Sławomir Mrowiec

University of Silesia in Katowice, Catowice, Silesian Voivodeship, Poland

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Publications (21)18.24 Total impact

  • Jacek Pająk · Lukasz Liszka · Sławomir Mrowiec · Dariusz Gołka · Paweł Lampe

    No preview · Article · Mar 2012 · Advances in anatomic pathology
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    ABSTRACT: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms located in the alimentary tract. Our aim was to assess the influence of prognostic factors on survival in patients surgically treated for GISTs. One hundred and five patients treated between January 1989 and December 2008 were available for study. A retrospective analysis of prognostic factors (age, gender, mitotic index, tumor location, tumor size, risk of malignant behavior, and coexisting other neoplasm) was performed. Univariate and multivariate survival analyses were undertaken. Univariate analyses revealed the importance of patient gender (p = 0.007), disease location (p = 0.055), mitotic index (p = 0.054) and coexistence with other neoplasms (p = 0.004). However, multivariate analysis showed 3 independently statistically significant factors: coexistence with other neoplasm (RR = 3.53, p = 0.004), male gender (RR = 2.60, p = 0.011) and mitotic index ≥10/50 HPF, (RR = 2.60, p = 0.042). Our study has shown that male gender, a high mitotic index ≥10/50 HPF, and coexistence with other malignant neoplasms were independent poor prognostic factors in patients with GIST. The presence of middle or lower gut disease location leads to an increased risk of mortality when compared with the upper gut.
    No preview · Article · Dec 2011 · European Surgical Research
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    ABSTRACT: Serous neoplasms (SN) of the pancreas account for 1-2% of all pancreatic tumours. Six morphological variants of SN were previously recognized: serous microcystic (cyst)adenoma, serous macrocystic (cyst)adenoma, von Hippel-Lindau-associated serous cystic neoplasm, solid serous adenoma/neoplasm, mixed serous-neuroendocrine neoplasm and serous cystadenocarcinoma. It was recently postulated that SN shows a continuous spectrum of morphological patterns rather than distinct clinico-pathological subtypes. To address this issue, we performed a detailed review of 40 SN cases diagnosed at our institution between 1989 and 2011. We found 11 cases of serous microcystic (cyst)adenoma, 5 cases of serous macrocystic (cyst)adenoma, and a single case of von Hippel-Lindau-associated serous cystic neoplasm. Apart from that, we found 20 cases of SN which showed features of both microcystic and macrocystic (cyst)adenomas, 2 cases of small 'incipient' SN and a single case of a mixed microcystic and solid adenoma. In conclusion, we showed that 'borderline' lesions among SNs truly exist and are not rare. The reason for such a wide diversity of morphological patterns of SN remains unknown.
    No preview · Article · Dec 2011 · Polish journal of pathology: official journal of the Polish Society of Pathologists
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    ABSTRACT: Early onset pancreatic cancer (EOPC) constitutes less than 5% of all newly diagnosed cases of pancreatic cancer (PC). Although histopathological characteristics of EOPC have been described, no detailed reports on precursor lesions of EOPC are available. In the present study, we aimed to describe histopathological picture of extratumoral parenchyma in 23 cases of EOPCs (definition based on the threshold value of 45 years of age) with particular emphasis on two types of precursor lesions of PC: pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasms (IPMNs). The types, grades, and densities of precursor lesions of PC were compared in patients with EOPCs, in young patients with neuroendocrine neoplasms (NENs), and in older (at the age of 46 or more) patients with PC. PanINs were found in 95.6% of cases of EOPCs. PanINs-3 were found in 39.1% of EOPC cases. Densities of all PanIN grades in EOPC cases were larger than in young patients with NENs. Density of PanINs-1A in EOPC cases was larger than in older patients with PC, but densities of PanINs of other grades were comparable. IPMN was found only in a single patient with EOPC but in 20% of older patients with PC. PanINs are the most prevalent precursor lesions of EOPC. IPMNs are rarely precursor lesions of EOPC. Relatively high density of low-grade PanINs-1 in extratumoral parenchyma of patients with EOPC may result from unknown multifocal genetic alterations in pancreatic tissue in patients with EOPCs.
