Early Results Of Surgical Treatment Research Articles

Early Results of Surgical Treatment of Volar Barton Fractures by Plating In Adults

Early Results of Surgical Treatment of Volar Barton Fractures by Plating In Adults

Extracranial Carotid Artery Aneurysms: 20-Year Experience of Surgical Management

Extracranial carotid artery aneurysm (ECAA) is a rare vascularpathology with reported incidence of 0.2-5.0% of all carotid artery surgical interventions. Most of ECAAs remain clinically asymptomatic, however, they can manifest in neurological symptoms as transient ischemic attack or stroke. The presence of a pulsating formation, swallowing disorders, signs of compression of cranial nerves may beindicative of the aneurysm growth, which is associated with higher risk of thromboembolic complications and less oftenwith rupture. Surgical treatment is a method of choice in symptomatic patients or in cases of the aneurysm growth and includes resection with arterial reconstruction, ligation of the artery or endovascular intervention.
 The aim. To improve the results of surgical treatment of ECAAs.
 Materials and methods. The results of clinical examination, laboratory, instrumental, intraoperative observations were analyzed in 39 patients (35 [89.7%] men and 4 [10.3%] women) with 44 ECAAs, who were admitted to the Vascular Surgery Department of Lviv Regional Clinical Hospital for the period from 2003 to 2022. To conϐirm the diagnosis of ECAA, preoperative instrumental examination included duplex ultrasonography and multispiral computed tomography angiography.
 Results. Etiological causes of ECAAs included: atherosclerosis (79.5%),ϐibromuscular dysplasia (7.7%), trauma (5.1%), previous operations in the neck region (5.1%) and infection (2.6%). The justiϐication of the choice of surgical tactics depended on the localization of aneurysm, concomitant carotid occlusive disease or pathological deviation of carotid arteries. Early results of surgical treatment were evaluated up to 30 days of the postoperative period. The postoperative complications included: transient ischemic attack in 1 (2.6%), ischemic stroke in 2 (5.1%), cranial nerve damages in 4 (10.3%), thrombosis of arterial reconstruction in 2 (5.1%), hematoma of postoperative wound in 4 (10.3%), infection of postoperative wound in 1 (2.6%) cases. Postoperative mortality was 2.6%.
 Conclusion. ECAA is a rare clinical disease that requires an active surgical approach to reduce the risk of ischemic stroke. Reconstructive surgery of ECAAs is a highly effective method of treatment that allows to achieve satisfactory results and prevent the development of severe complications.

Assessment of early results of surgical treatment of acute biliary pancreatitis at Viet Duc University Hospital

treatment requires radical treatment. ERCP, percutaneous lithotripsy, and surgery are effective treatments. The purpose of this paper is to evaluate the early results of surgical treatment of acute biliary pancreatitis. Patients and methods: A retrospective review of all patients diagnosed with acute pancreatitis due to gallstones was surgically treated at the Department of Hepatobiliary Surgery of Viet Duc University Hospital from January 2019 to December 2021. Results: The study group has 49 patients (26 female, 23 male). The mean age at surgery was 56.8 (28-87 years). CT scan identified 100% of pancreatic lesions and gallstones before surgery, of which common bile duct stones accounted for 20.4%, the rest were common bile duct stones combined with gallstones and stones in the liver. One patient was diagnosed with septic shock caused by cholangitis had to be resuscitated before surgery. The surgical intervention on biliary tract was cholecystectomy, stone removal, endoscopic lithotripsy, T tube drainage, combined cholecystectomy and left lobectomy. Open surgery was performed on 35 patients, accounting for 71.4%, and laparoscopic surgery accounted for 28.6%. The intervention on the pancreas was on 8 patients, mainly removing the necrotic pancreatic tissue, draining the lesser sac. Most patients had surgery in the first 2 days, as early as 22 hours, as late as 8 days. There were two patients complicated the surgical site infection, two patients with biliary leak, one patient with acute pancreatitis, all were treated medically. The mean hospital stay was 5.1 days. Laparoscopic surgery gave good results, accounting for 92.9%, there were no severe cases of recurrence or death. 49 patients were followed up 30 days after surgery with a good result (85.7%), no mortality was observed. Conclusion: Surgical treatment for acute biliary pancreatitis is safe which assesses pancreatic damage, gives good postoperative results. Keywords: Acute pancreatitis, gallstones, surgery

