Oddzial Chirurgii Ogolnej i Onkologicznej

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Oddzial Chirurgii Ogolnej i Onkologicznej

Poland

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Klek S.,Oddzial Chirurgii Ogolnej i Onkologicznej | Jankowski M.,Nicolaus Copernicus University | Kruszewski W.J.,Medical University of Gdańsk | Fijuth J.,Medical University of Lódz | 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.


Klek S.,Oddzial Chirurgii Ogolnej i Onkologicznej | Jarosz J.,Centrum Onkologii | Kapala A.,Medical University of Warsaw | Krawczyk J.,Medical University of Warsaw | And 4 more authors.
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.


Klek S.,Oddzial Chirurgii Ogolnej i Onkologicznej | Piechowicz M.,Klinika Ginekologii i Onkologii | Szybinski P.,Oddzial Chirurgii Ogolnej i Onkologicznej | Szczepanek K.,Jagiellonian University | And 3 more authors.
Nowotwory | Year: 2013

Aim: Parenteral nutrition (PN) represents a recognized therapeutic modality for intestinal failure patients, independently of its etiology. Home parenteral nutrition (HPN) has, however, become controversial in oncological patients, and creation of widely accepted indications for this treatment has become difficult. The aim of the study was to assess treatment outcome in cancer HPN patients as well as to propose recommendations for this kind of treatment in advanced cancer patients. Material and methods: 69 patients (42 F, 27 M, mean age 58.1 y.) treated between January 2009 and June 2012 were analyzed. The study group was formed of gastric, pancreatic, colon, esophagus, gall bladder, ovarian and uterus cancer patients. The time of treatment and quality of life of the patients were analyzed. Results: The mean overall survival time reached 99.8 days but varied among tumour groups. It was longer in ovarian and uterine cancer than in any other neoplasm (231.8 vs. 99.8 days, p < 0.05). The quality of life was also higher in the ovarian and uterine cancer group (7.8 vs. 4.3 points, p < 0.05), while it was significantly lower in the others. Conclusions: Home parenteral nutrition should be considered as a therapeutic option in every patient with advanced ovarian and uterine cancer. In other advanced cancer patients its use should be carefully considered as its value is not so convincing. © Polskie Towarzystwo Onkologiczne.


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.


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

Background. According to the international classification of disorders (ICD-10) sleep disturbances are diagnosed if patient declared not enough quality or quantity of sleep three times per week in minimum two months and reduction of daily function. Objectives. The aim of the study was to assess the prevalence of sleep disorders in population of geriatric patients treated in surgical ward, its relation to symptoms of dementia and depression and frequency of usage of hypnotics. Material and methods. 200 subjects (100 female and 100 male) aged 65-91 participated in this study. Mean age was 78.3 years. Sleep disorders were declared by 63.5% women and 61.1% men. Patients with cognitive disorders had rarely problems with sleep initiation but problems with early awakenings. Early awakenings and daytime naps were more common in patients with symptoms of depression. 8% of women and 9% of men were taking hypnotics. Conclusions. Sleep disorders are very common among geriatric patients treated in surgical ward. Symptoms of depression and dementia increase frequency of sleep disorders. None of patients with insomnia was treated by a specialist. © Copyright by Wydawnictwo Continuo.


Background. Already in ancient times problems of movement aroused interest in context of health. We do not have data whether by XVIIIth century anybody dealt with movement in context of health. In the second half of XXth century movement treatment was popularized. Limited amount of movement is considered one of reason of civilization disease. Among others we include diabetes, degenerations, obesity, metabolic diseases, heart and respiratory diseases. Objectives. The aim of the study was evaluation of subjective not verified patient's feelings concerning physical activity among patients treated in our surgical ward. Material and method. 100 chosen patients aged 19-40 years treated in our ward from September 2006 to August 2009 were investigated. They fulfilled authored anonymous questionnaire which included questions concerning physical activity of patients. Participation in this research was voluntary. Results. 94.5% of patients ascertained that movement generally improves the mood, 94.3% of patients declared that movement has positive impact on health. 95% of surveyed patients recognized that physical activity caused reduction of body mass to a great extent. 76.4% of patient declared keeping an active lifestyle. Conclusions. The results indicated that the level of physical activity of patients aged 19-40 is high. Physical activity causes brisk walking, shaped figure, good physical and mental well-being. It was evaluated only by subjective not verified patient's feeling concerning physical activity. © Copyright by Wydawnictwo Continuo.


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.


Wysocki W.M.,Klinika Chirurgii Onkologicznej | Burzynski T.,Oddzial Chirurgii Ogolnej I Onkologicznej | Komorowski A.L.,Hospital Virgen Del Camino W Sanlucar Of Barrameda | 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.

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