    Full-text · Article · Mar 2011 · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin
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    ABSTRACT: The aim of our study was to identify and describe potential inconsistencies between two alternative staging systems of pancreatic neuroendocrine neoplasms (pNENs)--the European Neuroendocrine Tumor Society (ENETS) system (2006) and the American Joint Committee on Cancer/Union for International Cancer Control (AJCC-UICC) system (2010). To address this issue, we performed a retrospective clinico-pathological study of 50 cases of pNENs. We found 9 (18%) cases of ENETS/AJCC-UICC discrepancies regarding the primary tumor stage. They included 7 cases of T2/T3 disagreement and 2 cases of T3/T4 disagreement. In addition, we discussed the issue of potential T1/T2 discrepancy (however, we did not observe any such a case). Another inconsistency was related to the application of different stage prognostic groupings between both systems. In conclusion, the discrepancies between ENETS and AJCC-UICC staging systems for pNENs are relatively frequent and heterogeneous. We believe that they should be rigorously recognized. This is necessary for the evaluation of prognostic factors and the effectiveness of therapeutic options used in patients with pNENs.
    No preview · Article · Feb 2011 · Pathology - Research and Practice
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    ABSTRACT: There are a few studies concerning epidemiology of pancreatic ductal adenocarcinoma (PDAC) in the Polish population. Analysis of age distribution patterns of patients with different types of cancer may be useful for studying their specific biology. In the present study we aimed to describe age distribution patterns of 580 patients with PDAC diagnosed in one centre during a 25-year period. All the histopathological diagnoses were re-reviewed using current histopathological diagnostic criteria. Age distributions of selected subpopulations of patients (defined based on gender, potential tumour resectability and type of the surgery) were compared using mean values, medians, age frequency density plots and logarithmic plots of age-specific frequencies. The mean and median values of patients' age were 60.8 y and 61.0 y, respectively. Females were approximately 2 y older than males at the time of PDAC diagnosis. Females with non-resectable PDAC were approximately 2 y older than females with resectable tumours. Mean age values of males with non-resectable and resectable PDAC were similar. Patients treated with pancreaticoduodenectomy were approximately 2 y older than patients undergoing other types of resections. Age distribution density plots showed that some subgroups of patients studied were somewhat heterogeneous and might include several yet poorly recognized clinico-pathological entities. Logarithmic plots of age-specific frequencies showed that PDAC epidemiology is in concordance with a multistage theory of carcinogenesis. PDAC is an age-dependent cancer. Single-institutional pathology-oriented cancer epidemiological databases may add some information to population-based cancer registries.
    No preview · Article · Jun 2010 · Polish journal of pathology: official journal of the Polish Society of Pathologists
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    ABSTRACT: Intraductal oncocytic papillary neoplasms (IOPN) are rare tumors of the pancreatic and biliary ductal system. It is not absolutely clear if the molecular and clinicopathologic characteristics of IOPN differ significantly from other related lesions, namely intraductal papillary mucinous neoplasms (IPMN). Therefore it is not clear if it is reasonable to consider IOPN as a separate diagnostic and clinical entity. In order to describe the clinicopathologic characteristics of IOPN and to compare them with the IPMN profile, we performed a systematic review of the literature and additionally studied five previously unreported IOPN cases. IOPN differ from IPMN by lack of K-ras gene mutations in all studied cases. Several differences in the clinical and biological profile between IOPN and IPMN exist, but they are of quantitative rather than of qualitative nature. Additionally, pancreaticobiliary or gastric-foveolar IPMN components may coexist with IOPN component within a single lesion, which suggests at least a partial relation of the pathogenetic pathways of IPMN and IOPN. Importantly, the pathogenesis of accumulation of mitochondria and oxyphilic appearance of IOPN remains unknown. At present, there are no reliable criteria other than histopathological picture and K-ras gene status to differentiate IOPN from IPMN. In particular, no clear differences in optimal treatment options and prognosis between these tumors are known. Further studies are needed to clarify the biology of IOPN and to establish their position in clinicopathologic classifications of pancreatic tumors.
