Early hospital rehabilitation in patients with a performed intestinal stoma

An intestinal stoma is an intentional connection between the light of the small intestine (ileostomy) or the large intestine (colostomy) and the skin surface. The aim of the study was to present the topic of early hospital rehabilitation in patients who had to have a selected stoma as a result of the procedure. Rehabilitation is a supplement to surgical treatment and conditions good functioning of the patient after surgery. The main components of the therapy are: respiratory exercises, exercises of expectoration and effective coughing, wound stabilization, learning to change position from lying to sitting, anticoagulation exercises, general development exercises, verticalisation. More and more often, the rehabilitation is complemented by the use of kinesiology taping. Properly conducted physiotherapy may bring measurable benefits to the patient in the form of functional improvement and return to efficiency before surgery, or reduction of the degree of disability. The patient improvement plan is subject to constant modification by the therapist and is adapted to the physical and mental abilities of the patient on a given day. An important element in the healing process of patients with a performed stoma is the interdisciplinary care provided by all members of the therapeutic team: a doctor, a nurse, a physiotherapist, a psychologist, a nutritionist

The assessment of the patients disability degree using the EDSS scale in various forms of multiple sclerosis

Purpose. The aim of the study is to assess the patients disability degree using the Extended Scale of Disability in various forms of multiple sclerosis.Material and Methods. The study was conducted on a group of 40 people suffering from multiple sclerosis, diagnosed and treated in the Neurology Clinic of the 10th Military Clinical Hospital in Bydgoszcz. In order to assess the patients disability degree, the Extended Disability Management Scale was used. The other information needed for statistical analysis was obtained from the clinical observation chart established for each patient.Results. The disability degree of patients with multiple sclerosis is determined by many variables. The Expanded Disability Rating Scale is a good tool to assess the degree of disability of patients with multiple sclerosis.Conclusion. 1. In the group of people with relapsing remitting MS, the average value of the degree of disability in the Expanded Disability Scale was the smallest. 2. The childbirth during the course of multiple sclerosis causes exacerbation of clinical symptoms immediately after the childbirth. 3. Optic neuritis as the initial symptom of multiple sclerosis predisposes to a milder course of the disease. 4. Symptoms of the first relapse of multiple sclerosis that support faster progression of disability are: lower limb paresis, sphincter dysfunction and balance disorders. 5. Multifocal symptomatology of the first relapse of multiple sclerosis speaks for faster progression of disability in relation to patients with the first relapse characterized only by one symptom

Quality of sexual life after inguinal hernia repair

Inguinal hernia repair is one of the most common surgical procedures. Post-operative pain is one of the main factors determining sexual life satisfaction and general quality of life. However, not much research has focused on the problem of chronic pain after a corrective surgery and its impact on the quality of human sex life. Recurrent inguinal hernia to a large extent has been reduced due to the use of synthetic mesh, but there was a serious problem - chronic postoperative pain, which significantly reduces the overall quality of life of patients

Surgical treatment of rectal cancer in Poland — a report from a prospective, multi-centre observational study PSSO_01 conducted under the auspices of the Polish Society of Surgical Oncology

Introduction. Since 2016, as part of the PSSO_01 multi-centre research project conducted under the auspices of the Polish Society of Surgical Oncology, clinical data on rectal cancer treatment have been collected. The objective of the study was to illustrate the state of early results of surgical treatment. Material and methods. The research project is multi-centre in nature. Data shall be collected electronically. The study protocol does not impose or suggest any course of procedure. It only systematizes the way data are collected for scientific purposes. The analysis of early results of surgical treatment was compared with the results of population studies from other European countries (Netherlands, Belgium). Results. By the end of June 2018, 736 patients were registered in the study. In 399 (54.2%) an anterior resection was performed. More than half of patients undergoing subsequent surgical treatment (54.2%) receive neoadjuvant treatment, with the percentage of patients undergoing radiotherapy or radiochemical treatment for lower rectal cancer being about 70%. Most patients (96%) are operated in elective procedure. The percentage of laparoscopic surgeries is low (8.6%). Postoperative complications are observed in 21.1% of patients. Severe complications (grades III–V according to Clavien-Dindo classification) occur in 7.6% of patients undergoing surgery. Postoperative mortality is 1.1%. Discussion. Although the project does not have the character of a registry and does not allow for drawing wider conclusions concerning the compliance with the standards of qualification for neoadjuvant treatment, the important information is that more than half of rectal cancer patients receive preoperative treatment, and the percentage of severe postoperative complications does not exceed 10%. Conclusions. The results of the PSSO_01 project are representative and reflect the actual situation concerning surgical treatment of rectal cancer patients in Poland

