation time was 15 + 2 minutes, with 24-hour hospitalisation. During the follow-up period of 12 months, there were no observed complications, such as bleeding, infections or recurrence. Extra anaelgetics were required in four cases. Conclusion: The use of diode laser in haemorrhoidal disease represents an additional treatment method, where as further studies are yet to evaluate and definitely confirm the successfulness of this method

Laser Treatment in Hemorrhoidal Disease - Our Experience

Cilj: U ovome se članku iznose iskustva, tehnika i rezultati u 21 bolesnika s hemoroidalnom bolešću, koji su operirani diodnim laserom. Metode: Učinjena je hemoroidektomija diodnim laserom u 21 bolesnika s verificiranim II.-III. stupnjem hemoroidalne bolesti. Rezultati: Prosječno trajanje operacije bilo je 15 ± 2 minute, a prosječna hospitalizacija 24 sata. Tijekom 12-omjesečnoga praćenja nije zabilježen ni jedan neželjeni događaj u vidu krvarenja, infekcije ili recidiva bolesti u svih operiranih bolesnika. Dodatna analgezija bila je potrebna u četvero bolesnika. Zaključak: Uporaba diodnoga lasera predstavlja dodatnu metodu u liječenju hemoroidalne bolesti te je potrebna daljnja evaluacija u budućim studijama, koja će potvrditi uspješnost te metode.Objective: This article brings experiences, technique and results in 21 patients with haemorrhoidal disease treated with diode laser. Methods: In this study, 21 patients with II-III grade haemorrhoidal disease were included and treated with diode laser. Results: Average operation time was 15 + 2 minutes, with 24-hour hospitalisation. During the follow-up period of 12 months, there were no observed complications, such as bleeding, infections or recurrence. Extra anaelgetics were required in four cases. Conclusion: The use of diode laser in haemorrhoidal disease represents an additional treatment method, where as further studies are yet to evaluate and definitely confirm the successfulness of this method

Two-Incision Laparoscopic Cholecystectomy – Our Experience

Cilj: Članak opisuje tehniku i rezultate izvođenja laparoskopske kolecistektomije kroz dvije incizije, primijenjene na 42 bolesnika, te ju uspoređuje sa standardnom laparoskopskom kolecistektomijom. Metode: Učinjena je laparoskopska kolecistektomija kroz dvije incizije (skupina A) u 42 bolesnika. Rezultati su uspoređeni s rezultatima standardne laparoskopske kolecistektomije (skupina B – 50 bolesnika). Rezultati: Srednje operacijsko vrijeme bilo je 45 ± 3,5 min (skupina A) i 43 ± 4 min (skupina B). Nisu zabilježene unutaroperacijske ili poslijeoperacijske komplikacije. Srednje vrijeme hospitalizacije bilo je jednako u objema skupinama. Zaključak: Laparoskopska kolecistektomija kroz dvije incizije jednako je siguran postupak kao standardna laparoskopska kolecistektomija kroz tri incizije, ali s boljim estetskim rezultatom te bez dodatnih troškova.Objective: This article describes the technique and the results of two-incision laparoscopic cholecystectomy performed on 42 patients, and compares it with standard cholecystectomy. Methods: Two-incision laparoscopic cholecystectomy (group A) was performed on 42 patients. Results were compared with standard laparoscopic cholecystectomy (group B) – 50 patients. Results: Mean operative time was 45 ± 3.5 min (group A), and 43 ± 4 min (group B). No intraoperative or postoperative complications were observed. Average hospital stay was equal in both groups. Conclusion: Two-incision laparoscopic cholecystectomy is equally safe as standard laparoscopic cholecystectomy with three incisions but with better cosmetic results and without the extra cost

Efficacy of Antimicrobial Triclosan-Coated Polyglactin 910 (Vicryl* Plus) Suture for Closure of the Abdominal Wall after Colorectal Surgery