    No preview · Article · May 2010 · Journal of Hepato-Biliary-Pancreatic Sciences
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    ABSTRACT: To develop a method of gross examination of pancreaticoduodenectomy specimens with pancreatic ductal adenocarcinoma, allowing adequate assessment of the entire pancreatic surface as a surgical margin, which would not affect the lymph node yield. We retrospectively compared the R1 rates (i.e., proportions of patients with microscopic residual tumour at surgical margins) and lymph node yield in a series of 67 consecutive cases of pT3 ductal adenocarcinomas diagnosed in pancreaticoduodenectomy specimens during three different periods of time and sampled using three different approaches: (1) period 2006-2007, when the pancreatic surface (except for the transection margin and superior mesenteric artery margin) was not examined; (2) period January-September 2008, when the posterior pancreatic surface (posterior circumferential radial margin) was examined using an improved method based on sampling of 2.0-2.5 mm thick consecutive slices perpendicular to the duodenal axis; and (3) period October 2008 - June 2009, when the whole surface of the pancreatic head was sampled using the approach mentioned above. The R1 rates in three consecutive time periods were 23.5%, 40% and 53.8%, respectively. Median numbers of retrieved peripancreatic lymph nodes were 11.0, 12.0 and 14.0, respectively. The newly proposed approach allowed adequate assessment of the entire pancreatic head surface as a surgical margin and reduced the risk of under-detection of R1 status. Moreover, this approach did not affect the number of peripancreatic lymph nodes examined.
    No preview · Article · Feb 2010 · Pathology
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    ABSTRACT: The aim of this report is to describe two cases of lymphoepithelial cysts (LEC) of the pancreas: 1. LEC coexisting with primary gastric lymphoma, 2. an incidental finding of LEC during imaging examination. 1. A 47-year old man complaining of epigastric pain showed a 2 x 1.5 cm cyst of the pancreatic head on computed tomography (CT) scan. Endoscopic biopsy revealed infiltration by a poorly differentiated neoplasm, probably carcinoma. The patient underwent gastrectomy with lymphadenectomy D 2. The pancreatic lesion was excised. Diffuse large B-cell lymphoma (pT4N1 M0BX) and LEC were diagnosed. Patient refused adjuvant therapy. No symptoms of recurrence were observed during 24-months follow-up period. 2. 50-year-old male with non-specific urinary complaints revealed a 4.2 x 3.5 cm cyst in the body of pancreas on CT scan. The cyst was excised and LEC was diagnosed. Patient had not reported any complaints during 42 months follow-up period. To the best of the authors' knowledge, the first of two presented cases is the first described case of coexistence of LEC of the pancreas and gastrointestinal lymphoma. It is difficult to ascertain if there is any causative relationship or if this coexistence is purely incidental. Incidental pancreatic cysts are more and more common finding in surgical practice.
    No preview · Article · Nov 2008 · Zeitschrift für Gastroenterologie
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    ABSTRACT: Gastrointestinal stroma tumors (GIST) arise from the pacemaker, the interstitial Wells of Cajal. These tumors constitute 1 to 3% of gastrointestinal neoplasms, and may occur in each portion of the gastrointestinal tract. The most useful prognostic factors are tumor size, mitotic index, cell structure and location within the gastrointestinal tract. The aim of the study was to assess the chosen prognostic factors (location in the gastrointestinal tract and mitotic index) in patients with GIST. Material and methods. Between 1989 and 2002, 74 patients (37 men and 37 women) with an average age of 54.9 years (range from 13 to 89 years) were operated for GIST in the Department of Gastrointestinal Surgery. Two- and five-year survival rates during observation were analyzed, as well as the location within the gastrointestinal tract and mitotic index. Based on the intraoperative and postoperative investigations, the tumor size, presence of metastases and histological type of predominant cells were estimated in each patent. Results were subjected to statistics, where p≤0.05 was considered to be significant. Results. Of the 74 patients included in the study, 3 patients (4%) had a primary tumor located in the lower oesophagus, 42 patients (56.8%) in the stomach, 4 patients (5.4%) in the duodenum, and 13 patients (17.6%) had tumors originated from the small intestine. In an additional 12 patients (16.2%), the tumor originated from the large intestine. The most frequent (51%) mitotic index was 2, and 9/50 hpf was considered an intermediate malignant potential risk. Two-year survival was common in patients with GIST located in the oesophagus, stomach, and duodenum, totalling 34 (79%) patients. A lower than two-year survival rate was noted in patients with GIST arising from the small intestine: 7 (63.6%) patients had tumors arising from the colon and 4 (36.3%) patients had rectal tumors. Five-year survival was also the most frequent in patients with GIST located in the upper part of gastrointestinal