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Lithuanian Surgery : Lietuvos Chirurgija
Number of Followers: 0  Open Access journalISSN (Print) 1392-0995 - ISSN (Online) 1648-9942 Published by Vilnius University  [38 journals]
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- Transanal Hemorrhoidal Dearterialization (THD): A Single Center Experience
on 100 Consecutive Cases
Authors: Aleksandar Mitevski, Vladko Cvetanovski, Petar Markov, Ilija Milev
Pages: 34 - 39
Abstract: Introduction. Surgeons, using all available means for the treatment of the hemorrhoidal disease, must make compromises between the radicality of the potential surgical treatment (to prevent recurrence) and the maintenance of the postoperative functionality of the anorectum (avoiding stricture, anal fissures, incontinence, reduction of postoperative pain etc.). Materials and methods. All patients treated with the THD method using a system manufactured by THD S.p.A., Correggio, Italy, consisting of a proctoscope equipped with a Doppler probe and a light source was used to perform the operation. Results. Out of 100
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Authors: Silvana Kraleva, Tatjana Trojikj, Darko Talevski, Dola Malefski, Gordana Bozinovska Beaka
Pages: 45 - 51
Abstract: Iatrogenic tracheal rupture is very rare condition and has a lot off causes (intubation, tracheostomy, bronchoscopy, esophagectomy), but orotracheal intubation is the most common. Diagnosis is based on the occurrence of symptoms that are not specific but highly suggestive: subcutaneous emphysema, respiratory insufficiency, pneumothorax, and hemoptysis. The appearance of subcutaneous emphysema as a first sign plays a main role for early diagnosis and rapid appropriate treatment. Diagnostic confirmation is possible by chest X-ray, thoracic computed tomography and bronchoscopy which confirmed the size and site of the lesion. Treatment can be conservative, in patients with small ruptures, less than 2 cm, and surgical in the majority of ruptures over 2 cm in length. Our case report presents an iatrogenic post-intubation tracheal rupture treated conservatively. Our patient was a 71-year-old woman, admitted in our hospital with fracture of right humerus for elective surgery. Her medical history was only arterial hypertension. She underwent general anesthesia, intubated with flexible ET tube, positioned in beach-chair position after introduction, and no complication occurred during surgery. 18 hours after surgery, after severe coughing, she suddenly developed subcutaneous emphysema of the facial, neck and upper anterior chest. Tracheal rupture was confirmed with a thoracic computed tomography and tracheobronchial fiber endoscopy. It showed a posterior tracheal transmural rupture 1 cm long, located 4 cm above the carina, covered with small tissue that opened in inspirium. Conservative treatment with antibiotic cover was performed, and the patient was discharged home in good condition, fourteen days after the initial injury.
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Report
Authors: Kipras Sasnauskas, Robert Vrublevski, Povilas Masionis, Sigitas Ryliškis
Pages: 56 - 60
Abstract: Intrathoracic displacement of the humeral head is rarely documented due to high mortality of the trauma. As a result, there is no clear consensus about how such case should be approached. In this report we reviewed our successful case, and reviewed the literature. The patient arrived after car accident with a broken humerus and upon taking X-ray found to have the humeral head lodged in the chest cavity. After humeral head removal and arthroplasty, patient was discharged without complications. In literature several cases were found in which a patient usually suffers because of high energy trauma with arm typically in abducted position. In all cases treatment involves removing humeral fragment from chest and prosthetic arthroplasty of the glenohumeral joint. Although some authors suggest leaving humeral fragment in some cases while others suggest to always remove. Exact indications of such decision are unclear. Cases like this pose a high risk of neurological and circulatory complications, although no complications were observed in this case. Nevertheless, there have been too few similar cases described to establish a proper methodology.
