Complications In Early Postoperative Period Research Articles

Influence of Body Mass Index and Glucose Metabolism on Results of Cabg for High Risk Patients

Aimto study influence of BMI and glucose metabolism on results of CABG for high-risk patients. Materialretrospective analysis of 194 high-risk patients who were discharged after CABG. Resultsanalysis of the BMI shown that 35 (18.04%) patients had normal weight, 86 (44.3%) - were overweight, I stage obesity had 58 (29.8%), II stage – 13 (6.7%), III st. obesity diagnosed in 2 (1.03%) cases. Impaired glucose metabolism was found in 132 (68.04%) patients. Type 2 DM had 50 (25.7%) patients, between which only 4 (8%) had BMI < 25 kg/m2, 46 (92%) – BMI > 25 kg/m2. IGT had 82 (42.2%) patients among which 15 (18.2%) had normal weight, 67 (81.7%) – BMI > 25 kg/m2. For all patients we performed CABG, in 187 (96.3%) cases off-pump. Average number of grafts was 3.37±0.96. Compering postoperative period of patients with BMI < 25 kg/m2 & normal glucose metabolism (n=16) against patients with BMI > 25 kg/m2 & impaired glucose metabolism (n=113) we found atrial fibrillation in 1 (6.25%) against 30 (26.5%) cases (p=0.0753); neurological dysfunctions 0 (0%) against 6 (5.3%), p=0.3452; wound infections 0 (0%) against 4 (3.5%), p=0.4446; pneumonia 0 (0%) against 4 (3.5%), p=0.4446 and acute kidney injury 0 (0%) against 2 (1.7%), p=0.5917. Conclusionsin high-risk patients with CAD before CABG impaired glucose metabolism diagnosed in 132 (68.04%) cases and BMI > 25 kg/m2 – in 159 (81.9%). Metabolic disorders influenced on appearance of infection, neurological and arrhythmic complications in early postoperative period. Off-pump CABG minimizes postoperative complications for high-risk patients.

An Observational Study on Complications in Early Postoperative Period after Emergency Laparotomy in a Tertiary Care Teaching Hospital

BACKGROUND&#x0D; An emergency laparotomy is a life-saving procedure undertaken mostly in acute conditions without much time for preoperative preparation of the patient. Patients undergoing emergency laparotomy have disproportionately high morbidity and mortality compared to elective laparotomies. We wanted to find out the incidence of postoperative complications after emergency laparotomy during the early postoperative period in Burdwan Medical College and Hospital which in turn will help to identify the areas requiring more improvement in terms of prevention, diagnosis and management of those complications resulting in an overall better outcome.&#x0D; METHODS&#x0D; This was an observational, descriptive study conducted on 100 patients undergoing emergency laparotomy for various indications, early postoperative complications were identified and tabulated and incidences of those were presented.&#x0D; RESULTS&#x0D; In this study, it was found that the most commonly occurring complications post emergency laparotomy were, wound infection (67%), fever (61%), nausea and vomiting (39%), respiratory infections (35%), paralytic ileus (19%), thrombophlebitis (11%), urinary infections (5%) and death (5%).&#x0D; CONCLUSIONS&#x0D; The most commonly occurring complications during the early postoperative period were wound infection and fever. Hollow viscus perforation was found to be the most common indication for emergency laparotomy associated with the maximum incidence of postoperative wound infection. Other complications such as nausea and vomiting, respiratory tract infection, paralytic ileus etc. were also found. Death was found to be the most dreaded complication during this early postoperative period.

Hepatobiliscintigraphy in the diagnosis of bile leakage in the early postoperative period in patients with cholelithiasis

The importance of hepatobiliar scintigraphy in the diagnosis of complications in early postoperative period in patients operated for cholelithiasis is considered. The high efficiency of this noninvasive method as compared with ultrasonography is shown.