tract (37.2%), in the median part of gastrointestinal tract (36.3%), and in the lower part of the gastrointestinal tract (27.7%). Correlation between location, mitotic index and survival of patients was assessed. The correlation studies showed a statistically significant influence of tumor location in the gastrointestinal tract (p=0.0264) and mitotic index (p=0.0003) with the survival of patients operated for GIST. Thus, the lower location and higher mitotic index of GIST are associated with shorter survival of patients. Conclusions. The mitotic index and location in the gastrointestinal tract are essential prognostic factors in analyzed patients with GIST. In the analyzed group, the lower locations and higher mitotic indices of GIST were associated with shorter survival of patients.
    No preview · Article · Jan 2008 · Polish Journal of Surgery
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    ABSTRACT: Quality of life after pancreatoduodenectomy (PD) for cancer of the head of the pancreas depends on multiple factors. Handling of the pancreatic remnant is a decisive factor for the success of the operation. The aim of the study is to assess quality of life of patients with cancer of the head of the pancreas undergoing pylorus-sparing PD and reconstruction with pancreaticojejunostomy (PJ) versus pancreaticogastrostomy (PG). Material and methods. An analysis was performed for 115 patients with malignancy of the head of the pancreas who underwent surgical treatment in the Department of Gastrointestinal Surgery Medical Academy of Silesia between 2004 and 2006. Quality of life was assessed with the EORTC QLQ-C30 and QLQ-PAN26 forms. These questionnaires were mailed to 34 patients at least 6 months after PD. The 20 patients who returned correctly completed questionnaires were divided into two groups. Group I included 14 patients after PD with (Traverso or Imanaga) PJ. Group II included six patients after PD with Flautner PG. Results. The study groups were homogeneous with respect to age, gender, preoperative and intraoperative factors, and complications. Better quality of life was observed in group I with respect to the cognitive functions, general fatigue, and insomnia scales., Group II exhibited better quality of life with respect to the physical functioning, social functioning, life activity, general health, dyspeptic symptoms, nausea and vomiting, diarrhea, respiratory disturbances, lack of satisfaction with own appearance, taste changes, liver symptoms, decreased muscle strength, indigestion, dry mouth and treatment of emergent side-effects scales. Conclusions. Patients in the study group following PD and Flautner PG exhibit markedly better quality of life.
    No preview · Article · Jan 2008 · Polish Journal of Surgery
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    ABSTRACT: For patients undergoing esophagectomy, the stomach is the organ that is most commonly used to restore continuity in the gastrointestinal tract. As a consequence of changes in stomach shape and location, patients in the postoperative period usually experience disturbed motility of the upper gastrointestinal tract of variable intensity. The aim of the study was to assess the motility of esophageal substitutes and the emptying rate of a narrowed stomach (in particular its prepyloric portion) using scintigraphy in patients undergoing esophageal resection compared to those in healthy controls. Material and methods. Between 2000 and 2006, 297 patients (105 women, 192 men) underwent surgical treatment for esophageal cancer in the Clinic of Gastrointestinal Surgery. Ten patients (average age 59; range 54 to 67 years) who underwent an attempted curative esophageal resection were selected into the study group. Patients from this group underwent scintigraphic assessment of gastric emptying between three to 11 months after the surgical procedure (an average 7 months). Furthermore, ten healthy volunteers (average age 28; range 19 to 43 years) constituted the control group. Results. The average radiotracer retention after two hours was 44.7±6.5% in the study group and 51.1±7.4% (p>0.2) in the control group. Frequency of contractions of the whole prepyloric segment, as well as its distal fragment, in the subsequent periods of examination was comparable in both groups. Correlation among the frequency of contractions, contraction duration and duration of relaxation of the whole prepyloric segment and its distal fragment was high for the control group (correlation coefficients 0.71 p<0.001; 0.71 p=0; and 0.63 p=0, respectively). In the study group, correlation between the frequency of contractions and contraction duration was poor (coefficients of correlation 0.03 p>0.8 and -0.02 p>0.9), while correlation between duration of relaxation of the whole prepyloric segment and its distal fragment was moderate (coefficient of correlation 0.34 p>0.06). Conclusions. Formation of a gastric substitute after its narrowing and denervation (truncal vagotomy) does not abolish gastric contractility. Frequency, amplitude, duration of contraction, and relaxation duration of the prepyloric portion of the ectopic substitute do not differ significantly from the patterns of motility of the upper gastrointestinal tract in healthy volunteers.
