Profesor Jan Oszacki – krótki biogram wielkiego chirurga

"Jan Oszacki urodził się 1 października 1915 roku w Morawskiej Ostrawie w rodzinie o tradycjach lekarskich. Jego ojciec, Aleksander, był profesorem chorób wewnętrznych w Uniwersytecie Jagiellońskim, natomiast kuzyn i rówieśnik Jerzy Oszacki nieco wcześniej niż Jan skończył studia i został internistą (zginął tragicznie w wybuchu komory tlenowej w 1939 roku)."(...

Short- and long-term outcomes of incarcerated inguinal hernias repaired by Lichtenstein technique

INTRODUCTION: The use of tension-free inguinal hernia repair techniques using commercially available implants is now rather common. However, it is widely accepted that the use of biomaterials should be limited to non-infected surgical fields. As such, most current studies pertain to the application of various implants during the surgical repair of uncomplicated hernias. AIM: To compare the short- and long-term outcomes of incarcerated inguinal hernia repair using the Lichtenstein or Bassini technique. MATERIAL AND METHODS: Between 1997 and 2012, 107 patients were operated on an emergency basis due to the incarceration of inguinal hernias – 105 subjects were included for further analysis in our study. RESULTS: Postoperative complications were observed in 13 out of the 84 (15.5%) patients subjected to Lichtenstein repair. In 9 of these patients (10.7%), morbidity was associated with the surgical wound. In 2 cases (2.4%), a small inflammatory infiltration was observed and resolved within a few days. Serous fluid accumulation within the wound was observed in 3 patients (3.6%), but the fluid was successfully drained by puncture. Finally, hematoma formed in 4 cases (4.8%). In total, 4 complications (19%) were recorded in the group of 21 patients who were operated on with the Bassini technique. In 3 of these cases (14.3%), the complications were related to suppuration of the surgical wound. CONCLUSIONS: Polypropylene mesh may be safely implanted during the repair of incarcerated hernia and this approach is reflected by satisfactory long-term outcomes

Variation in treatment modalities, costs and outcomes of rectal cancer patients in Poland

Aim of the study: To evaluate outcome, costs and treatment differences in rectal cancer patients between various regions in Poland. Material and methods: Data from the Polish National Health Fund of all patients with rectal cancer diagnosed and treated between 2005 and 2007 were analyzed. Overall, relative 5-year survival and the percentage of patients receiving chemotherapy, radiotherapy and surgery were analyzed. The possible influence of cost of treatment per patient and mean number of rectal cancer patients per surgical oncologist were analyzed as well. Results: In total 15,281 patients with rectal cancer were diagnosed and treated in Poland in 2005–2007 within the services of the National Health Fund. The overall, relative 5-year survival rate was 51.6%. Curative surgery was performed in 64.1% of patients. Radiotherapy and chemotherapy were used in 47.5% and 60.7% of patients, respectively. The mean cost of treatment of one rectal cancer patient was 32,800 PLN and there were 49.8 rectal cancer patients per specialist in surgical oncology. Important differences between regions were found in all these factors, but without a significant influence on survival. A correlation between numbers of patients per specialist in different voivodeships and survival rates was observed, as well as a correlation between percentage of surgical resection in voivodeships and survival rates (p = 0.07). Conclusions: Results of treatment of colorectal cancer in Poland improved significantly during the last decade. There exist however, important disparities between regions in terms of method of treatment, costs and outcomes

Laparoscopic and open liver resection : a literature review with meta-analysis

Introduction: In recent years laparoscopic approach to liver resections has gained important attention from surgeons worldwide. The aim of this review was to compare the results of laparoscopic and open liver resections. Material and methods: We have performed a search in Medline, Embase and the Cochrane Library databases. Studies comparing laparoscopic and open liver resections were included. Results: No randomized clinical trial were identified. In the 16 observational studies included in the analysis there were 927 laparoscopic and 1049 open liver resections. The laparoscopy group had lower blood loss (MD = 244.93 ml, p < 0.00001), lower odds of transfusion (OR = 0.35, p = 0.0002), lower odds of positive margins on pathology report (OR = 0.22, p < 0.00001), lower odds of readmission (OR = 0.36, p = 0.04), lower odds of pulmonary (OR = 0.38, p = 0.003) and cardiac complications (OR = 0.30, p = 0.02) and lower odds of postoperative liver failure (OR = 0.24, p = 0.001), but in many cases the results were based on a low number of events reported in included studies. Conclusions: Laparoscopic resection of liver yields complications rates comparable to open resection, but the results are based on low quality evidence from nonrandomised studies

Total number of lymph nodes and numer of metastatic lymph nodes harvested during radical mastectomy did not influence early postoperative drainage volume

Objectives: We aimed at evaluation of the influence of the extent of axillary lymph node dissection, measured by the total number of lymph nodes harvested, on the drainage volume. We also looked at the lymph node positivity (N+) and the number of metastatic axillary lymph nodes as a potential prognostic factors in this regard. Material and methods: We have analysed the data of 63 patients (F/M: 62/1) with breast cancer, who underwent radical modified mastectomy in 2008-2009 in the single department of surgical oncology. Results: We observed no significant correlation between the 1) total number of axillary lymph nodes harvested during lymphadenectomy, 2) presence of metastatic lymph nodes (node positive disease), 3) number of metastatic axillary lymph nodes and: drainage volume on the day of surgery, drainage volume on three consecutive postoperative days and drainage volume from the day of surgery to drain removal. Conclusion: The extent of axillary lymph node dissection, measured by the total number of lymph nodes excised, did not influence drainage volume after radical modified mastectomy. Neither total number of metastatic lymph nodes excised nor the node positivity (N+) were associated with increased drainage volume after mastectomy with axillary dissection