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Tytuł:
Laparoscopic cholecystectomy in the treatment of gallbladder polypoid lesions – 15 years of experience
Autorzy:
Matłok, Maciej
Migaczewski, Marcin
Major, Piotr
Pędziwiatr, Michał
Budzyński, Piotr
Winiarski, Marek
Ostachowski, Mateusz
Budzyński, Andrzej
Rembiasz, Kazimierz
Tematy:
gall-bladder polyps
laparoscopic cholecystectomy
gall-bladder cancer
gall-bladder ultrasound
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1396486.pdf  Link otwiera się w nowym oknie
Opis:
Due to the constant increase of public health awareness and widespread “cancerophobia”, the progressively larger number of incidentally diagnosed gall-bladder polyps became the source of anxiety, which leads patients and physicians to undertake therapeutic decisions, despite the absence of symptoms. The majority of gall-bladder polyps are benign. It is estimated that only 3 to 5% of polyps are malignant. Currently, there is lack of randomized control trials based on which the clear-cut criteria of qualification of patients with gall-bladder polyps for surgical procedure can be created. The aim of the study was to analyze gall-bladder polyps in patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum. Material and methods. The retrospective study was conducted on 5369 patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum with special attention to 152 (2.8%) patients in whom gall-bladder polyps were diagnosed preoperatively. Qualification criteria for surgery, surgical treatment results, and histopathological examination results were also analyzed. Results. Amongst the 5369 patients qualified for laparoscopic cholecystectomy, 152 (2.8%) were diagnosed with gall-bladder polyps during the preoperative ultrasound examinations. Postoperative histopathological examinations of 41 (27%) patients confirmed the presence of gall-bladder polyps. In 102 (67%) patients, only gall-stones were diagnosed without previously described polyps during the ultrasound examination. Analysis of the histopathological examination results revealed the presence of benign lesions in 35 (23.35%) patients. In 5 (3%) patients the presence of an adenoma, and in one (0.65%) the presence of adenocarcinoma were confirmed. Conclusions. Based on the conducted study and previous personal experience in the treatment of patients with gall-bladder polyps, we believe that due to the potential risk of neoplastic transformation, patients with polyps larger than 10 mm in diameter and polyps of proven rapid growth should be qualified for laparoscopic cholecystectomy. Indications for surgical treatment also seem reasonable in case of patients with present polyps and coexisting right upper quadrant pain, even though the above-mentioned is connected with gall-bladder deposits.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The influence of piroxicam, a non-selective cyclooxygenase inhibitor, on autonomic nervous system activity in experimental cyclophosphamide-induced hemorrhagic cystitis and bladder outlet obstruction in rats
Autorzy:
Skowron, Beata
Thor, Piotr
Dobrek, Łukasz
Baranowska, Agnieszka
Opis:
autonomic nervous system
Signs and symptoms of secondary overactive bladder (OAB) are observed both in course of infravesical obstruction of urine outflow in patients with benign prostatic hyperplasia, and as a result of development of hemorrhagic cystitis (HC) following administration of cyclophosphamide (CP). Non-steroidal antiinflammatory drugs (NSAIDs) alleviate symptoms of bladder overactivity reducing local synthesis of prostaglandins (PGs), but precise effects of those agents on functions of the autonomic nervous system (ANS) in course of OAB remain unknown. The purpose of this study was to evaluate the effect of piroxicam-induced prostaglandins (PGs) synthesis block on activity of the ANS in two experimental models of secondary OAB: bladder outlet obstruction (BOO) and cyclophosphamide-induced HC (CP-HC), by heart rate variability analysis (HRV). The experiment was performed on a group of rats with surgically induced 2-week BOO, and on a group of rats that were administered CP five times, with corresponding control groups. Study animals were given piroxicam (PRX) i.p. in two doses: 2 and 10 mg/kg b.w. In the BOO model, PRX in both doses revealed a trend for reduction of value of all non-normalized components of HRV. The lower PRX dose caused an increased nHF value, and PRX administered in the dose of 10 mg/kg b.w. caused an increase of the nLF value. In the CP-HC model, the lower PRX dose caused a trend for an increase of values of all non-normalized components, and the higher dose ñ for their decrease. Both doses of PRX in that model caused increase of the nLF value. Inhibition of PGs synthesis caused changes of ANS function in both models of OAB. Both in BOO and in CP-HC, PGs seem to be ANS-activating factors, responsible for maintenance of a high parasympathetic activity. In both models, inhibition of PGs synthesis with PRX administered at the dose of 10 mg/kg b.w. lead to functional reconstruction of ANS, with marked sympathetic predominance. That may contribute to reduction of the bladder contractile action and improvement of its compliance in the filling period, which was demonstrated by other authors in urodynamic tests for NSAIDs.