This study compared Triclosan coated polyglactin 910 (Vicryl* Plus) with polyglactin 910(Vicryl*) on abdominal wall healing in colorectal surgery patients. 184 patients with colorectal cancer were included in the study. In 91, the abdominal wall was closed with the Vicryl* Plus, and in 93 patients with Vicryl*. Demographic characteristics, biochemical inflammatory parameters, wound appearance, length of hospital stay, postoperative wound complications and postincisional hernia were recorded. In the Vicryl* Plus group there was a shorter hospital stay (13.2±1.3 days; 21.4±2.8 respectively). In the Vicryl* Plus group inflammatory parameters decreased to normal within the first week whereas in the Vicryl* group remained increased. In the Vicryl* Plus group four patients had a wound discharge, seven had inflammatory reactions to the skin sutures. One dehiscence was noticed. In the Vicryl* group 12 patients had an SSI, 14 patients had inflammatory reactions to the skin sutures and 7 patients had a wound dehiscence. Closure of the abdominal wall using Vicryl*Plus decreases postoperative wound complications, length of hospital stay and is associated with a more rapid return of inflammatory markers to normal

Microelements in the soils and leaves of apple cultivars in the orchards of Slavonia and Baranja

Istraživana je opskrbljenost, odnosno količina mikroelemenata: bakar, bor, mangan i cink u tlu, a u lišću jabuka: bakar, bor, mangan, cink i molibden u pet voćnjaka na području Slavonije i Baranje. U voćnjacima podignutim na tlima: lesivirano tipično, smeđe lesivirano, lesivirani pseudoglej na lesu, fluvijalno livadsko tlo i aluvijalno mineralno ne karbonatno, uzgojene su u gustom sklopu u obliku vretenastog grma sorte: Golden Delicious, Fuji, Jonaprinc, i Jonagold supra na podlozi M 9. Sorte jabuka su u dobi pune rodnosti, a postigle su dobru vegetativnu razvijenost. U voćnjacima se provodi intenzivna pomotehnika, agrotehnika i natapanje. Ustanovljeno je da je u svim voćnjacima, odnosno istraživanim tlima do dubine od 0-40 cm, razina bora, odnosno opskrbljenost borom vrlo niska do niska. Količine mangana kreće se u skupini bogate opskrbljenosti, osim u fluvijo livadskom tlu gdje je opskrbljenost niska. Količine bakra i cinka kreću se u skupini dobre opskrbljenosti u lesiviranom pseudogleju na lesu, aluvijalno mineralnom nekarbonatnom i fluvijo livadskom tlu. Opskrbljenost bakrom umjerena je u tipičnom lesiviranom i fluvijo livadskom tlu. Opskrbljenost cinkom niska je u smeđe lesiviranom tlu, a umjerena u fluvijo livadskom tlu. Lišće svih sorti jabuka u voćnjacima, na istraživanim tlima, dobro je opskrbljeno: bakrom, cinkom, manganom i molibdenom, a slabo do srednje borom.The investigation was carried out on nutrition status of microelements: copper, boron, manganese and zinc in the soils, and in apple leaves: copper, boron, manganese, zinc and molybdenum in five orchards in Slavonia and Baranja (Croatia). The orchards were raised on the soils: Luvisol typical on calcareous Pleistocene, Pseudogley luvic, Eutric cambisol luvic on calcareous Pleistocene, Humofluvisol and Alluvial soil noncalcareous. In the orchards were grown apple cultivars: Golden Delicious, Fuji, Jonaprinc and Jonagold supra on rootstock M 9 in high density planting, with training form superspindle. Intensive pomotechnology, agrotechnics and irrigation was carried out. The apple trees are in phase the full production, and are obtained good vegetative growth. In the soils, at depths o f 0 -40 cm, the level of boron is very low to low. The amount of manganese is in the group of rich supplies, except in Humofluvisol where the supply is low. The amount of copper and zinc is in the range of the group of good supplies for Pseudogley luvic, Alluvial soil non-calcareous and Humofluvosol soil. The copper content is moderate in Luvisol typical and Humofluvisol. The zinc content is low in Eutric cambisol, luvic on calcareous Pleistocene and moderate in Humofluvisol. The nutrition status in the leaves of varieties: Golden Delicious, Fuji, Jonaprinc and Jonagold supra in the orchards, on the investigated soils, is well supplied with: copper, zinc, manganese and molybdenum, and poorly to medium with boron

