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Treska V.,Chirurgicka klinika LFUK a FN v Plzni.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti | Year: 2012

Thoracic aortic injury (TAI) is burdened with high mortality (80-90%). The diagnostic and therapeutic algorithm has changed radically over the last couple of years. The authors present their experience with diagnosis and treatment of TAI at the University Hospital Trauma Centre. 24 TAIs were evaluated in a retrospective study, in 20 (83.3%) cases they were part of a polytrauma. The average age of the patients was 39.4 years (20-67). Traffic accidents formed the majority of TAIs (87.5%). Multi-detector computed tomography was used as a basic examination to detect TAI. Thoracic endovascular aortic repair (TEVAR) was the treatment of choice in 21 and open surgery in 3 injured patients. The 30-day postoperative mortality was 12.5%, in one case it was associated with TEVAR. 30-day morbidity was 37.5% (circulatory instability, respiratory insufficiency, bronchopneumonia, type I endoleak). MDCT and TEVAR are currently the methods of first choice in the diagnosis and treatment of TAI. TAI requires a highly specialized multidisciplinary approach within Trauma Centres providing complex cardiovascular services.


Skalicky T.,Chirurgicka klinika LFUK a FN v Plzni.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti | Year: 2010

THE AIM: The aim of the work was to evaluate the set of 10 patients, who were operated on hepatic and pulmonary metastases of colorectal carcinoma at the Surgical Clinic of Medical Faculty of Charles University and Faculty Hospital in Plzeń in years from 2005 till 2009. With regard to limited experience with the patients who underwent hepatic as well as pulmonary resection, we focused on the evaluation of a long-term survival of the patients and their mortality and morbidity. THE SET OF THE PATIENTS: In years from 2005 till 12/2009 we operated 10 patients during whose affection there occurred hepatic and pulmonary metastases of colorectal carcinoma and these were solved surgically. This concerned 5 men and 5 women at an average age of 62.4 years (42-71 years). In 10% it was hepatic resection in the first period after the operation of primary carcinoma, it was the first performance on the hepatic parenchyma in 90%. THE RESULTS: Morbidity of the set was 20.1% regarding hepatic resections and 5.6% regarding pulmonary resections. A 30-day postoperative mortality was 0%. In three cases a hepatic involvement was bilateral, in two cases in the left lung and 5 patients had an involvement of the right pulmonary lobe. In 4 cases primary carcinoma was in the rectum and in 6 cases in the large intestine. The period of three months was an average time between hepatic and pulmonary resection. Resection on liver parenchyma was the most often performance and metastasectomy with the help of laser on the pulmonary parenchyma. Rectal carcinoma spread into lungs in 50%. An average time of a 5-year survival in the patients after resection of hepatic and pulmonary metastases of colorectal carcinoma was 26%. THE CONCLUSION: Hepatic and pulmonary resection in the selected patients with generalized colorectal carcinoma extends the period of a survival and does not worsen the quality of the life. The patients after resection of both--hepatic and pulmonary metastases have got a worse long-term survival than the patients being only after hepatic resections.


PubMed | Chirurgicka klinika LFUK a FN v Plzni.
Type: Journal Article | Journal: Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti | Year: 2012

Thoracic aortic injury (TAI) is burdened with high mortality (80-90%). The diagnostic and therapeutic algorithm has changed radically over the last couple of years. The authors present their experience with diagnosis and treatment of TAI at the University Hospital Trauma Centre.24 TAIs were evaluated in a retrospective study, in 20 (83.3%) cases they were part of a polytrauma. The average age of the patients was 39.4 years (20-67). Traffic accidents formed the majority of TAIs (87.5%). Multi-detector computed tomography was used as a basic examination to detect TAI. Thoracic endovascular aortic repair (TEVAR) was the treatment of choice in 21 and open surgery in 3 injured patients.The 30-day postoperative mortality was 12.5%, in one case it was associated with TEVAR. 30-day morbidity was 37.5% (circulatory instability, respiratory insufficiency, bronchopneumonia, type I endoleak).MDCT and TEVAR are currently the methods of first choice in the diagnosis and treatment of TAI. TAI requires a highly specialized multidisciplinary approach within Trauma Centres providing complex cardiovascular services.

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