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Janczak D.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | Kabzinski P.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | Rac J.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | PaweLczyk J.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | PawLowski L.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego
Family Medicine and Primary Care Review

Background. The thyroid cancer occurs both within a goiter as well as within a normal gland. The differential diagnosis of the goiter is crucial for its early diagnosis. In Poland approximately 50% cases of thyroid cancers is identified postoperatively on the basis of the final pathological examination. Objectives. The aim of the study was the analysis of the all thyroidectomies performed in the General Surgery Department of the 4 th Teaching Military Hospital in Wroclaw between 1996 and 2010 focusing on the thyroid cancer frequency. Material. Between 1996 and 2010 in this department 1583 patients (1329 women and 254 men) underwent thyroidectomies due to different thyroid diseases, i.e. multinodular nontoxic or toxic goiter, Graves-Basedow disease, or solitary thyroid nodule. Methods. Having done the initial examination and the necessary lab tests, the surgical procedures were performed under general anaesthesia. The Kocher's approach (the 2 cm long collar incision above the suprasternal notch, between the median margins of the sternocleidomastoid muscle) was usually made. In our department the following surgical rules were introduced: in case of multinodular goiter - a total thyroidectomy, in case of solitary thyroid nodule - a thyroid lobectomy with the isthmus, in case of biopsy-proven thyroid cancer - a total thyroidectomy with pretracheal lymph nodes dissection, in any doubt (i.e. clinical suspicion of neoplasia) - intraoperative (frozen section) examination. The analysed data was collected from the accessible medical documentation, mainly medical history, preoperative lab tests and postoperative pathological reports. Results. In the presented group the initial benign diagnosis was confirmed by pathological examination in 1474 out of 1538 patients (95.8%). The thyroid cancer was demonstrated in 64 patients (4.2%). Only in 9 cases the preoperative biopsy-proven diagnosis of neoplasm was in accordance with the postoperative final report. Conclusions. 1. Despite the rapid development of preoperative cytological procedures, the final diagnosis is often made postoperatively. 2. The adequate preoperative diagnosis as well as the resulting effective surgical treatment are the matter of essential importance. 3. The standard procedure of ipsilateral radical surgery is recommended in case of the lack of preoperative thyroid cancer diagnosis. © Wydawnictwo Continuo. Source

Janczak D.,Zaklad Specjalnosci Zabiegowych | Rucinski A.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | Rucinska Z.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | Janczak D.,Klinika Chirurgiczna 4. Wojskowego Szpitala Klinicznego | And 2 more authors.
Polimery w medycynie

The authors present the impact of the topical hemostatic agents (PerClot®, Fibrillar®, and Surgiflo®) in both primary arterial anastomoses, and anastomoses with synthetic prostheses. In 2012, in the Department of Vascular Surgery in Wroclaw, the topical hemostatic dressings were successfully applied to 106 patients (Fibrillar® - 65, PerClot® - 26, and Surgiflo® - 15) in case of difficulties to stop bleeding. The topical hemostatic agents appear both to reduce blood loss and to shorten the operation time in 95% of cases. The decrease both in blood loss and operation time can lead to the patient safety improvement. Source

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