Microelements in the soils and leaves of apple cultivars in the orchards of Slavonia and Baranja

Istraživana je opskrbljenost, odnosno količina mikroelemenata: bakar, bor, mangan i cink u tlu, a u lišću jabuka: bakar, bor, mangan, cink i molibden u pet voćnjaka na području Slavonije i Baranje. U voćnjacima podignutim na tlima: lesivirano tipično, smeđe lesivirano, lesivirani pseudoglej na lesu, fluvijalno livadsko tlo i aluvijalno mineralno ne karbonatno, uzgojene su u gustom sklopu u obliku vretenastog grma sorte: Golden Delicious, Fuji, Jonaprinc, i Jonagold supra na podlozi M 9. Sorte jabuka su u dobi pune rodnosti, a postigle su dobru vegetativnu razvijenost. U voćnjacima se provodi intenzivna pomotehnika, agrotehnika i natapanje. Ustanovljeno je da je u svim voćnjacima, odnosno istraživanim tlima do dubine od 0-40 cm, razina bora, odnosno opskrbljenost borom vrlo niska do niska. Količine mangana kreće se u skupini bogate opskrbljenosti, osim u fluvijo livadskom tlu gdje je opskrbljenost niska. Količine bakra i cinka kreću se u skupini dobre opskrbljenosti u lesiviranom pseudogleju na lesu, aluvijalno mineralnom nekarbonatnom i fluvijo livadskom tlu. Opskrbljenost bakrom umjerena je u tipičnom lesiviranom i fluvijo livadskom tlu. Opskrbljenost cinkom niska je u smeđe lesiviranom tlu, a umjerena u fluvijo livadskom tlu. Lišće svih sorti jabuka u voćnjacima, na istraživanim tlima, dobro je opskrbljeno: bakrom, cinkom, manganom i molibdenom, a slabo do srednje borom.The investigation was carried out on nutrition status of microelements: copper, boron, manganese and zinc in the soils, and in apple leaves: copper, boron, manganese, zinc and molybdenum in five orchards in Slavonia and Baranja (Croatia). The orchards were raised on the soils: Luvisol typical on calcareous Pleistocene, Pseudogley luvic, Eutric cambisol luvic on calcareous Pleistocene, Humofluvisol and Alluvial soil noncalcareous. In the orchards were grown apple cultivars: Golden Delicious, Fuji, Jonaprinc and Jonagold supra on rootstock M 9 in high density planting, with training form superspindle. Intensive pomotechnology, agrotechnics and irrigation was carried out. The apple trees are in phase the full production, and are obtained good vegetative growth. In the soils, at depths o f 0 -40 cm, the level of boron is very low to low. The amount of manganese is in the group of rich supplies, except in Humofluvisol where the supply is low. The amount of copper and zinc is in the range of the group of good supplies for Pseudogley luvic, Alluvial soil non-calcareous and Humofluvosol soil. The copper content is moderate in Luvisol typical and Humofluvisol. The zinc content is low in Eutric cambisol, luvic on calcareous Pleistocene and moderate in Humofluvisol. The nutrition status in the leaves of varieties: Golden Delicious, Fuji, Jonaprinc and Jonagold supra in the orchards, on the investigated soils, is well supplied with: copper, zinc, manganese and molybdenum, and poorly to medium with boron

Effects of diclofenac, L-NAME, L-Arginine, and pentadecapeptide BPC 157 on gastrointestinal, liver, and brain lesions, failed anastomosis, and intestinal adaptation deterioration in 24 hour-short-bowel rats

