Szymon Wcisło

Comparison of effectiveness of electrocautery and phenol application in partial matricectomy after partial nail extraction in the treatment of ingrown nails

UNLABELLED Ingrowing nail also known as onychocryptosis is a common health problem. This disease mostly affects young people, often carrying a considerable amount of socio-economic implications. Its foot problem that usually manifests as inflammation of tissue along the side of a toenail. The aim of the study was to asses and to compare effectiveness of electrocautery and phenol application in partial matrixectomy after partial nail extraction in the treatment of ingrown toenails. MATERIAL AND METHODS The group of 60 patients with ingrowing toenail which was randomized into two groups underwent partial matrixectomy in surgical outpatient clinic between 2009-2013. This group of patients was under surgical observation for 100 days in outpatient clinic. RESULTS In all operated patients we obtained surgical success however we had 13 recurrences during the follow up period, 5 in the phenolization group and 8 in the electrocoagulation group. CONCLUSIONS There was statistically significant difference between these two techniques, which indicated that matrix phenolization is connected with shortened healing time vs the matrix electrocoagulation.

Giant mesentery fibromatosis presenting as acute abdomen - case report

Mesentery fibromatosis, also called abdominal desmoid, is a rare clinical entity. It is part of the clinical-pathologic spectrum of so-called deep fibromatoses. The deep fibromatoses encompass a group of benign fibroproliferative processes that are locally aggressive; they may infiltrate the adjacent organs or recur, but do not create distant metastatic lesions. The small bowel mesentery is the most common site of intraabdominal fibromatosis. However, the omentum, ileocolic mesentery, transverse or sigmoid mesocolon, or ligamentum teres may be the site of origin for intraabdominal fibromatosis. Mesenteric fibromatosis occurs in a wide age range of patients, and has no gender or race predilection. Most cases of abdominal fibromatosis occur sporadically. In this article we would like to present a case report of a patient who was admitted to the clinic due to severe abdominal pain with clinically advanced peritoneal signs. The intraoperative findings were astonishing; we found a giant desmoid which originated in the mesentery. The tumor oppressed the ileum, leading to its obstruction.

A case of three synchronous primary lung cancers within the same lung lobe

We present the case of a 74-year-old patient with three synchronous primary lung cancers within the same lung lobe. Computed tomography and positron emission tomography investigations revealed two suspicious nodular lesions in the upper lobe of the left lung. Fine-needle aspiration biopsy confirmed that one of the lesions was non-small cell lung cancer. The patient was qualified for surgical treatment, and left upper lobectomy plus lymphadenectomy was performed. Histopathological examination confirmed the presence of three primary cancers in the left lung: keratinizing squamous cell carcinoma, neuroendocrine carcinoma, and acinar adenocarcinoma, localized within the same lung lobe. The patient was classified as having stage T3N1M0 lung cancer (stage IIIA) according to the latest, 7th edition of the TNM classification.

Outcome of pleurodesis using different agents in management prolonged air leakage following lung resection.

Prolonged air leaks (PAL) are a common problem after pulmonary resection. PAL can be a source of significant complications. One of the treatment options is chemical pleurodesis.

Is it Possible to Mathematically Predict the outcomesof Treatment of Abdominal Inflammation

Intra-abdominal infections are characterized by both a high rate of incidence and mortality in patients treated surgically. It is believed that in the first decade of the 21st century, approximately 20% of patients following major visceral surgery developed severe sepsis. After pneumonia, it is the second most common cause of infectious morbidity and mortality in intensive care units [1]. Despite advancements in surgical techniques, intensive therapy or new generations of antibiotics and other pharmaceutical compounds, the results of treatment of abdominal sepsis are poor. What follows are prolonged hospitalization and increased costs of treatment. This is predominantly the concern of patients receiving treatment in intensive therapy wards requiring further surgical intervention. In the CIAO conducted by Sartelli et al, the overall mortality rate in patients with complicated intra-abdominal infections was 7,7% (166/2152) [2]. However, if patients with severe sepsis or septic shock on admission to hospital are taken into account, the mortality rate increased from between 10% and 42,3% [3,4].

Oesophageal perforation - therapeutic and diagnostics challenge. Retrospective, single-center case report analysis (2009-2015).

