Lukasz Krokowicz

Poznan University of Medical Sciences · Department of General Surgery Gastroenterological Oncology Surgery and Plastic Surgery

One of the target of perioperative tratment in surgery is decreasing intraoperative bleeding, which increases the number of perioperative procedures, mortality and treatment costs, and also causes the risk of transfusion of blood and its components. Trying to minimize the blood loss(mainly during the operation) as well as the need to transfuse bloo...

IntroductionIn some clinical scenarios, stoma site may be located close to the abdominal wound edge impeding optimal wound management and stoma care. We present a novel strategy of utility NPWT for management of simultaneous abdominal wound healing with stoma presence. Material and methodsRetrospective analysis of seventeen patients treated with a...

IntroductionRestoration of bowel continuity is associated with a significant postoperative morbidity. The aim of the study was to report the outcomes of the restoring the intestine continuity in a large patient cohort.Material and methodsRetrospective analysis of 91 patients with terminal stoma qualified for restoring GI tract continuity between Ja...

Introduction: The stoma reversal (SR) procedure is associated with a relatively high risk of perioperative complications with surgical site infection (SSI) as the most common. Recently closed incision negative pressure wound therapy (ciNPWT) was applied widely to prevent SSI. Aim: To investigate the efficiency of ciNPWT in terms of the incidence...

Introduction: Anastomotic leaks remain the most fearful complications. Aim: We present a novel endoscopic salvage therapy known as endoscopic vacuum therapy with instillation (iEVT) as a combination of standard endoscopic vacuum therapy (EVT) and negative pressure wound therapy with instillation (iNPWT). Material and methods: A case series of...

Background: Deep neck infection (DNI) is a life-threatening complication associated with significant mortality and morbidity rates. The most common causes of DNI are the tonsilitis, dentitis, salivary glands inflammation, malignancies, and foreign bodies. As a result of neck infection, patients are at high risk of potential secondary complications...

Aim An ileal pouch anal anastomosis (IPAA) leak is one of the most severe complication after restorative proctocoletomy (RPC). We present a rare case of a successful management of IPAA leak after RPC without defunctionig stoma with the utility of endoscopic vacuum therapy. Methods A 57-year-old male with a ileal pouch anal anastomosis leak after RP...

COMPARISON OF THE EFFECTIVENESS OF THE TREATMENT USING STANDARD METHODS AND NEGATIVE PRESSURE WOUND THERAPY (NPWT) IN PATIENTS TREATED WITH OPEN ABDOMEN TECHNIQUE

The comparison of quality of life in patients with pilonidal sinus disease. Negative pressure wound therapy versus standard wound dressings – a randomized pilot study.

THE COMPARISON OF QUALITY OF LIFE IN PATIENTS WITH PILONIDAL SINUS DISEASE. NEGATIVE PRESSURE WOUND THERAPY VERSUS STANDARD WOUND DRESSINGS – A RANDOMIZED PILOT STUDY.

An increased number of patients developing difficult-to-heal wounds results in billions spending for chronic wound care management. Introduction of TIME conception has been a breakthrough idea for wound healing based on phase-adapted wound therapy that interacts and influence each other and included: T – tissue management, I - infection control, M...

Introduction: Negative pressure wound therapy (NPWT) in the open abdomen (OA) is recognized as a gold standard management method. Currently minimally invasive procedures are implemented in many clinical scenarios. Aim: To demonstrate the feasibility of using negative pressure wound therapy in a laparoscopic approach for OA management in a porcin...

Introduction: Haemorrhagic shock leads to systemic oxygen deficit (hypoxaemia) that results in systemic inflammatory response syndrome (SIRS), a recognised cause of late mortality in this case. The aim of this study was to analyse the impact of fluid resuscitation, using two Ringer solutions, on the microcirculation changes that take place during e...

A checklist is a collection of information that helps reduce the risk of failure due to limitations in human memory and attention. In surgery, the first Surgical Safety Checklist (SSC), created under the supervision of WHO (World Health Organization), was established in 2007 and covers three stages related to the patient's stay in the operatin...

The most appropriate cisplatin treatment schedule delivered with radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) is unknown. The aim of this study was to compare the acute toxicity and its impact on the course of the treatment, administered cisplatin and radiation doses, the length of hospitalization and supportive drugs...

Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from c...

Purpose: The purpose of this study was to determine the effect of a conservative regimen for the treatment of constipation in persons living with a colostomy. Design: Prospective, noncontrolled, single-center study. Subjects and setting: The study sample comprised 35 patients with a colostomy who were diagnosed with constipation. Subjects with...

PurposeBiofragmentable anastomosis ring (BAR) is an alternative to manual and stapled anastomoses performed within the upper and lower gastrointestinal (GI) tract. The aim of this study was to evaluate the effectiveness of BAR utility for bowel anastomoses based on our own material. MethodsA retrospective analysis was performed to a total of 203 pa...

Background Chronic anal fissure (CAF) is a linear split of the anoderm. The minimally invasive management of CAF such as botulinum toxin (BT) injection is recommended. However, the exact efficient dose of BT, number of injections per session and the injection sites are still debatable. The aim of this analysis was to assess the dose-dependent effic...

Background: Cell based vaccines encoding Hyper-IL-6 (H6) and Hyper-IL-11 (H11) present high activity in murine melanoma and renal cancer model. We evaluated the efficacy of cellular vaccines modified with H6 or H11 combined with cyclophosphamide in orthotopic murine prostate cancer model. Material and methods: TRAMP cells were transduced with H6...

Pulsed Acoustic Cellular Expression (PACE) is a novel technology utilizing Extracorporeal Shock Waves (ESW) in as a source of acoustic energy in a pulsed manner capable of delivering a cellular expression response. It has multiple indications in medicine but exact mechanism of PACE remains unknown. In our experiment in a large group of animals we c...

Obesity, a major public health issue of the 21st century, is increasingly common in adults and children. No good results of pharmacological treatment of obesity results in rapid development of bariatric surgery, which treats obesity and comorbidities associated. There are many surgical options for treating obesity. Options for surgical management o...

Restorative proctocolectomy is a current gold standard procedure for patients who require a colectomy for ulcerative colitis. The incidence of ileal pouch neoplasia is low. The aims of this study were to assess the prevalence of neoplasia in ileal pouch and investigate the risk factors for ileal pouch neoplasia. A total of 276 patients who underwen...

Stoma is an intestinal fistula created in emergency or by elective indications, and it is done to drain out the digestive tract content. In some patients there is a disturbance passage of gastric contents through the stoma, which may take the form of chronic constipation or even periodic subileus that will sooner or later require surgical treatment...

Ipilimumab is a fully human monoclonal antibody (mAb) targeting cytotoxic T-lymphocyte antigen-4 (CTLA-4). Ipilimumab is currently approved in the U.S. and Europe for the treatment of metastatic melanoma in the first- and second-line treatment. Treatment with ipilimumab is linked to immune-related adverse events (irAEs) occurring in the majority of...

Iatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased. The aim of the study was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in t...

Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pre...

Zenker diverticulum (ZD) is the most common type of diverticula of the esophagus. Most often refers to men with a peak incidence in the seventh and eighth decade of life. In the majority diverticula remains asymptomatic and in patients with symptomatic course of the disease symptoms are often nonspecific. Aim of the study was to present the authors...

About 40% to 60% of melanomas present BRAF mutation. Selective BRAF inhibitors such as vemurafenib and dabrafenib are currently approved for the treatment of advanced melanoma patients with BRAF mutation. The treatment-induced tumor regression occurs in the majority of patients; however, acquired resistance to BRAF inhibitors is observed in most of...

IntroductionThe surgical treatment of anal fistulas is a complex problem, associated with high relapse rates. Wounds frequently heal by the secondary intention. The process is time-consuming and frequently causes discomfort to the patient. Negative pressure wound therapy seems to be one of the methods which might accelerate the healing process in p...

Introduction: Traveller's diarrhoea (TD), defined by UNICEF/WHO as three or more unformed stools with or without other symptoms, imposes a considerable burden on travellers from developed countries. Various efforts have focused on decreasing the prevalence and severity of this condition. Aim: To assess the efficacy of a combination of sodium but...

Aim: The aim of the study was to assess the impact of the long-term use of the composite probiotics in patients after restorative proctocolectomy. Method: Forty-three patients (20 females and 23 males, aged 21 to 68 years) after restorative proctocolectomy were included in the study. After randomization patients were divided into placebo group a...