Early Results of Surgical Treatment of Intra-Articular Calcaneal Fractures Using T-Shaped Plates

Background: Displaced intra-articular calcaneus fractures are still now a controversial topic among orthopedic surgeons. There is no single treatment option to manage all different fractures. Objective: The aim of this study was the assessment and evaluation of providing and maintaining stable fixation by the use of a T-shaped plate for displaced intra-articular calcaneal fractures. Patients and Methods: A randomized controlled study was conducted on18 patients were conducted between the ages of 18 to 50 years in the Orthopedic and Traumatology Department of Zagazig University Hospital from August 2020 to April 2021 including 6 months follow-up periods, all patients with closed D.I.A.C.F with no morbidity. T plates were the method of fixation for all patients. Results:Mean A.O.F.A.S. hindfoot scale result was 86.61, 88.8% of patients their results were satisfying (excellent and good), and 11.1% of patients their results were unsatisfying (fair). Complications were seen in 27.7% (wound complication, subtalar arthritis, symptomatic hardware, and delayed union). Conclusion: T-shaped plates can provide stable support and rigid fixation as they maintain proper reduction and alignment to displaced intra-articular calcaneus fractures.

Assessment of the results of surgical treatment and postoperative physiotherapy in patients with degenerations of the cervical spine

Background. Cervical spine pain syndromes are a serious contemporary problem, both medical and social. They lead to limiting professional life in highly developed countries. Surgical treatment of cervical degenarations and discopathy is the method of choice when conservative treatment has not improved. The aim. The aim of this study was to attempt to assess the early results of surgical treatment of patients treated for osteoarthritis of the cervical spine. Material and methods. A group of 36 patients was examined, including 20 women and 16 men surgically treated for osteoarthritis of the cervical spine. Patients were divided into two groups. The study group received additional developed recommendations and a list of exercises in the field of independent post-hospital physiotherapy. The evaluated parameters were evaluated twice: before surgery and 2 months after surgery. The following research tools were used to evaluate treatment results: DASH questionnaire, NDI functional assessment scale, visual analog pain scale (VAS). Conclusions. The applied treatment resulted in a decrease in the intensity of pain, a decrease in the degree of disability of the limb and an improvement in the functional status of patients. In the group of patients with additional recommendations on the principles of rehabilitation and prevention, a higher degree of improvement was obtained in the scope of: intensity of pain radiating to the limbs and functional state.

Early Results of Surgical Treatment of Triangular Fibrocartilage Complex Tears in Children and Adolescents

To investigate the clinical results and patient-reported outcomes following surgical treatment for triangular fibrocartilage complex (TFCC) tears in the pediatric and adolescent population. We reviewed 149 patients with 153 arthroscopy-confirmed TFCC tears. Mean age at surgery was 15.5 years (range, 7-19 years). There were 86 females. Plain radiographs and magnetic resonance imaging were used to characterize bony and soft tissue pathology. Mayo Modified Wrist Score (MMWS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Short Form assessed functional outcomes. Median patient follow-up was 21.8 months (IQR:5.9-55.4). Pre-operatively, all patients had wrist pain or instability with activities. The median pre-operative MMWS was 80 (interquartile range [IQR], 65-90). Fifty-six (35%) presented with positive ulnar variance. Concomitant pathology included distal radioulnar joint (DRUJ) instability (14%), ulnocarpal impaction (20%), ulnar styloid nonunion (33%), and distal radius growth arrest (30%). On arthroscopy, there were 15 (10%) isolated 1A, 79 (52%) 1B, 1 (1%) 1C, 30 (20%) 1D tears, and 25 (16%) cases of multiple tears. Twenty-six percent of wrists underwent TFCC debridement, 68% arthroscopy-assisted repair, 6% both for combined tears. Fifty-one percent of wrists underwent bony procedures-most commonly ulnar-shortening osteotomy to achieve neutral ulnar variance (40%) and symptomatic ulnar styloid nonunion excision with concomitant TFCC repair (39%). At final follow-up, pain, wrist range of motion, DRUJ stability, ulnar variance, and MMWS (median, 95 [IQR, 86.5-100]) improved significantly. The median PROMIS T-score at final follow-up was 57 (IQR, 45-57). The MMWS was better in those with concomitant bony procedures at index surgery than those with only repair or debridement of TFCC tears. Most pediatric TFCC tears are posttraumatic and peripheral. Surgical treatment of TFCC tears and concomitant pathology in the pediatric and adolescent population results in decreased pain, improved motion and stability, and excellent functional outcomes in the majority of patients. Therapeutic IV.