    No preview · Article · Jan 2008
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    ABSTRACT: Introduction: Intraductal papillary mucinous neoplasms (IPMN) are, along with serous cystic neoplasms and mucinous cystic neoplasms, the most common cystic neoplasms of the pancreas. Aim of study: Clinicopathological evaluation of patients with IPMN submitted to pancreatic resections. Material and methods: Eight patients with IPMN (3 women and 5 men, age range 22-74 years) submitted to pancreatic resections in years 1995-2006 were reviewed. Standard hematoxylin and eosin staining, histochemical analysis of neutral and acid mucins (AB/PAS and HID/AB) as well as immunohistochemical assessment of p53 protein expression, bcl-2, chromogranin, somatostatin, glucagon, insulin, serotonin, pancreatic polypeptide, estrogen and progesterone receptors and proliferative index Ki67 were performed. Additionally, stromal microvessel density was evaluated. Histochemical and immunohistochemical evaluation of mucinous cystadenoma (2 cases), mucinous cystic carcinoma (2 cases), ductal adenocarcinoma (8 cases), chronic pancreatitis (20 cases) and normal pancreatic tissue (9 cases) was performed for comparative purposes. Results: Presenting symptoms including abdominal pain, nausea and vomiting were observed in all patients. Majority of patients were submitted to pancreatoduodenectomy. No postoperative surgical complications were observed. Two cases of adenoma and 6 cases of invasive IPMN were found. Intraductal papillary mucinous neoplasms cells showed the strongest expression of sialomucins and neutral glycoproteins. Positive p53 expression was found in all cases of malignant IPMN. Bcl-2 was negative in all cases of IPMN. Proliferative index Ki67 was lower in benign IPMN than in malignant IPMN. No estrogen receptors were found in IPMN. Progesterone receptors were found in occasional cells in IPMN. A proportion of IPMN cases showed expression of chromogranin, glucagone, somatostatin, serotonin, insulin, and pancreatic polypeptide. Malignant IPMN were characterized with a higher stromal microvessels density in comparison with benign IPMN. Conclusions: To authors' knowledge, the presented study includes the largest group of patients with IPMN diagnosed and treated in one centre in Poland. Clinical characteristics and surgical treatment results are similar to those described in the literature. Interpretation of the results of histochemical and immunohistochemical staining is complex. A precise and definite description of the IPMN pathogenesis and morphology in terms of differences and similarities with ductal adenocarcinoma and mucinous cystic neoplasms requires probably the use of molecular biology tools.