Leczenie chirurgiczne raka odbytnicy w Polsce — raport z prospektywnego, wieloośrodkowego badania obserwacyjnego PSSO_01 prowadzonego pod auspicjami Polskiego Towarzystwa Chirurgii Onkologicznej

Wstęp. Od 2016 roku w ramach wieloośrodkowego projektu badawczego PSSO_01 prowadzonego pod auspicjami Polskiego Towarzystwa Chirurgii Onkologicznej, gromadzone są dane kliniczne dotyczące leczenia raka odbytnicy. Celem pracy było zobrazowanie stanu dotyczącego wczesnych wyników leczenia chirurgicznego. Materiał i metody. Projekt badawczy ma charakter wieloośrodkowy. Dane gromadzone są elektronicznie. Protokół badania nie narzuca ani nie sugeruje żadnego sposobu postępowania, systematyzuje jedynie sposób zbierania danych w celach naukowych. Analiza dotycząca wczesnych wyników leczenia chirurgicznego została porównana z rezultatami populacyjnych badań z innych krajów europejskich (Holandia, Belgia). Wyniki. Do końca czerwca 2018 roku w badaniu zarejestrowano 736 chorych. U 399 (54,2%) wykonano resekcję przednią. Leczenie neoadiuwantowe otrzymała ponad połowa chorych, poddanych następnie leczeniu operacyjne­mu (54,2%), przy czym odsetek pacjentów poddanych radio- bądź radiochemioterapii z powodu raka dolnej części odbytnicy wyniósł około 70%. Większość chorych (96%) operowana była w trybie planowym. Odsetek operacji wykonanych techniką laparoskopową jest niski (8,6%). Powikłania pooperacyjne zaobserwowano u 21,1% chorych. Ciężkie powikłania (III–V st. wg klasyfikacji Claviena-Dindo) sięgały 7,6% operowanych chorych. Śmiertelność po­operacyjna wyniosła 1,1%. Dyskusja. Chociaż projekt nie ma charakteru rejestru i nie pozwala na wyciągniecie szerszych wniosków dotyczących przestrzegania standardów kwalifikacji do leczenia neoadiuwantowego, istotną informacją jest to, że ponad połowa chorych na raka odbytnicy otrzymuje leczenie przedoperacyjne, a odsetek ciężkich powikłań pooperacyjnych nie przekracza 10%. Wnioski. Wyniki projektu PSSO_01 są reprezentatywne i odzwierciedlają faktyczną sytuację dotyczącą leczenia chirurgicznego chorych na raka odbytnicy w Polsce

Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study

Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Methods: Patients with stage I-III rectal cancer were treated with curative intent. The necessity for radiotherapy and chemotherapy was determined before surgery and/or postoperative histopathological results. Results: Of 365 rectal cancer patients, 76 (20.8%) developed recurrent disease. In total, 27 (7.4%) patients presented with a local tumor recurrence (isolated in 40.7% of cases). Radiotherapy was performed in 296 (81.1%) patients. The most often used schema was 5 × 5 Gy followed by immediate surgery (n = 214, 58.6%). Local recurrence occurred less frequently in patients treated with 5 × 5 Gy radiotherapy followed by surgery (n = 9, 4%). Surgical procedures of relapses were performed in 12 patients, six of whom were operated with radical intent. Only two (7.4%) patients lived more than 5 years after local recurrence treatment. The incidence of local recurrence was associated with primary tumor distal location and worse prognosis. The median overall survival of patients after local recurrence treatment was 19 months. Conclusions: Individualized rectal cancer patient selection and systematic treatment algorithms should be used clinical practice to minimize likelihood of relapse. 5 × 5 Gy radiotherapy followed by immediate surgery allows good local control in resectable cT2N+/cT3N0 patients. Radical resection of isolated local recurrence offers the best chances of cure