Complications of X-ray Endovascular Interventions in Patients with Coronary Heart Disease with Reduced Left Ventricular Systolic Function

The work is dedicated to the research of direct results and immediate possible complications of interventions in X-ray surgery with coronary stent implantation. Our patients with chronic coronary syndrome and reduced left ventricular ejection fraction (LVEF) of less than 40% were studied. The study included 112 patients who were divided into two groups. The first group included 51 patients with LVEF &lt;40% (mean value 32.8 ± 1.14%), the second group involved 61 patients with LVEF &gt;40% (mean value 59.4 ± 1.02%). The mean age of the subjects ranged from 59 to 74 years (mean value 63.85 ± 1.73 years).&#x0D; There were no gender-related differences among the selected patients. There was no statistical difference in comorbidities in both groups. Both groups of patients were examined and managed according to the protocol of diagnosis and treatment adopted at the National Amosov Institute of Cardiovascular Surgery for patients suffering from chronic coronary syndrome.&#x0D; The study results show that patients with coronary artery disease and reduced LVEF 2 times more often developed complications in early postoperative period after PCI with revascularization through stent placement than in group of patients with preserved contractile myocardial function. Duration of PCI procedure and contrast agent use was 26.3±1.4% and 29.8±4.2% higher, respectively; the frequency of life-threatening arrhythmias was 54% higher. Intraoperational signs of acute heart failure developed 4.8 times less often in the control group than in the experimental group. In general, all the patients after stenting achieved good anti-ischemic effect.

Efficacy and Safety of Heparinization before Deployment of Endograft for Blunt Traumatic Aortic Injury in Severely Injured Patients

The administration of unfractionated heparin (UFH) during endovascular repair of blunt traumatic aortic injury (BTAI) is controversial. The aim of the study is to report the early outcomes of patients undergoing thoracic endovascular aortic repair (TEVAR) for BTAI, and to assess the individualized intraoperative use and dose of UFH. This is a retrospective analysis including consecutive patients treated with TEVAR for BTAI of the descending aorta between January 1st, 2005 and December 31st, 2018. Intraoperative use and doses of UFH were analyzed. Primary outcome included a reintervention because of new onset bleeding and/or thromboembolic complication and 30-day mortality. Technical success, injury severity score (ISS), timing of treatment, and neurologic deterioration were secondary outcome. Thirty-six patients with a mean age of 47 ± 18 years, 30 males (83%), were included. Intraoperative administration of UFH was recorded in 30/36 patients (83%) with a mean dose of 4750 ± 2180 IU. Two patients had no UFH because of extensive intracranial hemorrhage or suspected relevant liver laceration, respectively; 1 died in theatre, 1 was already anticoagulated having a mechanical aortic valve, and in 2 no information about heparin use was found. During 30 days of follow-up, 3 patients died (8%; 3/36): 1 patient with completely transected aorta died on-table and 2 on the fifth postoperative day, 1 from trauma-associated brain injury and 1 with multi organ failure. No bleeding or thromboembolic complication requiring reintervention occurred in any patient during 30 days follow-up. In 3 patients partial unintentional coverage of the left common carotid artery occurred, resulting in technical success of 89% (32/36). Mean ISS was 43 ± 15. Thirty-five patients (97%) were severely injured having an ISS ≥ 25. Twenty-nine patients (81%) were treated within 24 hr and 6 patients (17%) within 1 week. No stroke or spinal cord ischemia was observed. Systemic heparinization in different doses during TEVAR for BTAI can be safe with no intraoperative bleeding or thromboembolic complications in early postoperative period.

Imaging after laparoscopic sleeve gastrectomy - literature review with practical recommendations.

In the XXI century obesity has become one of the most demanding epidemiological threats worldwide. At the same time, bariatric surgery has established itself as an effective treatment for morbidly obese patients, with laparoscopic sleeve gastrectomy (LSG) emerging as the most popular bariatric procedure. This paper reviews the role of imaging studies of patients after LSG. Computed tomography is widely considered as the method of choice in detection of complications in early postoperative period. The dynamic character of upper gastrointestinal examination allows for the assessment of passage through the gastric remnant. The paper also discusses evaluation of the shape and volume of the gastric remnant assessed by imaging studies.