Surgical treatment of rectal cancer in Poland — a report from a prospective, multi-centre observational study PSSO_01 conducted under the auspices of the Polish Society of Surgical Oncology

Introduction. Since 2016, as part of the PSSO_01 multi-centre research project conducted under the auspices of the Polish Society of Surgical Oncology, clinical data on rectal cancer treatment have been collected. The objective of the study was to illustrate the state of early results of surgical treatment. Material and methods. The research project is multi-centre in nature. Data shall be collected electronically. The study protocol does not impose or suggest any course of procedure. It only systematizes the way data are collected for scientific purposes. The analysis of early results of surgical treatment was compared with the results of population studies from other European countries (Netherlands, Belgium). Results . By the end of June 2018, 736 patients were registered in the study. In 399 (54.2%) an anterior resection was performed. More than half of patients undergoing subsequent surgical treatment (54.2%) receive neoadjuvant treatment, with the percentage of patients undergoing radiotherapy or radiochemical treatment for lower rectal cancer being about 70%. Most patients (96%) are operated in elective procedure. The percentage of laparoscopic surgeries is low (8.6%). Postoperative complications are observed in 21.1% of patients. Severe complications (grades III–V according to Clavien-Dindo classification) occur in 7.6% of patients undergoing surgery. Postoperative mortality is 1.1%. Discussion. Although the project does not have the character of a registry and does not allow for drawing wider conclusions concerning the compliance with the standards of qualification for neoadjuvant treatment, the important information is that more than half of rectal cancer patients receive preoperative treatment, and the percentage of severe postoperative complications does not exceed 10%. Conclusions. The results of the PSSO_01 project are representative and reflect the actual situation concerning surgical treatment of rectal cancer patients in Poland.

Initial Results of D3 Lymphadenectomy in the Surgical Treatment of Cancer of the Right Half of the Segmented Intestine

Introduction. Despite recent significant progress in chemotherapy treatment of primary non-metastatic cancer of the right half of the segmented intestine, surgery remains the primary method of treatment. Radical surgery includes removal of the tumour within the healthy tissues and regional lymph glands. Considering localisation of the primary tumour in the right half of the segmented intestine, hemicolectomy is typically performed on the right side. W. Hohenberger et al. have formulated a new concept of radical surgical treatment of the segmented intestine, consisting of the following components: complete mesocolic excision, early ligation of the lymphovascular pedicle and lymph dissection in the D3 volume.Purpose of the research: to analyse the early results of surgical treatment of cancer in the right half of the segmented intestine in the volume of the right-side hemicolectomy with D3 lymph node dissection depending on the method of surgical treatment.Materials and methods. At the premises of the Surgical Department No. 3 of the Republican Oncologic Dispensary (city of Ufa) a retrospective analysis of data of 59 patients was performed following right-side hemicolectomy using complete mesocolic excision, ligation lymphovascular pedicles and lymph node dissection in the D3 volume. Depending on the surgical access, all patients were divided into two main groups: group I (48 patients) — surgeries were performed using open method; group II (11 patients) — using laparoscopy.Results and discussion. Table 2 shows that the surgery performed with laparoscopy takes longer. However, statistically it results in significantly less blood loss. Patients who underwent open surgery were characterised by a longer stay in hospital. One of the effectiveness criteria is the number of removed lymph glands not differing for either group.Conclusion. Extended lymph dissection in the D3 volume for segmented intestine on the right side during cancer is a possible and safe method in case of laparoscopic and open procedures.

