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Klek S.,Oddzial Chirurgii Ogolnej i Onkologicznej | Jankowski M.,Nicolaus Copernicus University | Kruszewski W.J.,Medical University of Gdansk | Fijuth J.,Medical University of Lodz | And 5 more authors.
Nowotwory | Year: 2015

Malnutrition affects a large part of patients with malignant neoplasm. Proper nutritional treatment determines the effectiveness and success of therapy in these patients. Given the importance of this issue, thanks to the collaboration of scientific societies: Polish Society of Surgical Oncology (PTChO), Polish Society of Oncology (PTO), Polish Society of Clinical Oncology (PTOK) and Polish Society for Parenteral, Enteral Nutrition and Metabolism (POLSPEN) standards for nutritional therapy in oncology have been set. An introduction to nutritional therapy is the correct identification of malnourished patients. In Poland, hospitalized patients are subject to screening towards malnutrition. Nutrition intervention should be tailored to the clinical situation. It involves the use of dietary advice, use of oral diet products (oral nutritional support), enteral or parenteral nutrition, in hospital or in home, in consideration of special situations. © Polskie Towarzystwo Onkologiczne. Source


Klek S.,Oddzial Chirurgii Ogolnej i Onkologicznej | Kapala A.,Medical University of Warsaw | Krawczyk J.,Medical University of Warsaw | Misiak M.,Oddzial Intensywnej Terapii i Anestezjologii | Jassem J.,Medical University of Gdansk
Nowotwory | Year: 2014

The manuscript presents the second part of recommendations on enteral and parenteral nutrition in oncology. It describes indications, methods of intervention, types of diets and techniques for monitoring. The enteral nutrition (EN) is a method of choice for nutritional support, hence it should be always considered as the first step, whenever the latter is necessary. The beneficial Effect of EN was demonstrated in many clinical studies. © Polskie Towarzystwo Onkologicznes. Source


Wysocki W.M.,Klinika Chirurgii Onkologicznej | Burzynski T.,Oddzial Chirurgii Ogolnej i Onkologicznej | Mitus J.,Klinika Chirurgii Onkologicznej
Nowotwory | Year: 2011

Aim: To determine the influence of selected clinical factors on drainage volume after radical mastectomy for breast cancer in the first postoperative day (DO) and first three postoperative (TPD) days. Material and method: Prospective analysis of 318 patients (315 females i 3 males; mean age 61.2 years) operated on for breast cancer (Madden radical mastectomy). Operative technique was similar in all cases. The diabetes was present in 7,9% participants, preoperative chemotherapy was used in 14.8%, INR >1,1 in 35.5%, intraoperative frozen section was performed in 9.7% patients, dissection was performed with scalpel in 36.2% patients (in the remaining group electrocautery was used), in 79.4% compressive dressing was applied to the surgical site. Results: In DO drainage volume was significantly higher in patients operated on with scalpel dissecting technique compared to electrocautery (184.5 vs. 160.6 ml, p=0.017). In DO no significant influence of the following factors on the drainage volume was observed: age; body mass index (BMI); ASA classification; diabetes; preoperative chemotherapy; intraoperative frozen section; compressive dressing on the surgical site; INR >1.1. In TPD drainage volume was significantly higher in patients operated on with scalpel dissecting technique compared to electrocautery (606.7 vs. 543.8 ml, p=0.009); higher BMI (<20, 20-24.99, 25-29.99 and ≥30 kg/m2: 477.7 vs. 491.3 vs. 570.3 vs. 634.0 ml, p<0.00001) and higher ASA classification (I vs. II vs. III grade: 502.3 vs. 584,4 vs. 580.3 ml; p=0.005). In TPD no significant influence of the following factors on the drainage volume was observed: age; diabetes; preoperative chemotherapy; intraoperative frozen section; compressive dressing on the surgical site; INR >1,1. Higher drainage volume in TPD was significantly associated with breast volume (cup of bra size: A vs. B. vs. C vs D vs DD, E and EE, respectively: 438,8 vs. 554,0 vs. 560,8 vs. 615,7 vs. 622,5 ml, p=0.035), larger perimeter measured under the bust (p<0.0001) and longer surgery duration (p<0.0001; every 30 minutes longer duration increased daily drainage output by mean 24 ml. Conclusions: Significantly higher drainage volume in DO and TPD after radical mastectomy was associated with dissection using scalpel compared with electrocautery. Moreover higher drainage volume in TPD was associated with: higher BMI, higher ASA classification, greater breast volume, larger perimeter measured under the bust and longer surgery duration. Source


Wysocki W.M.,Klinika Chirurgii Onkologicznej | Burzynski T.,Oddzial Chirurgii Ogolnej i Onkologicznej | Komorowski A.L.,Servicio de Cirugia General | Mitus J.,Klinika Chirurgii Onkologicznej
Wspolczesna Onkologia | Year: 2010

Metastatic breast cancer is usually an incurable disease and surgery of the primary site was not believed to prolong life in patients presenting with stage IV breast cancer. This article is based on a review of relevant publications published from January 2000 to May 2010 with data on the possible impact of breast surgery in stage IV breast cancer on treatment results. Recent studies show a significant survival benefit from breast surgery in metastatic breast cancer patients. In the majority of the papers radical surgery (wide local excision or mastectomy) was shown to be correlated with improved survival (median survival time in patients operated on was nearly double in many studies). A minority of studies did not show any benefit from surgery or attributed the benefit to other factors (mainly preoperative chemotherapy). Randomized controlled studies to clarify the potential role of local breast surgery in this setting are currently underway. Source


Chrzan R.,Oddzial Chirurgii Ogolnej i Onkologicznej | Kulpa T.,Oddzial Chirurgii Ogolnej i Onkologicznej
Family Medicine and Primary Care Review | Year: 2010

The data from Chief Bureau of Statistics (GUS) inform that the share of smoking men dropped from 47.3% to 38.0% and in women from 24.4% to 23.1%. Objectives. The aim of the study was to analyze factors which influence nicotine addition as well as to evaluate motivation by patients treated because of surgical reasons to give up smoking. Material and methods. The study was conducted on randomly chosen 650 patients (324 women and 326 men) aged 19-80 treated in our ward between January and December 2009. Patients filled anonymous survey included demographical data and Fagerström and Schneider test. Participation in this study was voluntary. Results. 48% of patients declared smoking, 8% gave up smoking. The others declared that they never smoked. Number of smoking men - 73%, smoking women - 27%. High addiction to nicotine declared 62% of men and 52% of women, medium - 11% of men and 9% by women, slightly - 27% of men and 39% of women. 38% of patients: 25% of men and 13% of women declared willingness to stop smoking. Conclusions. 1. The rate of smoking patients is high. 2. The rate of addicted to nicotine is high. 3. The rate of declared willingness to stop smoking is low. © Wydawnictwo Continuo. Source

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