Impact of comorbid chronic heart failure with preserved left ventricular ejection fraction on the management of elderly cancer patients before and after total resections

To determine the predictors of safe enhanced recovery after surgery in elderly cancer patients with comorbid chronic heart failure (CHF) and preserved left ventricular ejection fraction (LVEF). There were 75 patients over 65 years old (mean 73.6±5.6 years) with cancer of abdominal and pelvic organs and comorbid cardiovascular diseases for the period from January 2018 to July 2020. All patients underwent total resections with enhanced postoperative recovery at the Petrovsky National Research Centre of Surgery. CHF with preserved LVEF was diagnosed in 42 (56%) patients (NYHA class I - 20 patients, class II - 19 patients, class III - 3 patients). ACE/ARA/neprilysin inhibitors were described in 74.7% of patients, beta-blockers - 70.7%, calcium channel blockers - 37.3%, diuretic therapy - 21.3%, antithrombotic therapy - 62.7%, statins - 54.7%, antiarrhythmic therapy - 12%. Preoperative correction of cardiac therapy was required in 60% of patients. Mean LVEF was 58.5±6.8%, pulmonary artery systolic pressure - 29±7.8 mm Hg, impairment of local myocardial contractility was observed in 6.7% of patients. Serum NT-proBNP level was 534.5±63.9 pg/ml, LDL-C - 3.3±1.1 mmol/l, GFR - 65.95±17.1 ml/min/1.73m2, glycated hemoglobin 6.37±0.67%. Perioperative risk of cardiovascular complications within 30-day postoperative period was assessed using the Revised Cardiac Risk Index (RCRI) score (6% in 59 patients, 10.1% in 11 patients, and 15% in 5 patients). Incidence of cardiovascular complications in early postoperative period was 4%, postoperative 30-day mortality rate - 1.3%. Our small study of surgical treatment of elderly cancer patients with comorbid CHF with preserved LVEF demonstrates the need for a personalized assessment of preoperative clinical and instrumental data to optimize cardiac therapy and perioperative monitoring. Multidisciplinary approach reduces perioperative mortality and cardiovascular morbidity from 7.2% to 4%.

Endoscopic transversus abdominis release separation in the treatment of patients with midline incisional hernias

Abstract. The issues of reconstruction of the anterior abdominal wall in patients with median postoperative ventral hernias remain relevant for many years. The paradigm of their treatment is gradually shifting towards functional minimally invasive reconstructions of the anterior abdominal wall. The indications and technical aspects of endoscopic posterior separation surgery are considered. The analysis of 70 transversus abdominis release was carried out. The average age of patients with postoperative ventral hernias was 61,210 years. The median follow-up was 14,28,2 months and the anaesthesia risk was 2,80,5. The mean hernia width was 151,773,7 cm2 and the implant size was 832,9243,3 cm2. In the early postoperative period complications were observed in 7 (10%) patients, including the one with retromuscular hematoma, four with retromuscular space infection and two with superficial vein thrombophlebitis. Late complications were observed in 6 (8,7%) patients, there were persistent seroma (3) and chronic pain (3). No hernia recurrence was detected during this period. Thus, the use of endoscopic abdominal wall separation reduces the risk of local complications compared to similar open surgery. At the same time, there is a low level of hernia recurrence and a satisfactory quality of life. In total there were 70 (100%) transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release operations performed, among them 14 (77,8%) were bilateral transversus abdominis release and 32 (61,5%) were unilateral transversus abdominis release 4 (22,2%) and 20 (38,4%) respectively were transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal 10 (14,3%) operations with combined access were performed: 3 (16,7%) and 7 (1,5%) respectively transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release. In 13 (18,6%) cases simultaneous operations occurred, including 7 (10%) laparoscopic cholecystectomy and 6 (8,6%) endoscopic inguinal hernioplasty.

Hemorrhagic and thromboembolic complications in patients with implanted left ventricular assist devices in early postoperative period