heart rate variability
prostaglandins
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Tuberculosis of gall-bladder mimicking malignancy – a case report
Autorzy:
Dahiya, Divya
Kaman, Lileswar
Rajendran, Jayapal
Garg, Mandeep
Tematy:
gall-bladder tuberculosis
gall-bladder cancer
hepatobiliary tuberculosis
tuberculosis
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1393918.pdf  Link otwiera się w nowym oknie
Opis:
A correct preoperative diagnosis of gall-bladder tuberculosis is exceptionally unusual in the absence of pathognomic features both on clinical presentation and on imaging. Herein we present a case of 50 year female who was operated with a provisional diagnosis of gall-bladder malignancy and was found to have tuberculosis of gall-bladder on histopathology
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Ultrasound measurement of the gallbladder wall thickness in the assessment of the risk of conversion from elective laparoscopic cholecystectomy to open surgery — Olkusz county experience
Autorzy:
Kania, Dariusz
Tematy:
laparoscopic cholecystectomy
conversion
gall-bladder wall thickness
gall-bladder ultrasound
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1393735.pdf  Link otwiera się w nowym oknie
Opis:
The aim of the study was to assess the risk of intraoperative difficulties, conversion and biliaryintestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gallbladder wall thickness. Material and methods. A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χ2 ) independence test was used, and the results were interpreted for the significance threshold of α = 0.05. Results. The relationship between the gall-bladder wall thickness and the occurrence of intraoperative difficulties in the analysed set is deterministic (AUC = 1), and the wall thickness of ≥ 5 mm allows to predict their occurrence as soon as at the stage of diagnostic evaluation (p < 0.001). In addition, the ultrasound-measured GB wall thickness is a good predictor of conversion (AUC = 0.976; 95% CI 0.444–0.975; p < 0.001) and biliary-intestinal fistula (AUC = 0.935; 95% CI 0.121–0.738; p = 0.001). Conclusions. The results allow prediction of technically difficult laparoscopic cholecystectomies in patients with CCh, and selection of the right surgical team helps to reduce the number of conversions and possible complications. In addition, bearing in mind the above results in everyday practice should facilitate planning and increase effectiveness in the operating room.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The influence of montelukast on the activity of the autonomic nervous system estimated by heart rate variability in experimental partial bladder outlet obstruction in rats
Autorzy:
Dobrek, Łukasz
Skowron, Beata
Baranowska, Agnieszka
Thor, Piotr
Żurowski, Daniel
Opis:
Due to their paracrine action, leukotrienes released from the urothelium are involved in control of the bladder function. Anti-leukotriene agents appear to exert an ameliorating effect in bladder overactivity. It is unknown, whether their possible, modulatory impact on the autonomic nervous system (ANS) activity may also contribute to the potentially beneficial effect of those compounds. Therefore, our aim was to indirectly estimate the ANS function using the heart rate variability (HRV) study in rats with experimental partial bladder outlet obstruction (PBOO), reflecting human benign prostatic hyperplasia (BPH), treated with leukotriene receptor antagonist - montelukast (MLKT). Twenty rats with surgically induced PBOO lasting for 14 days, divided into two groups: group 1 (10 control subjects) and group 2 (10 MLKT-treated rats; 2 mg/rat/day) were subjected toHRV recordings, preceded by daily urine collection and a subsequent cystectomy with histopathological evaluation of collected bladders. Standard HRV time and spectral parameters were calculated. MLKT-treated animals demonstrated an increase in power of non-normalized LF (low frequency) and HF (high frequency) components with no change of the total HRV power. Moreover, an increase and decrease in normalized nLF and nHF, respectively, were assessed in those animals compared to the control. Additionally, a decrease in daily diuresis measurement was demonstrated in MLKT-treated animals. Montelukast treatment resulted in the functional ANS status re-arrangement, with sympathetic overdrive and parasympathetic withdrawal. Those changes may contribute to alleviation of bladder overactivity symptoms, independently on leukotriene receptors blockade.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Sonography of tumors and tumor-like lesions that mimic carcinoma of the urinary bladder
Guzy i zmiany guzopodobne imitujące raka pęcherza moczowego w badaniu ultrasonograficznym
Autorzy:
Smreczyński, Andrzej
Bojko, Stefania
Ostasz, Oksana
Gołąbek, Tomasz
Szopiński, Tomasz
Opis:
One of the basic abdominal organs that is assessed during transabdominal ultrasound examination for urological reasons is the urinary bladder. The bladder must be filled with urine. This is a prerequisite for a reliable assessment and, at the same time, an acoustic window in examining adjacent structures and organs, for instance the prostate gland. In some cases, doubts occur with respect to the nature of lesions detected. The paper presents anatomic lesions, defects and pathologies which might be erroneously interpreted as tumors of the urinary bladder, i.e. transitional cell carcinoma of the urinary bladder. The following lesions are discussed: 1) anatomic defects (including urachus remnants, ligaments that stabilize the bladder or cyst in the opening of the ureter into the bladder - ureterocele); 2) tumor- like lesions in the lumen of the urinary bladder (such as blood clots, fungus balls, stones or foreign bodies); 3) bladder wall pathologies (i.e. cystitis or endometriosis), focal decidual transformation of stromal cells or inflammatory pseudotumor; 4) lesions impressing on the bladder from the outside (the mesentery of the sigmoid colon, the bowel, pathological lesions in organs adjacent to the urinary bladder, inflammatory infiltration, vasogenic compression of the bladder, pelvic lipomatosis, pathological lesions of the pubic symphysis); 5) postoperative lesions. All these lesions may mimic carcinoma of the urinary bladder in sonography. Bearing this fact in mind is significant in establishing a diagnosis. Due to the malignant character of carcinoma of the urinary bladder and the need for aggressive surgical treatment, a correct diagnosis of this disease is essential for patients, particularly because the lack of adequate treatment and delayed treatment considerably affect prognosis.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Guzy i zmiany guzopodobne imitujące raka pęcherza moczowego w badaniu ultrasonograficznym
Sonography of tumors and tumor-like lesions that mimic carcinoma of the urinary bladder
Autorzy:
Smereczyński, Andrzej
Szopiński, Tomasz
Gołąbek, Tomasz
Ostasz, Oksana
Bojko, Stefania
Tematy:
bladder pseudotumors
bladder tumors
ultrasound imaging
urinary bladder neoplasms
guzy pęcherza moczowego
guzy rzekome pęcherza moczowego
nowotwory pęcherza moczowego
ultrasonografia
Pokaż więcej
Wydawca:
Medical Communications
Powiązania:
https://bibliotekanauki.pl/articles/1058049.pdf  Link otwiera się w nowym oknie
Opis:
One of the basic abdominal organs that is assessed during transabdominal ultrasound examination for urological reasons is the urinary bladder. The bladder must be fi lled with urine. This is a prerequisite for a reliable assessment and, at the same time, an acoustic window in examining adjacent structures and organs, for instance the prostate gland. In some cases, doubts occur with respect to the nature of lesions detected. The paper presents anatomic lesions, defects and pathologies which might be erroneously interpreted as tumors of the urinary bladder, i.e. transitional cell carcinoma of the urinary bladder. The following lesions are discussed: 1) anatomic defects (including urachus remnants, ligaments that stabilize the bladder or cyst in the opening of the ureter into the bladder – ureterocele); 2) tumorlike lesions in the lumen of the urinary bladder (such as blood clots, fungus balls, stones or foreign bodies); 3) bladder wall pathologies (i.e. cystitis or endometriosis), focal decidual transformation of stromal cells or infl ammatory pseudotumor; 4) lesions impressing on the bladder from the outside (the mesentery of the sigmoid colon, the bowel, pathological lesions in organs adjacent to the urinary bladder, infl ammatory infi ltration, vasogenic compression of the bladder, pelvic lipomatosis, pathological lesions of the pubic symphysis); 5) postoperative lesions. All these lesions may mimic carcinoma of the urinary bladder in sonography. Bearing this fact in mind is signifi cant in establishing a diagnosis. Due to the malignant character of carcinoma of the urinary bladder and the need for aggressive surgical treatment, a correct diagnosis of this disease is essential for patients, particularly because the lack of adequate treatment and delayed treatment considerably affect prognosis.
Jednym z podstawowych narządów jamy brzusznej ocenianych w trakcie badania ultrasonografi cznego przez powłoki jamy brzusznej wykonywanego ze wskazań urologicznych jest pęcherz moczowy. Jego dobre wypełnienie moczem stanowi bezwzględny warunek wiarygodnej oceny, a zarazem okno akustyczne w diagnostyce innych sąsiadujących struktur i narządów, np. stercza. W niektórych przypadkach pojawiają się wątpliwości co do natury wykrytych zmian. W pracy przedstawiono zmiany anatomiczne, wady oraz stany chorobowe, które można mylnie zinterpretować jako guz pęcherza moczowego, czyli rak przejściowokomórkowy pęcherza moczowego. Kolejno omówiono następujące zmiany: 1) wady anatomiczne (w tym pozostałości moczownika, więzadła stabilizujące pęcherz moczowy, torbiel ujścia pęcherzowego moczowodu – ureterocele); 2) zmiany guzopodobne w świetle pęcherza moczowego (tj. skrzepy krwi, kule grzybicze, złogi, ciała obce); 3) patologie ściany pęcherza (tzn. zapalenie pęcherza moczowego, gruczolistość macicy zewnętrzną – endometriozę), ogniskową przemianę doczesnową komórek podścieliska, guza rzekomego zapalnego; 4) zmiany modelujące od zewnątrz pęcherz moczowy (krezkę okrężnicy esowatej, jelito, zmiany chorobowe w narządach przylegających do pęcherza moczowego, naciek zapalny, ucisk pęcherza naczyniopochodny, otłuszczenie miednicy, zmiany patologiczne spojenia łonowego); 5) zmiany pooperacyjne. Wszystkie powyższe zmiany mogą dać obraz ultrasonografi czny imitujący raka pęcherza moczowego. Znajomość tego faktu jest istotna w diagnostyce. Ze względu na złośliwy charakter raka pęcherza moczowego oraz konieczność agresywnego leczenia operacyjnego właściwe rozpoznanie tej choroby ma ogromne znaczenie dla pacjenta, zwłaszcza że nie tylko brak odpowiedniej terapii, ale również jej odwleczenie w czasie znacznie pogarsza rokowanie.
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-10 z 150

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