BACKGROUND Esophageal perforation is a life-threatening condition of a complex etiology. No clear guidelines are available regarding the management of this condition. In this study, we review publications related to esophageal perforation, and analyze patients treated for this condition at our Department of Thoracic, General and Oncological Surgery. OBJECTIVE The objective of the study was to retrospectively assess and analyze management methods for esophageal perforations of different etiologies. All patients were treated in the Department of Thoracic, General and Oncological Surgery in years 2009-2015. Patients with perforations resulting from post-operational leaks within surgical anastomoses were excluded from the study. Material, methods, results: The analysis involved a total of 16 cases of esophageal ruptures. All cases were treated in years 2009-2015. Patients with perforations resulting from postoperative leaks within surgical anastomoses following elective surgeries for either oncological or non-oncological causes were excluded. The most common reason for esophageal rupture was iatrogenic injury (7 cases, 44%). Other causes included Boerhaave syndrome (5 cases, 31.2%), blunt trauma (2 cases, 12.5%), abscess perforation (1 case, 6.2%), and ulcer perforation (1 case, 6.2%). Ten patients underwent surgery, and the rest underwent esophageal prosthesis placement, of whom 2 cases required drainage of the mediastinum and pleural cavity. The mortality rate in the study group was 9/16 cases (56.2%). CONCLUSIONS Esophageal perforation poses a significant interdisciplinary challenge regarding diagnostic workup, selection of treatment methods, and management of potential postoperative complications. This retrospective study was conducted in a single center. Although the analyzed period was long, we found only 16 cases. In spite of a variety of etiologies present, we found several statistically significant results of potential clinical value. 1. Most perforations that are not diagnosed within 48 hours affected the lower part of the esophagus and presented with unclear symptoms and imaging findings 2. Delaying diagnosis and treatment beyond 24 hours was associated with a higher mortality rate.

Primary malignant peripheral nerve sheath tumor of the pleural cavity: rapid progression.

Malignant peripheral nerve sheath tumor (MPNST) accounts for 5-10% of all malignant soft tissue tumors. It often affects the extremities and abdominal cavity and very rarely develops in the thoracic cavity. The incidence in the general population is 0.001%. In our paper we would like to present a case report of a 74-year-old female patient with primary MPNST of the pleural cavity which was previously misdiagnosed as a non-small cell lung cancer. Despite the combined treatment, after four months the patient developed a secondary tumor in the contralateral pleural cavity which was also treated operatively.

Evaluation of the impact of radical tumor resection in lung cancer patients on the activity of selected antioxidant enzymes.

Introduction Oxidative stress appears to play an essential role as a secondary messenger in such physiological processes as apoptosis and survival as well as in proliferative signaling pathways. Oxidative damage is also considered to play a pivotal role in ageing, several degenerative diseases, and carcinogenesis. Lung cancer is the most common type of cancer, resulting in over 1.3 million deaths each year worldwide. Aim The aim of this study was to evaluate the activity of selected antioxidative enzymes in patients with lung cancer before and after radical surgery. Material and methods The study included 20 patients in the study group and 10 healthy volunteers in the control group. In the study group, blood samples were collected twice: one day before and one day after the operation. In the control group, blood samples were collected once. We estimated the activity of catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD) in erythrocytes. The total antioxidant status in blood plasma was also determined. Results The activity of the selected antioxidative enzymes was greater in the case of GPX and CAT after surgery; the results were statistically significant in the study group. The activity of SOD remained at a comparable level. The total antioxidant status also increased after surgery in the study group in comparison to its preoperative level.

Isolated retroperitoneal mixed germ cell tumor presenting as acute abdomen – case report

Extragonadal germ cell tumors are an uncommon clinical entity. Their prevalence varies between 1 and 5% of all germ cell tumors. Approximately 85–90% of cases have metastatic changes at the time of diagnosis. In our article we would like to present a case of an 18-year-old patient who was admitted to the hospital due to acute abdominal symptoms. A day earlier, the patient suffered blunt abdominal trauma during workout. Post-traumatic changes, which were described after admission in computed tomography, intraoperatively proved to be masses of extraperitoneal tumor.