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Authors: Narimantas Evaldas Samalavičius
Pages: 71 - 81
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Authors: Narimantas Evaldas Samalavicius
Pages: 82 - 82
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Authors: Narimantas Evaldas Samalavičius
Pages: 83 - 85
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Factors, Treatment: Literature Review
Authors: Gabrielė Ūbaitė, Aurelija Remeikaitė, Justas Žilinskas
Pages: 86 - 96
Abstract: Background. Colorectal cancer (CRC) ranks as the third leading cause of cancerrelated mortality worldwide. Recent years have witnessed an increase in the incidence of CRC. The main reasons are ageing population, increased consumption of processed food, obesity, genetic predispositions. Aim. To review the latest scientific developments and novel factors on the epidemiology, etiology, pathogenesis of colon cancer, focusing on the influence of genetics and epigenetics, risk factors, and the advancement of prevention and treatment methods. Material and methods. The research method is a literature review. Publications were searched in the PubMed database using the following keywords and their combinations in English: colon cancer, colorectal cancer, management, prevalence, causes, risk factors, genetic and epigenetic changes. Selection criteria for publications: scientific articles in English relevant to the research topic and 90% of articles published in the last 10 years (2014–2024). Results. Using theoretical analysis methods, 72 publications were selected that met the inclusion criteria. Our findings emphasize the central role of genetic mutations (particularly in APC, TP53, KRAS and MMR) and epigenetic alterations, such as DNA methylation and histone modification, in the pathogenesis of colorectal cancer. These genetic and epigenetic factors drive the progression from benign polyps to malignant carcinomas, with environmental, lifestyle, and chronic disease factors also playing a critical role. In particular, diet, physical inactivity, smoking and alcohol significantly increase risk, especially in men and those over 50. Innovations such as CRISPR/Cas9 offer new avenues for targeted treatments, while advances in vaccines and liquid biopsy techniques are improving immune response activation and disease monitoring. In addition, diets rich in fiber, antioxidants and healthy fats, as well as the use of probi...
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Authors: Amjaad Alkhezzi, Sajad Ahmad Salati, Lamees Sulaiman Alsulaim, Mohammad Ahmed Elmuttalut, Yasir Ahmed Alsalamah
Pages: 97 - 107
Abstract: Giant gallstones are rare occurrences and measure 5 cm in any one dimension. They present unique set of features and complications. Due to their rarity, we conducted this systematic review to investigate the profile of patients with giant gallstones applying seven variables. For this study, we used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After an initial search of 111 peer reviewed articles from reliable sources, we included 29 articles for this study enrolling 30 patients with mean age of 66.7 years. Majority (97%) were symptomatic, reporting with cholecysto-enteric fistula/gallstone ileus (33%), acute cholecystitis (30%) and chronic dyspepsia (24%). The management options adopted included open cholecystectomy (48%), laparoscopic cholecystectomy (33%), endoscopic lithotripsy (6%) and conservative management (6%).
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Authors: Cenk Ozkan, Serhan Yilmaz, Osman Sibic
Pages: 116 - 119
Abstract: The epigastric hernia sac usually contains preperitoneal fat tissue, omentum, and intestines, but the presence of liver tissue is extremely rare. Epigastric hernia is a type of hernia in the midline of the abdominal wall between the umbilicus and the xiphoid process. It may be asymptomatic in some patients and cause complaints such as pain and nausea in most patients, but serious complications such as incarceration and strangulation are rare. In the present case, a 74-year-old woman was examined and found to have an irreduced omentum, transverse colon and liver tissue inside the hernia sac. She underwent an open procedure with onlay mesh-assisted hernia repair. Rare but serious complications, such as liver tissue incarceration, should be considered in epigastric hernia patients.
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Authors: Ljubinka Damjanoska Krstikj, Ana Rajkovska Kimovska, Roza Krsteska, Mare Stevkovska
Pages: 120 - 126
Abstract: Introduction. Congenital deformities of the outer ear are common; reported incidence are from 1:6000 to 1:6830 newborns. Multitude of corrective procedures are described in the literature. Purpose of the case study. The adequate surgical treatment of the congenital constricted ear remains a challenge. Selected tailor made approach should be employed on case by case basis, thus, in this study we present our case of moderate constricted ear and the used surgical procedures done under general anesthesia, as well as the outcome of the treatment. Case report. A 6 year old girl presented in pediatric and plastic surgery department with complaint of right ear deformity from birth and additional psychological effects such as increased difficulty in social integration and lack of self- confidence. On clinical examination, we considered as constricted ear grade IIB by Tanzel. Two separate procedures under general anesthesia were done. In the first procedure, advancement of the helix and otoplasty was performed; an effective expansion, of about 1 cm in the length of the pinna was obtained. In the second procedure, about 0.5 cm expansion of the helix was performed, and also the breadth of the pinna. Conclusion.
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