КРИОАБЛЯЦИЯ РАКА ПРОСТАТЫ В СРАВНЕНИИ С РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИЕЙ ЭКСТРАПЕРИТОНЕОСКОПИЧЕСКИМ ДОСТУПОМ

Currently, prostate cancer is one of the most common oncological pathologies in Russia. We analysed the early results of surgical treatment of 259 patients with prostate cancer who were under our surveillance from 2016 to 2017. These patients were divided into two groups: first group underwent cryoablation of the prostate (31 patients), second group underwent radical prostatectomy without lymphadenectomy (39 patients). According to results of the preoperative examinations there was obtained no data on extracapsular tumour process, as well as on regional lymphadenopathy. All patients had no interest in sexual function. Prostate volume ranged from 12 to 65 cm3, PSA level ranged from 4.1 to 10 ng / ml, Gleason score ranged from 5 to 8 points. According to the first results we observed PSA level decrease in both groups of patients. Retention of urine, as well as the intensity of postoperative pain in patients undergoing cryoablation of the prostate is better in comparison with Laparoscopic radical prostatectomy, however, we continue evaluation of long-term oncological and functional results.

ASSESSMENT OF SURGICAL TREATMENT FOR INFECTED PREAURICULAR SINUS AT HUE CENTRAL HOSPITAL AND HUE UNIVERSITY HOSPITAL

Background: This study aims to research clinical characteristics and to evaluate the results of early surgical treatment of infected preauricular sinus. Subjects and methods: Studied 46 patients (46 ears) sufferring from infected preauricular sinus surgically treated, by the method of descriptive observative prospective study with clinical intervention. Results: Age group of ≤ 15 years old accounted for the highest percentage with 71.8%. Combined defects accounted for 2.2%. Number of patients having familial factors accounted for 60.9%. Location of preauricular sinus: classic position 91.3%, posterior to classic position 8.7%. Positive bacteria culture with the proportion of 38.5%. Common bacterium was Staphylococcus aureus 60%. Most bacteria were sensitive to antibiotics. Stages of the infected preauricular sinus: inflammation 71.7%, abcess 48.5%. Surgical procedures: hot 69.6%, warm 30.4%. Average inpatient time: 8.5 ± 3.1 days. Recurrence after surgery 3 months having 1 ear, accounted for 2.2%. Results after surgery 3 months: good 91.3%, moderate 6.5%, bad 2.2%. Conclusions: Infected preauricular sinus were most common in children, combined defects were rare, having the role of family factors. Preauricular sinus having classic position occupied high percentage. Majority of postoperative results were good. Key words: Preauricular sinus

MINIMALLY INVASIVE SPINAL CANAL RECONSTRUCTION FOR DEGENERATIVE LUMBAR SPINAL STENOSIS

Objective. To analyze early results of surgical treatment in patients with lumbar spinal stenosis using minimally invasive techniques for reconstruction of the spinal canal and fixation of the spine. Material and Methods . A total of 168 patients were treated with minimally invasive unilateral microsurgical decompression for spinal stenosis at the lumbar level. Results . The average length of post-operative inpatient care was 5.8 ± 2.8 days. When assessing the pain intensity in the legs and lumbar spine, as well as in daily activity, positive dynamics was noted after 1 and 6 months. Of the installed 732 screws, 18 (2.4 %) screws were displaced into the spinal canal by less than 2 mm and 4 (0.5 %) – by less than 4 mm. Signs of persistent subcompensated spinal stenosis at the operated level were detected in 5 (2.9 %) patients. The average intraoperative blood loss was 121.1 ± 22.0 ml. All patients were activated at the first day after surgery. Conclusion . Minimally invasive unilateral decompression, if necessary in combination with correction and fixation with percutaneous pedicle screw system and TLIF, eliminates factors causing compression of neural structures, reduces intraoperative blood loss, allows early activation of patients and shortens the length of hospital stay.