Stable gastric pentadecapeptide BPC 157 was previously used to ameliorate wound healing following major surgery and counteract diclofenac toxicity. To resolve the increasing early risks following major massive small bowel resectioning surgery, diclofenac combined with nitric oxide (NO) system blockade was used, suggesting therapy with BPC 157 and the nitric oxide synthase (NOS substrate) L-arginine, is efficacious. Immediately after anastomosis creation, short-bowel rats were untreated or administered intraperitoneal diclofenac (12 mg/kg), BPC 157 (10 μg/kg or 10 ng/kg), L-NG-nitroarginine methyl ester (L-NAME, 5 mg/kg), L-arginine (100 mg/kg) alone or combined, and assessed 24 h later. Short-bowel rats exhibited poor anastomosis healing, failed intestine adaptation, and gastrointestinal, liver, and brain lesions, which worsened with diclofenac. This was gradually ameliorated by immediate therapy with BPC 157 and L-arginine. Contrastingly, NOS-blocker L-NAME induced further aggravation and lesions gradually worsened. Specifically, rats with surgery alone exhibited mild stomach/duodenum lesions, considerable liver lesions, and severe cerebral/hippocampal lesions while those also administered diclofenac showed widespread severe lesions in the gastrointestinal tract, liver, cerebellar nuclear/Purkinje cells, and cerebrum/hippocampus. Rats subjected to surgery, diclofenac, and L-NAME exhibited the mentioned lesions, worsening anastomosis, and macro/microscopical necrosis. Thus, rats subjected to surgery alone showed evidence of deterioration. Furtheremore, rats subjected to surgery and administered diclofenac showed worse symptoms, than the rats subjected to surgery alone did. Rats subjected to surgery combined with diclofenac and L-NAME showed the worst deterioration. Rats subjected to surgery exhibited habitual adaptation of the remaining small intestine, which was markedly reversed in rats subjected to surgery and diclofenac, and those with surgery, diclofenac, and L-NAME. BPC 157 completely ameliorated symptoms in massive intestinal resection-, massive intestinal resection plus diclofenac-, and massive intestinal resection plus diclofenac plus L-NAME-treated short bowel rats that presented with cyclooxygenase (COX)-NO-system inhibition. L-arginine ameliorated only L-NAME-induced aggravation of symptoms in rats subjected to massive intestinal resection and administered diclofenac plus L-NAME

Orbitalni kavernozni hemangiom

The aim of this case report was to present a patient with a benign orbital tumor, cavernous hemangioma, who presented with symptoms of compressive orbital mass: unilateral axial proptosis, with motility restriction and sudden vision loss in the left eye. Ophthalmologic examination (visual acuity, applanation tonometry, Goldmann tonometer, visual field) and radiologic examination diagnosed a benign, well circumscribed, vascular, intraconal tumor that compresses the optic nerve. Treatment was operative: lateral orbitectomy Krönlein procedure and the tumor was removed. Pathologic and pathohistologic examination confirmed the previous diagnosis. Follow up examination, visual field and MRI of the orbit showed considerable improvement. Surgical treatment was also the final treatment and no adjuvant therapy was necessary. Prognosis for visual acuity and life is excellent.Cilj ovog rada bio je prikazati slučaj pacijentice s benignim tumorom orbite, kavernoznim hemangiomom, koji se javlja sa simptomima kompresivne tvorbe u orbiti: unilateralnom proptozom, smetnjama motiliteta te naglim gubitkom vida lijevog oka. Oftalmološkom obradom (ispitivanje vidne oštrine, aplanacijska tonometrija, ispitivanje vidnog polja po Goldmannu) te radiološkom obradom (MR, MSCT, MSCT angiografija) postavlja se dijagnoza benigne, dobro ograničene, vaskularne tvorbe u konusu koja pritišće očni živac. Pristupilo se operativnom zahvatu, napravila se lateralna orbitektomija po Krönleinu i odstranio tumor u cijelosti. Patološka i patohistološka pretraga potvrđuju raniju dijagnozu. Postoperativni tijek protiče uredno te se na nalazu kontrolnog vidnog polja i kontrolnim snimkama MR-a utvrđuje značajno poboljšanje. Kod pacijentice je kirurško liječenje bilo i konačno te nije bila potrebna dodatna terapija. Prognoza za vidnu oštrinu i život je odlična