The work is devoted to study hemorrhagic and thromboembolic complications in early postoperative period after implantation of left ventricular assist devices (LVAD). We performed retrospective analysis of 10 patients, males aged 55±13.5 years, with a BMI of 30.8±8.3, with a left ventricular ejection fraction ranging from 9% to 28%, which in the period from 11.03.2016 to 22.11.2017 year, in the Silesian center of the Heart Disease (Poland), in conditions of artificial blood circulation, LVAD was implanted. In the early postoperative period, patients received daily anticoagulant target therapy (ACCT), consisting of the following drugs: heparin (6-11 U/kg/h), aspirin (75-150 mg), Clopidogrel (75-150 mg), warfarin (1.5-7 mg), Nadroparinum Ca (0.3-0.6 ml/twice on day), Fondaparinux Na (2.5-5 mg/twice on day). Two patients received mono-heparin therapy, one patient received monotherapy with warfarin for 14 days. Other patients during the same period received combined heparin therapy in the first three days with a subsequent transition to warfarin, aspirin, Clopidogrel, Fraxiparin, or thrombin blocker. The mechanical support of the left ventricle was carried out essentially by two different implantable systems, performing one function of support of the left ventricle: POLVAD – programmed controlled pneumatic membrane mechanical circulation of blood to two patients, and LVAD program-controlled electro-centrifugal circulation for eight patients. The duration of support by POLVAD system was from 102 to 156 days. Length of support – LVAD ranged from 20 to 78 days. A comparison of the analyzed results led to the conclusion that anticoagulant mono-therapy with heparin or warfarin leads to an increase in the percentage of complications and mortality compared with the alternative combination anticoagulant targeted therapy consisting of the following drugs: heparin (6-11 U/kg/h), aspirin 75-150 mg), Clopidogrel (75-150 mg), warfarin (1.5-7 mg), Nadroparinum Ca (0.3-0.6 ml/ twice on day), Fondaparinux Na (2.5-5 mg/ twice on day), Where survival rates were significantly higher by 60%.

Диференційований підхід до вибору способу дислокації тонкокишкового трансплантата в порожнину малого таза

Мета. Покращити результати реконструктивно-відновних операцій після колектомії з наднизькою передньою резекцією прямої кишки шляхом оптимізації методів забезпечення вільної дислокації тонкокишкового трансплантата в порожнину малого таза.&#x0D; Матеріали і методи. Розроблені нові способи дислокації тонкокишкового трансплантата під час виконання реконструктивно-відновних операцій після колектомії з наднизькою передньою резекцією прямої кишки, мукозектомії хірургічного анального каналу, які передбачають мобілізацію кореня брижі тонкої кишки, пересічення судинної аркади верхньої брижової артерії (ВБА) та прямих її судин. Зазначені способи використано у 32 пацієнтів у комплексі з відомими методами в складних анатомічних умовах залежно від анатомічних особливостей брижі тонкої кишки, розташування відрізка клубової кишки, архітектоніки ВБА.&#x0D; Результати. Ускладнень в ранньому післяопераційному періоді, обумовлених дислокацією тонкокишкового трансплантата в порожнину малого таза, у оперованих пацієнтів не спостерігали. В пізньому післяопераційному періоді у 1 (3,1%) пацієнта виник ішемічний резервуарит, який не був пов’язаний з особливостями техніки дислокації.&#x0D; Висновки. Розроблені нові способи дислокації тонкокишкового трансплантата після резекції термінальної ділянки клубової кишки сприяють збільшенню його довжини та покращенню мобільності. Диференційований підхід до використання розроблених нових способів дислокації тонкокишкового трансплантата в комплексі з відомими методами забезпечував переміщення трансплантата в порожнину малого таза в складних анатомічних умовах, обумовлених зменшенням довжини термінальної ділянки клубової кишки, без натягу брижі тонкої кишки, суттєвого ризику виникнення його ішемії та некрозу.

IMPROVEMENT OF THE METHODOLOGY OF MINIINVASIVE METHOD FOR THE TREATMENT OF CHRONIC HEMORRHOIDS

AIM. To improve results of latex ligation of internal hemorrhoids. MATERIAL AND METHODS. Results of 432 latex ligation of hemorrhoids were analyzed. The average age of the patients was 42,1 ± 7,3 years, 293 (67,8%) patients had third or the fourth degree of the disease. A new method of latex ligation of the mucosa and submucosa of the lower rectum with the aim to close hemorrhoidal vessels and lifting hemorrhoidal tissue complex was suggeste and usedfor III-IV degree hemorroids. RESULTS. In the early postoperative period complications not requiring reinterventions developed in 5 patients. In the late period good results were obtained in 87,3% of patients. CONCLUSION. Suggested modified latex ligation in the treatment of chronic hemorrhoids is minimally invasive, simple and low cost. It extends the indication of this method for hemorroids of advanced stages.