Степлерна гемороїдектомія при комбінованому геморої III–IV стадії, в поєднанні з хронічною анальною тріщиною

Мета роботи: порівняти ранні результати степлерної циркулярної гемороїдектомії та гемороїдектомії за Мілліган–Морганом при хронічному комбінованому геморої III–IV стадії, в поєднанні з хронічною анальною тріщиною.Матеріали і методи. Всім пацієнтам у передопераційний період проведено клінічні та біохімічні дослідження крові та сечі, ультразвукове дослідження органів черевної порожнини, консультації інфекціоніста, онколога. Всім пацієнтам проведено інструментальні дослідження прямої та ободової кишки для виключення іншої патології.Результати досліджень та їх обговорення. У роботі представлено порівняльний аналіз ранніх результатів хірургічного лікування хронічного геморою III–IV стадії, в поєднанні з хронічною анальною тріщиною: 27 (55,1%) хворим першої групи було виконано степлерну гемороїдектоміюзгідно з розробленим нами способом, висікання анальної тріщини лазером, 22 (44,9 %) хворі другої групи перенесли гемороїдектомію за Мілліганом–Морганом в другій модифікації НДІ проктології м. Москви, висікання анальної тріщини лазером.У ранній післяопераційний період (до 10 діб) оцінювали: тривалість операції; інтенсивність болю за 10-бальною візуальною аналоговою шкалою через 24, 120 і 240 год після операції; тривалість больового синдрому; час повернення до нормальної активності; частоту ранніх (до 30 діб) післяопераційних ускладнень. Встановлено, що повернення до нормальної активності в другій групі тривало в середньому в 1,6 раза довше, ніж в першій; ранні результати в першій групі були кращими, ніж в другій.

Prospective monitoring of the early treatment results of the GI tract tumours at the Oncology Centre in Warsaw

The current treatment of GI tract tumours is based to a large degree on the combined use of varied types of therapy: surgery, chemotherapy, irradiation. Severe post-operative complications may significantly affect the possibilities of application of non-surgical methods of treatment. Therefore, monitoring the early results of surgical treatment is extremely crucial to ensuring the appropriate necessary follow up and keep the risk of post-operative complications to a minimum. This paper describes the methodology of prospective collection of clinical data, which allows monitoring the quality of the surgical treatment of GI tumours on a current basis. On the basis of the data collected in the period from 2010 to 2015, the results of the analysis of three types of surgeries were presented (anterior resection of the anus, right hemicolectomy and a total gastric resection) and the actions taken on the basis of the annual report concerning the post-operative complication risks were described. Moreover, the examples of the application of prospectively collected clinical information for academic purposes were presented.

Результати лікування хворих із супратенторіальними пухлинами мозку з інсультоподібним перебігом у ранній післяопераційний період

Objective – to study early results of surgical treatment in 176 patients with supratentorial tumors (ST) with a stroke-like course. Materials and methods. The results of surgical treatment of 176 patients with stroke-like tumors were studied. They were treated at the urgent neurosurgery clinic of the Kyiv Emergency Hospital during the period from 2008 to 2015. The age of the patients was 20-70 years, the average age was (53.7 ± 13.4) years. There were 104 (59.1 %) men, 72 (40.9 %) women. Intracerebral tumors were diagnosed in 156 (88.6 %) cases, metastasis was observed in 35 (19.9%), 20 (11.4 %) patients have extracranial tumors Patients were divided into two groups depending on cerebrovascular accident: the group I – 103 patients had hemorrhagic type of cerebrovascular accident, the group II – 73 patients had ischemic type of cerebrovascular accident. In early postoperative period, CT and/or MRI was performed in all cases to detect postoperative complications and evaluate the radicality of surgical resection. An ophthalmologic review before and after surgery was performed. Results. Total resection was achieved in 68 (38.6 %) patients, near total – in 82 (46.6 %), subtotal – in 26 (14.8 %). All 176 patients had less than 70 points of Karnovsky scale before surgery, after treatment the number of this patients decreased to 36 (20.5 %) patients. Improvement of quality life was noted in regression of neurological deficits, restoration of functional disorders, high degree of social adaptation. Conclusions. The main criteria of successful surgical treatment of tumors with stroke-like course. is the survival of patients with radical surgical resection and satisfactory quality of life in the postoperative period. Factors that influence the removal of the tumors with stroke-like course are size of the lesion, its localization, and the histological characteristics of the tumors. Therapeutic tactics in patients with tumors with stroke-like course should be based on an individual approach. Adequate surgical removal of the tumors and hematomas evacuation improve the quality of life in most patients (79.5 %).

