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ANZ Journal of Surgery 01/2013; 83(1-2):96-7. · 1.25 Impact Factor
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ABSTRACT: There is a debate in the literature whether a pathologic nipple discharge is a distinct sign of breast carcinoma. Our own results obtained by the use of microdochectomy as a minimally invasive operative procedure in 184 patients with pathologic nipple discharge were analysed. The aim of this retrospective 20-year study was to assess the efficacy of microdochectomy in detecting early stages of intraductal breast carcinoma.
The study included data on 184 patients aged 24-77 years (median 46.6) divided into two groups of premenopausal (n = 123) and postmenopausal (n = 61) women. There were 139 patients with unilateral single-duct sanguinolent discharge and 45 patients with other types of nipple discharge. The operative procedure consisted of the discharging duct excision by use of a guide probe, preceded by cytology and ductography studies.
Histopathology of the excised ducts revealed only three carcinomas in premenopausal women and ten carcinomas in postmenopausal women. In a total of 13 carcinomas, there were 4 ductal carcinomas in situ, detected in patients aged 41-72 (median 66) years. Twelve carcinomas were associated with sanguinolent nipple discharge. Papilloma was the most common histology finding (56.5%).
Results of the study suggested mainly the association of sanguinolent single-duct nipple discharge and papilloma, whereas the rate of malignancies detected (7.0%) was consistent with literature reports. Microdochectomy proved to be a highly efficient operative method free from any impairment of the breast integrity. Conservative treatment with close clinical monitoring of the patient with cytology and ultrasonographic assessment might be possible in selected cases.
Archives of Gynecology 05/2010; 283(4):851-4. · 0.91 Impact Factor
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ABSTRACT: Agricultural injuries are a complex surgical problem, especially because of frequently extensive skin lesions prone to infection and delayed healing. The aim of the study was to assess the local effect of pesticides, chemical substances widely used in agriculture, on wound healing, especially on wound contraction. Local effects of the combined herbicide composed of atrazine and dual (Primextra) and insecticide alphametrin (Fastac 10% SC) on primary wound healing were assessed in a bioassay performed in 18 New Zealand white rabbits. Relative size of the wound, measured on days 0, 1, 3, 6, 9 and 12 of wounding was analyzed by two-factor analysis of variance with repeat measurements. The activity of the process of restoration was assessed on histopathologic preparations obtained after the last measurement. Results of the study showed the final wound contraction to be smaller and the process of healing slower in the experimental groups of animals. Histopathology revealed defects of epithelialization, phasic delay in healing, infiltration with eosinophilic granulocytes, and decreased density of newly formed collagen. Pesticides were concluded to have adverse local effects on the wound, causing impairment of the mechanisms of healing.
Collegium antropologicum 04/2007; 31(1):203-8. · 0.61 Impact Factor
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ABSTRACT: The total number of 542 patients with colorectal cancer surgery have been analyzed in order to estimate the effect of receiving transfusion local recurrences, and the disease free - survival. It should be examined whether there are changes in general immunity indicators which would be connected with perioperative transfusion. A significant connection has been found between local recurrences and blood transfusion (p<0.0001), the most noticeable being in Dukes A (p =0.045), localization on rectum (p=0.036). The receiving of blood transfusion is linked significantly with disease free - survival reduction (p =0.0068; log rank), the most significant being in Dukes A stage (p =0.0123; log rank) and with localization on rectum (p=0.0231). The analysis of general immunity indicators has shown significant immunocompromitation of patients just before the surgery and this could have effect on immunomodulation caused by transfusion and just as on the treatment prognosis of colorectal carcinoma.
Collegium antropologicum 01/2007; 30(4):885-93. · 0.61 Impact Factor
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ABSTRACT: The paper analyses and compares the results of the treatment of acute cholecystitis with open and laparoscopic approach in a seven-year period. From 1994 to 2000, 311 patients with clinical picture of acute cholecystitis were operated. Open cholecystectomy was done in 162 (52.09%) patients, and laparoscopy in 149 (47.91%). In both patient groups the time from the onset of clinical symptoms to the surgery, and preoperative workup and preparation, were the same. In patients with open surgery the procedure lasted 93 (+/-SD) minutes, and in those with laparoscopic surgery 114 (+/-SD) minutes. Those operated with open method received 5.83 (+/-SD) ampules and 3.75 (+/-SD) tablets of analgesics, and those with laparoscopic surgery 3.2 (+/-SD) ampules and 2.1 (+/-SD) tablets per patient. Antibiotics were administered to 149 patients with open surgery for 4.9 (+/-SD) days and to 68 of those with laparoscopic surgery for 2.29 (+/-SD) days. Patients with open surgery stayed in the hospital 9.55 (+/-SD) days and were on sick leave 43 (+/-SD) days, and those with laparoscopy spent 4.35 (+/-SD) days in hospital and were 16 (+/-SD) days on sick leave. In conclusion, better clinical results and faster return to everyday activities point to the significant advantage of laparoscopic cholecystectomy. Analysis of the results shows that total costs of treatment of working patients are significantly lower than of those with laparoscopic surgery, due to shorter hospital stay, shorter sick leave, and faster recovery.
Lijec̆nic̆ki vjesnik 126(5-6):137-40.