    No preview · Article · Jan 2007 · Gastroenterologia Polska
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    ABSTRACT: Proctocolectomy with the creation of the ileal pouch (IPAA) is the procedure of choice, in case of patients with advanced ulcerative colitis (UC) and familial intestinal polyposis (FAP). Considering the above-mentioned, other operations are also performed including proctocolectomy with ileostomy (TPC) and colectomy with ileorectal anastomosis (IRA). Aim of the study was to compare treatment results, as well as the quality of life of patients' subjected to surgical treatment by means of the above-mentioned methods. Material and methods. During the period between 1987 and 2002, 59 (64%) patients were operated for ulcerative colitis, while 33 (36%) for familial intestinal polyposis. Retrospective analysis of the course of treatment was conducted and the quality of life evaluated, based on Derogatis's: "Psychosocial adjustment to the illness scale". The t-Student test was used for statistical analysis. p<0.05 was considered as statistically significant. Results. In case of patients following proctocolectomy with ileal pouch formation, significantly fewer perioperative complications (28%) were observed, in comparison to patients after proctocolectomy and ileostomy (63%)(p<0.05). A significantly higher frequency of long-term postoperative complications (p<0.05) was observed in case of patients following proctocolectomy and ileostomy (78%), as compared to patients after ileorectal anastomosis (30%). Surgical treatment resulted in the lower impact on the quality of life of 57% of patients after proctocolectomy and ileal pouch formation, 59% following ileorectal anastomosis, and 73% after proctocolectomy and ileostomy. On the other hand, percentages considering the patients' professional lives were 43%, 47% and 46%, respectively. The improvement in the quality of life was considerable in case of all groups (57-65% of patients), in comparison to their situation before surgery. Conclusions. The quality of life of patients during the late postoperative period did not significantly differ amongst the analyzed groups. In case of patients with maintained digestive tract continuity (IPAA, IRA) fewer postoperative complications were noted, in comparison to patients with an ileostomy.
    No preview · Article · Jan 2006
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    ABSTRACT: Aim of the study. 1) define changes in pancreatic microcirculatory perfusion following experimentally induced acute pancreatitis and inflammatory process analysis during consecutive stages; 2) compare changes in pancreatic perfusion following the effect of normal saline administration into the pancreato-bilary duct (which seems to be one of the factors causing inflammation), as well as changes caused by the administration of sodium taurocholate. Material and methods. 16 rats were divided into the following 2 groups: group K - control group, which received 09.% normal saline solution into the pancreato-biliary duct (n=8) and group Z - rat group, in which acute pancreatitis was induced through the administration of 5% sodium taurocholate into the pancreato-biliary duct (n=8). Microcirculatory perfusion analysis was performed using laser Doppler. The observation period in both groups amounted to 3 hours, being sub-divided into 3 one-hour intervals. Results. Statistically significant perfusion variations were observed between time intervals 1 and 2, 1 and 3, 2 and 3 in each group and between time intervals 1 and 2, 1 and 3, 2 and 3 in groups K and Z. Conclusions. 1. Acute pancreatitis leads towards gradual decrease in organ perfusion - most significantly observed between the 1st and 2nd hour following the onset of acute pancreatitis. 2. The decrease in perfusion involved with the administration of sodium taurocholate into the pancreato-biliary duct is significantly greater than the decrease following the administration of normal saline, which proved the strong destructive effect of taurocholan and underlined the fact that taurocholan-induced pancreatitis is one of it's most severe cases.
    No preview · Article · Jan 2003
  • P. Lampe · M. Olakowski · S. Mrowiec · J. Ciosek
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    ABSTRACT: Aim of the study was to present surgical treatment results in case of benign hepatic neoplasms. Material and methods. During the period between January 1990 - December 2000, 239 patients underwent surgery in our Department due to neoplastic liver diseases. Benign liver diseases were noted in 106 patients. The study group comprised 57 women and 39 men, aged between 26-72 years (mean age: 52 years). Only symptomatic lesions were selected for surgical management. The following surgical procedure modifications were performed: major resection (hemihepatectomy) - 9 (8%)patients, minor resection (segmentectomy, wedge resection) - 42 (40%) patients, tumor enucleation - 36 (34%) patients, drainage - 12 (11%) patients, other procedures - 7 (7%) patients. Laparoscopic management was used in three patients with liver cysts. Results. Mean intraoperative blood loss amounted to 500 ml (100-2400 ml). Pringle's manoeuvre (on average - 25 minutes) was performed in 34 patients. Postoperative complications were observed in 27(25%) patients. Complications were observed in 4 (44%) of 9 patients after major resection and in 23 (29%) of 78 patients, in whom minor resections or tumor enucleation had been performed. The hospital mortality rate amounted 4% (4 patients). Mean hospitalization amounted to 24 days (5-65 days). There were no cases of hepatic cyst recurrence. Conclusions. 1. Limited resection in case of benign hepatic neoplasms is a procedure characterized by low morbidity and mortality rates. 2. Laparoscopy is effective in the management of cysts communicating with the surface of the liver.