ROBOTIC INTERVENTIONS IN THORACIC TUMORS (EXPERIENCE OF 30 PRIMARY OPERATIONS)

OBJECTIVE. The research evaluated the data of robotic thoracoscopic interventions. MATERIALS AND METHODS. The article presents the results of robotic surgery in 30 patients aged 41 to 78 years with lung tumors of various localization and tumors of anterior mediastinum. The non-typical resection of the upper lobe was performed on 17 patients and extended lobectomy was conducted in 10 cases. The removal of anterior mediastinal tumor was made in 3 patients. RESULTS. There weren’t noted any complications in early postoperative period. The length of non-typical resection consisted of 40-50 min, but in case of removal of lung lobe with lymphodissection the duration of surgery was 3-3,5 hours. The removal of tumor from the anterior mediastinum took from 80 min to 1,5 hours. The diagnosis was made according to postmortem examination in all cases. All the patients were discharged from hospital in order to continue treatment. CONCLUSIONS. The results obtained showed the safety and efficacy of robotic interventions.

IMMEDIATE RESULTS OF FEMORALPOPLITEAL BYPASS AND DEEP FEMORALPOPLITEAL BYPASS

The authors analyzed the results of 415 reconstructive operations. There was noted an advantage of Deep Fem-Pop Bypass as more effective operation than Fem-Pop Bypass according to the results of operations, number and structure of complications in early postoperative period. It was shown that the access to donor artery influenced on the rate of lymphorrhea.

APPLICATION OF MINI-PLATES AND MINI-SCREWS IN TREATMENT OF PATIENTS WITH RADIAL HEAD FRACTURES

An article presents an experience of application of compression headless mini-screws (Gerbert’s screws) and mini-plates in treatment of radial head fractures. The authors showed advantages and disadvantages of given methods of treatment in 41 patients. Gerbert’s screws were used in 32 cases and miniplates were applied in 9 patients. Mini-plates in combination with Gerbert’s screws were used in 4 patients. There weren’t noted complications in early postoperative period. Patients (27–84%) with Gerbert’s screws were followed up in terms more than 6 months. Mean score was 91 according to the scale of Mayo Elbow Performance Score. Results of application of mini-plates were followed up in terms more than 6 months in 7 (77%) patients. Mean score of Mayo Elbow Performance Score consisted of 72. Based on the analysis of results, the authors concluded that the application of mini-screws in radial head fractures allowed doctors to obtain a good anatomical and functional result. Osteosynthesis by mini-plates didn’t always support the secure fixation of all fractures due to strictly given positioning on the head of radial bone. In case of osteosynthesis of splintered fractures of Mason type III, it should be reasonable to combine mini-plates and Gerbert’s screws.

100 ROBOTIC-ASSISTED OPERATIONS IN COLORECTAL CANCER (FIRST OUTCOMES)

This article analyzed the immediate treatment results of 210 patients, underwent endovideosurgical operative treatment concerning colorectal cancer (106 laparoscopic and 104 robotic-assisted operations). According to the first results, there was no significant difference between two methods in such medical indices as the volume of intraoperative hemorrhage, terms of hospital stay and peristalsis recovery, the rate of conversion and complications in. early postoperative period, quantity of removed lymph nodes, quality of TME. The application of robotics allowed performance of precision work in conditions of limited space of the small pelvis.

Laparoscopic diagnosis and treatment of acute early adhesive intestinal obstruction

To estimate the role of emergency laparoscopic interventions in diagnosis and treatment of acute early adhesive intestinal obstruction. It is presented the results of diagnostic and curative laparoscopic interventions in 58 patients with suspected acute early adhesive intestinal obstruction after abdominal surgery. Complex clinical-instrumental, non-invasive diagnosis does not always reveal this complication in early postoperative period. Diagnostic laparoscopy was the most informative method to assess state of abdominal cavity, to establish and characterize acute early adhesive intestinal obstruction, to determine following treatment and choice of surgery in all patients. Diagnosis of intestinal obstruction was not confirmed in 15 (25.9%) patients based laparoscopic checkup. Acute early adhesive intestinal obstruction was established in 43 (74.1%) patients. Small intestine injuries were observed in 2 (4.5%) cases during laparoscopy. Contraindications to laparoscopic treatment of obstruction were determined in 18 (41.9%) patients in whom conventional operations were performed with complications and death in 7 (38.8%) and 3 (16.6%) cases respectively. Curative laparoscopy was applied in 23 (53.4%) patients with successful resolving of intestinal obstruction and complications in 19 (82.7%) and 4 (17.4%) cases respectively.