Penetrating cranial injury with giant intraorbital foreign body

The article describes clinical and radiological picture as well as early results of surgical treatment of a rare kind of open craniocerebral trauma - cranio-orbital injury with giant intraorbital foreign body

Extended myectomy in the treatment of patients with hypertrophic obstructive cardiomyopathy.

IntroductionPartial resection of the septal muscle is a well-established and effective method of surgical treatment for patients with hypertrophic obstructive cardiomyopathy (HOCM). The procedure is characterized by a low operative mortality rate and long-term clinical improvement that has been confirmed in numerous publications. Mitral insufficiency in patients with HOCM is mostly functional due to the effect of systolic anterior motion (SAM).AimTo present the early results of surgical treatment provided to HOCM patients and to compare the effectiveness of two surgical procedures: isolated myectomy and myectomy combined with mitral valve replacement.Material and methodsThe study analyzed a group of 49 patients (20 women) with HOCM who underwent surgical treatment between 2012 and 2015. Isolated myectomy was performed in 67.25% (n = 33) of patients, myectomy combined with mitral valve replacement in 30.61% (n = 15), and 1 (2.04%) patient underwent myectomy combined with mitral valvuloplasty (papillary muscle repositioning).ResultsA greater reduction of the left ventricular outflow tract (LVOT) gradient was observed in the population with concomitant mitral valve replacement in comparison to patients after isolated myectomy; the difference was statistically significant (p = 0.020). No significant correlation was observed between residual SAM and the grade of mitral regurgitation (p = 0.699) or between residual SAM and the LVOT gradient (p = 0.280).ConclusionsSurgical myectomy is a well-established, effective method of reducing increased LVOT gradients in patients with HOCM. Additional mitral valve replacement may be associated with greater reductions of the LVOT gradient in the early postoperative period. Valve replacement should be considered in patients with concomitant mitral valve degeneration and patients with narrowed left ventricular cavities.

Diagnosis and treatment of craniosynostosis: Vilnius team experience

Background. The aim of the study was to review the methods of diagnosis of craniosynostosis and to analyze Vilnius (Lithuania) team experience of surgical treatment, surgical methods, aspects of anesthesia for patients with craniosynostosis and to present early results of surgical treatment. Materials and methods. A retrospective review of all patients with various types of craniosynostosis treated surgically during the period from 1 January 2009 to 31 December 2014 was performed. The following data were analyzed: age, type of deformity, surgical technique, surgical time, methods and course of anesthesia, intra- and postoperative complications, parents’ satisfaction, head form. Results. 24 patients were treated. The mean patient’s age at the time of surgery was 13.47 ± 8.2 months (min 7.3, max 46.5). Eliminating 3 patients whose age at the time of surgery was over 2 years (24.5, 29 and 46 months, respectively), the mean age of other 21 patients was 10.63 ± 1.77 (min 7.3, max 14.1) months. There were 9 cases of isolated trigonocephaly (37.5%), 7 cases of isolated scaphocephaly (29.2%), 7 cases of isolated anterior plagiocephaly (29.2%) and 1 case of posterior plagiocephaly combined with scaphocephaly (4.17%). All craniosynostoses were diagnosed clinically and diagnosis was confirmed with computed tomographic scanning. The median duration of surgery was 336.47 ± 59.63 minutes (min 308.13, max 364.82). The medium stay in the intensive care unit was 2.53 ± 1.28 days (min. 1.92, max 3.14). In all cases rigid osteosynthesis was performed. 2 children were diagnosed with syndromic craniofacial abnormalities. In 23 (95.83%) cases an intraoperative or postoperative blood transfusion was required. In 24 treated patients there was no mortality. During the early and late postoperative period no infections, CSF leakage and dural tears were observed. No neurological impairments or any signs of neurological deficits were observed by any of the treated patients. In all of cases parents were satisfied with their children’s changed head shape and aesthetic results. Conclusions. Cranioplasties for correction of craniosynostosis give good aesthetic results and this is a safe method, which helps to correct the head shape as well as improves the social adaptation of patients.