Microencapsulated sodium butyrate (MSB) has been previously associated with anti-inflammatory and regenerative properties regarding large bowel mucosa. We aimed to examine a role of MSB in patients with diverticulosis, hypothesizing its potential for reduction of diverticulitis episodes and diverticulitis prevention. Seventy-three patients with div...

The incidence of cancer has been increasing worldwide. Melanoma is known to be one of the most immunogenic malignancies in humans. In recent years innovative and promising therapeutic strategies that modulate the immune response or target various intracellular pathways in melanoma have been developed. Recently new drugs which improved overall survi...

Detection of mutations in families with a hereditary predisposition to colon cancer gives an opportunity to precisely define the high-risk group. 36 patients operated on for colon cancer, with familiar prevalence of this malignancy, were investigated using the DNA microarrays method with the potential detection of 170 mutations in MLH1, MSH2, MSH6,...

Pulsed acoustic cellular expression (PACE) is a treatment that applies focused acoustic shock waves to promote tissue healing. The aim of this study was to assess the effect of PACE treatment on inflammatory responses in a cremaster muscle ischemia/reperfusion injury model. Seventeen cremaster muscle flaps were evaluated in four groups: nonischemic...

Aim: Abdominal pain, defaecation disorder and change of bowel habit are the commonest symptoms of irritable bowel syndrome (IBS). The effect of microencapsulated sodium butyrate (MSB) was assessed on the severity of symptoms in patients with IBS. Method: Sixty-six patients treated with one of the standard pharmacological therapies for at least 3...

We present an extremely rare case of late metastases of breast cancer to both suprarenal glands 28 years after mastectomy. The patient originally underwent Patey’s radical mastectomy of the left breast. In the follow-up, metastases were detected in the skin of the thorax and labia majora and were subsequently resected. During the most recent hospit...

Tissue ischemia and reperfusion (I/R) affects blood flow restoration and oxygen delivery to the damaged tissues contributing to tissue morbidity and microcirculatory compromise. Pulsed acoustic cellular expression (PACE) technology is known to support tissue neovascularization. The aim of this study was to test PACE conditioning mechanism of action...

Screening of the colon cancer seems to be important to improve the results of the surgical treatment. There are different screening programs, the most common use the fecal occult blood (FOB) tests or colonoscopy. was to evaluate the results of the colon cancer screening based on the FOB test and perform the algorhytm improving the effectiveness of...

Extracorporeal Shock Wave Therapy (ESWT) is a golden standard for treatment of kidney and urinary calculi. It is also widely used in a number of orthopedic pathologies and other fields of medicine. Although clinical success the exact mechanism of shock wave technology is not well established. Cremaster muscle model used in our experiment is structu...

When performing in situ harvesting of cranial bone grafts, there is a risk of entering the pericranial-intracranial venous system, either directly or indirectly through the arachnoid foveolae. The aims of this study were to investigate the size and location of arachnoid foveolae and to provide an anatomic road map to prevent penetrating these struc...

Pulsed Acoustic Cellular Expression (PACE) treatment is a novel technology with potential to improve tissue perfusion, but the mechanism of this action is unknown. We assessed in vivo the effect of PACE therapy on muscle microcirculatory hemodynamics, neovascularization, and proangiogenic and proinflammatory gene expression. Cremaster muscles were...

The high antigenicity of skin components of composite tissue allografts is the most challenging factor in achieving long-term viability after composite tissue allografts transplantation. The vascularization pattern of vascularized skin allografts (VSA) and nonvascularized skin allografts (NVSA) differs significantly and these differences may alter...

INTRODUCTION: Aim of the study was comparison of volume replacement with: 6% Hetastarch (HET), 5% Albumin (ALB), and 10% Pentastarch (PENT) following induction of hypovolemic shock (HS). METHODS: Rat cremaster model was used to evaluate microcirculatory changes after HS induction. Rats were randomized into groups: 1) (n=10) had parameters recorded...

Background and Goals: There is no clear indication which volume replacement therapy may have the best prognosis on hemorrhagic resuscitation. Aim of the study was comparison of volume replacement with Ringer's acetate (RA) versus Ringer's lactate (RL) solutions following induction of hypovolemic shock (HS).Material and Methods: Rat cremaster model...