Dismembered pyeloplasty for ureteropelvic junction syndrome treatment in children

Open dismembered pyeloplasty remains the preferred surgical technique for ureteropelvic junction syndrome (UPJS) in most paediatric urology units. The authors present their experience of 230 patients and describe their form of presentation, treatment and early and long-term results. Retrospective analysis of clinical records of 230 patients submitted to dismembered pyeloplasty in an 8-year period, from 1999 until 2007. Pre-operative data, early and long-term complications were registered. Image studies included renopelvic ultrasonography, mercapto-acetyl triglycine (MAG3) renal scan with furosemide test and, in some cases, elimination urography and retrograde cystography. Pre-operative and post-operative results were compared. Median age of our patients at time of surgery was 14.9 months (range: 21 days until 16.6 years). The majority of patients were male (72%, n = 166) and 74% (n = 120) had pre-natal diagnosis. The majority of hydronephrosis were in the left side (61%, n = 141). There were only 3% of complications in early post-operative period: four had acute pyelonephritis, two had renocutaneous fistula and one died due to respiratory failure. Mean follow-up period was 5 years, ranging from 12 months to 9.7 years. There was only one case of recurrence with the need of reoperation. Comparing pre-operative and post-operative imaging results, we found that 89% had normal renal function, 7% diminished but better than before and 2% equal as before surgery. Open dismembered pyeloplasty is a safe and effective treatment in paediatric UPJS.

Procalcitonin in Early Detection of Postoperative Infectious Complications. the Comparison with a Set of Cytokines, Soluble Cytokine Receptors and Acute Phase Proteins

Background: Infections and sepsis are relevant complications in patients undergoing large abdominal surgery and still constitute a diagnostic challenge. Only limited markers can differentiate incipient postoperative sepsis from uncomplicated early postoperative reaction. A prospective clinical study was performed to examine the accuracy of procalcitonin (PCT), set of cytokines, soluble cytokine receptors and acute phase proteins in patients following major abdominal surgery. Subjects and Methods: Between January 2006 and February 2008, 48 patients with febrile episode of the early postoperative period after abdominal surgery were entered into the study. Blood samples were obtained on the first day of fever for the measurement of plasma PCT (Kryptor), TNFalpha, IL-1beta, IL-1ra, IL-2, IL-6, sIL-6R, IL-8 (ELISA), and 10 acute phase proteins (nephelometry). Data were compared with reference group: 24 patients with the planned resection of colorectal cancer at stage Ib-IV and uncomplicated healing; venous blood samples were obtained repeatedly before surgery, 6, 12, 18, 24, 48, and 72 h after start of surgery Results: Febrile reaction of 26/48 patients was linked with positive blood culture results. PCT and IL-6 concentrations of blood culture positive subjects differed significantly from non-bacteremic patients (p < 0.01 for both parameters) as well as from uncomplicated patients (p < 0.003 and p < 0.001). Cutoff levels to distinguish blood culture positive and negative subgroups using ROC were 0.96 ng/ml for PCT and 345 pg/ml for IL-6. Other inflammatory parameters showed high sensitivity but lower specificity for bacterial complications in relation to uncomplicated postsurgical course. PCT and monitored cytokines culminated 18—36 h following uncomplicated surgery and postoperative PCT levels did not exceed 1.02 ng/ml in this group Conclusions: Simultaneous PCT and IL-6 examination is a reliable approach to distinguish incipient infectious complications in early postoperative period. Their measurement is well founded for daily monitoring of high-risk patients after large abdominal surgical procedures. Supported with grant IGA-MZ-CR-4825—3.

Cystic neck growth in children

The treatment of cystic neck lesions in 105 patients hospitalized in our institution over last 5 years was analyzed retrospectively in this study. The most frequent lesion was medial cyst of the neck, manifesting in almost 50% of patients. Lateral cysts, dermoid cysts and cystic hygroma were found in 25%, 10% and 8%, respectively. Although congenital in origin, clinical manifestation of medial cervical cyst occurs usually in preschool and particularly in school period (average 6 year). Cysts of the neck were present in male and female equally. The most frequent complication in early postoperative period was hematoma. During three-year follow-up there was neither recurrence nor malignant alteration.