Early clinical results of surgical treatment of patients with femoroacetabular impingement

Surgical treatment is the treatment of choice in patients with symptoms and radiological signs of femoroacetabular impingement. Our experience and early results of surgical treatment of patients with signs of femoroacetabular impingement and early hip osteoarthritis are reported. The results of treatment of 21 patients aged 23-54 years with different types of femoroacetabular impingement are presented. Safe open surgical dislocation of the hip was performed in all patients. Before and after surgery, the WOMAC score was performed, clinical and radiographic data of the operated hips were evaluated and t-tests were used for statistical analyzes of data. The WOMAC score improved from 70.5 points (range 56.3 to 89.8 points) to 90.3 points (range 70.3 to 100 points) at one year of follow-up (p < 0.0001), anterior impingement test was negative in all operated cases, average hip internal rotation improved significantly, no complications were found, except trochanteric nonunion at the site of osteotomy, which was reaffixed. Postoperative results have shown that the surgical approach to treating patients with femoroacetabular impingement is the method of choice. Three operated patients, with advanced osteoarthritis of the hip, had to be converted to total hip replacement.

The early results of surgical treatment of congenital clubfoot by a modified soft tissue release

577 Background and objective: Talipes Equinovarus (TEV) or Congenital Clubfoot is the most common congenital anomaly of the foot. The incidence of TEV is 1-2 per 1000 life births, about 30% of these cases is bilateral with a higher incidence in males than in females (2:1). Congenital Clubfoot is a complex deformity which has four components: Heel in equinus, hind foot in varus, mid foot in cavus, forefoot in adduction and supination. The presented study aimed to evaluate the surgical treatment outcome of congenital club foot by a modified soft tissue release (i.e. division of tendons of tibialis posterior and flexor hallucis longus). Methods: This is a prospective study done on the Result of treatment of congenital Clubfoot by soft tissue release. Numbers of patients are thirty three patients, forty eight feet, fifteen patients (45.46%) had bilateral, and eighteen patients (54.55%) had unilateral deformities. Twenty one patients (63.64) were male and twelve patients (36.37) were female, male to female ratio was 1.75:1, their ages range between 4-35 months (mean ages in months = 15.43 months). The patients whom included in this study had no previous treatment because of delay in presentation. Results: All patients were assessed clinically and radiologically. The result of our study was as follow: Excellent result for 28 feet (58.3%), Good result for 16 feet (33.3%), Poor result for 4 feet (8.3%). The over all result can be sub divided to two categories; a) satisfactory which involve both the excellent result and the good result (91.67%) and b) unsatisfactory result which involve only the poor result (8.33%). Conclusion: The study revealed that the use of this surgical method is of good result and

Comparison of Early Results of Surgical Treatment in Patients with Pancreatic Cancer

Pancreatic tumours are a serious medical and social issue. Patients come to the doctor too late, when the disease is well advanced. The most frequently applied method of surgical treatment is pancreatoduodenectomy (Whipple procedure). The most frequently used technique of pancreatoduodenectomy is the Child-Waugh method. The procedure can be performed in a classic way or as modified by Traverso (with preservation of the pylorus). Between August 2008 and June 2011, in the Department of Thoracic, General and Oncologic Surgery of Medical University in Łódź, a total of 79 patients with pancreatic tumours were hospitalized. In 61, pancreatoduodenectomy was performed. The patients were divided into two groups, depending on the diagnosis and the procedures performed: group 1 comprised patients in whom the pylorus was resected (n = 43); group 2 comprised patients in whom the pylorus was preserved (Traverso-Longmire procedure; n = 18). Mean duration of surgery was about 3 hours and 50 minutes in both groups. Mean duration of hospitalization after the procedure was 15.6 days in group 1 and 12.2 days in group 2 (p < 0.05). Early complications (within 30 days of the procedure) were observed in 33.2% of patients in both groups. Blood transfusion was necessary in 21% of patients in group 1 and 28% of patients in group 2 (p>0.05). There are specific indications for each method of surgical treatment, however, it seems that both techniques of pancreatic resection can be recommended as standard surgical treatment, and the number of complications after both procedures is similar.