    No preview · Article · Jan 2003
  • L Stefański · P Lampe · M Olakowski · S Mrowiec
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    ABSTRACT: Many centers besides radiography and endoscopy, perform manometric measurements in the diagnostics of diseases concerning esophagus and cardia. They which allow to determine esophageal body peristalsis, LES length with spatial distribution of pressures (Vector Volume). The aim of our study was the estimation of usefulness the esophageal and cardial computed manometry in disorders concerning motor activity of the upper part of gastrointestinal tract. In our hospital between March 1997 and March 1998 we examined 12 patients with cardial achalasia, 9 patients with hiatal hernia, 2 ones with features of gastroesophageal reflux without hernia and 1 patient with diffuse esophageal spasm. All patients were examined preoperatively, on the 7th postoperative day and postoperatively--after a month. Computer recording of pressures was made. In postoperative examination we revealed favourable improvement in gastroesophageal passage with marked decrease of LES pressures in patients after dilation. However in patients after Nissen's operation LES pressures exceeded upper normal range on the 7th day postoperatively, but they came back to normal range within a month after operation.
    No preview · Article · Feb 2000 · Wiadomości lekarskie (Warsaw, Poland: 1960)
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    ABSTRACT: The work presents a case of large size adrenal pseudocyst coexisting with cyst like changes in other organs (transparent septum of the brain, liver, right kidney). Diagnostic problems and often atypical course have been highlighted.
    No preview · Article · Feb 2000 · Wiadomości lekarskie (Warsaw, Poland: 1960)
  • Z Górka · M Lesiecka · K Kuśnierz · S Mrowiec · M Leidgens
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    ABSTRACT: The aim of the study was to evaluate the value of duodenojejunostomy and gastrojejunostomy in the treatment of neoplastic obstruction in the distal part of the duodenum. From 1992-1996, 37 patients (15 women, 22 men, aged 31-76 years) underwent a palliative operation for pancreatic cancer infiltrating the distal part of duodenum. Roux-en-Y procedure was used to create anastomoses between the duodenal bulb and jejunal loop. In 13 patients only alimentary by-pass was made whereas in the remaining 24 biliary decompression was also performed. The results were compared with the outcome in 26 patients in whom gastrojejunal side-to-side anastomosis been made. The advantage of Roux-en-Y duodenojejunostomy is that it does not interfere with gastric emptying and thus prevents jejuno biliary reflux and the consequent complications. Improvement of nutrition and quality of life in patients with inoperable pancreatic cancer, were noticed with this method.
    No preview · Article · Feb 1997 · Wiadomości lekarskie (Warsaw, Poland: 1960)
  • P Lampe · J Kabat · Z Górka · S Mrowiec · H Bursig
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    ABSTRACT: The authors present the results of using endoprosthesis made of bowine fascia which was conserved in special way. The endoprosthesis was used to cure salivary fistula in the place of anastomosis oesophagus with its replacement of the neck. The endoprosthesis was used to prevent leakness or stenosis in difficult operative circumstances and to pass the substitutive oesophagus in non-anatomical way. Prophylactic using of the endoprosthesis in technical difficulties caused by operative circumstances prevents leakness and stenosis in the place of anastomosis.
    No preview · Article · Feb 1997 · Wiadomości lekarskie (Warsaw, Poland: 1960)

Publication Stats

58 Citations
18.24 Total Impact Points

Institutions

  • 2012
    • University of Silesia in Katowice
      Catowice, Silesian Voivodeship, Poland
  • 2008-2010
    • Medical University of Silesia in Katowice
      • Department of Gastrointestinal Surgery
      Catowice, Silesian Voivodeship, Poland
    • Silesian University of Technology
      Gleiwitz, Silesian Voivodeship, Poland