J Jamski

Jagiellonian University, Cracovia, Lesser Poland Voivodeship, Poland

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Publications (23)0 Total impact

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    ABSTRACT: The aim of the study was to demonstrate the advantages of employing the ultrasonic scalpel in maintaining appropriate intraoperative hemostasis as compared with traditional methods of thyroid vessel ligation and coagulation Material and methods. Between December 2003 and May 2006, 2410 patients were managed for various thyroid diseases at the Department of Endocrine Surgery. In the presented group, 179 procedures that employed minimally invasive surgical techniques including 101 operations in which US was used to secure the thyroid vessels (group A) and 78 operations in which the superior thyroid vessels were clipped and subjected to bipolar coagulation without US (group B) were performed. Both groups were similar with respect to gender, age, indications for surgery and mean thyroid volume. Statistical analysis included mean operative time, postoperative blood loss, scar length and cosmetic satisfaction assessed on visual-analogue scale (VAS) at 1 month following surgery. Results. Mean operative time was significantly greater in group B vs A (54.5±14.2 vs 35.4±8.7 min, respectively; t-test; p<0.001). Mean postoperative blood loss was significantly higher in group B vs A (32.8±13.0 vs 12.9±5.7 ml, respectively; t-test; p<0.001). One case of transient paralysis of the recurrent laryngeal nerve and two instances of postoperative drop in calcium concentration values below the normal range was observed. The mean scar length at 1 month following surgery was significantly longer in group B vs A (21.5±1.9 vs 15.6±1.4 mm, respectively; t-test; p<0.001). Cosmetic satisfaction was significantly lower in group B vs. A patients (81.9±5.4 vs 88.9±9.7pts, respectively; t-test; p<0.001). Conclusion. The use of an ultrasonic scalpel in thyroid surgery reduces the mean operative time, achieves good hemostasis and improves cosmetic results without increasing the risk of morbidity.
    Preview · Article · Nov 2007 · Polish Journal of Surgery
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    ABSTRACT: Anaplastic thyroid cancer is one of the most malignant human neoplasms. The incidence of the above-mentioned ranges between 1.6-10%, especially in elderly subjects with female preponderance, the ratio as follows: 2:1-8:1. The incidence increases with age and most diagnoses concern patients >65 years. Anaplastic thyroid cancer is the most rapidly growing neoplasm with unfavorable prognosis. Aim of the study was to analyze long-term results of anaplastic thyroid cancer (ATC) treatment considering patients who underwent surgery in one endocrinological center during a period of 19 years. Material and methods. The study group comprised 44 patients operated for anaplastic thyroid cancer (ATC) at the Department of Endocrine Surgery, Jagiellonian University, during the period between 1984 and 2002. Analysis comprised patient characteristics, clinical symptoms and signs, TNM staging and type of surgical procedure. Follow-up data was collected by means of the outpatient registry, including the use of external irradiation and chemotherapy, as well as survival after surgery. Results. The number of patients subjected to surgical intervention, due to ATC amounted to an average of 2.3 per year (1-6 pts.), throughout the study period. In comparison to other thyroid neoplasms the percentage of patients with ATC gradually decreased by about 1.1% every year (p<0.001). Patient age ranged between 48 and 85 years (mean age: 68.3±9.2 years). More than 50% of patients were >70 years, while only five were<50 years. The study group comprised 37 (84%) female and 7 (16%) male patients. The F: M ratio was 5.3:1. Previous goiters were diagnosed in 33 (78%) patients. At the time of the operation, 90.9% of ATC patients were classified as T4. In most cases (>60%) symptoms of infiltration of surrounding tissues and organs were observed (stridor, dysphagia, respiratory insufficiency). Metastases to cervical lymph nodes were confirmed by means of histopathological examinations in 22.7% of patients, while distant lung metastases were diagnosed in 13.6% of patients. Radical surgery was performed in 13.6% of patients. 26 patients were qualified towards postoperative radiotherapy, and 6 received doxorubicin. Mean postoperative survival amounted to 6.1 months. Two-year survival was observed in only two (4.5%) patients. Conclusion. Thus far, long-term treatment results in case of ATC are very poor. Improvement should be obtained in case of early diagnosis and surgical treatment undertaken in locally non-advanced neoplasms.
    No preview · Article · Jan 2006
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    ABSTRACT: The permanent lesion of damaged recurrent laryngeal nerve (RLN) often manifests as an irreversible dysfunction of phonation and is the most common complication following thyroid surgery. The frequency of this complication ranges from 0.5 to 5% in different thyroid surgery centres and increases in case of both recurrent goiter and complete thyroidectomy due to thyroid cancer. The RLN lesion varies from irreversible, persistent and transient dysfunction with good prognosis of complete recovery. The time of RLN function recovery ranges from several weeks to two years (mainly 6 months). The aim of this study was to evaluate early and persistent RLN paralysis. We operated in our clinic 2323 patients between 1994 and 1997. 2137 patients were operated for the first time due to benign goiter. On the 3rd post-operative day 190 patients (8.9%) presented RLN paralysis of different grade. The follow-up examination (indirect laryngoscopy) was performed in 100 patients with early RLN paralysis in the period between 6 months and 3 years after surgery. The complete RLN recovery was diagnosed in 78%. The permanent paralysis was diagnosed in 1.9% of operated patients. In the light of law and medical aspects we suggest obligatory laryngological examination with the evaluation of vocal cords mobility before surgery and on the 3rd post-operative day in order to identify early RLN lesion. Permanent RLN paralysis may be diagnosed on the basis of multiple laryngological examination in the period between 3 and 24 months after surgery.
    No preview · Article · Feb 2004 · Przegla̧d lekarski
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    ABSTRACT: The paper is aimed at evaluating the frequency of incidence and the thyroiditis type in patients operated on for goiter. In the years 1989-2000, 5149 patients were operated on because of different thyroid disorders. The clinical data of 66 patients with thyroiditis, diagnosed in a post-operating histopathological examination, were subject to a retrospective analysis. There were 64 women and 2 men, aged from 22 to 70, on an average 50.1 years old. There were determined the preoperative diagnosis, the thyroid function--basing upon the levels of TSH and thyroid hormones, the type of operation effected as well as post operative complications. Then, there was also measured the weight of the resected lobes. The prevalent indication for the surgery was non-toxic goiter; instead, toxic goiter was such an indication only in a few cases. In most patients, the thyroid function revealed euthyreosis. The following complications were observed: transient hypocalcemia [two patients], transient paralysis of recurrent laryngeal nerve on one side [one], and wound suppuration [one]. The following types of thyroiditis were found in histopatological examination: Hashimoto (59 patients), Riedl (3 patients), de Quervain (2 patients) and non-specific thyroiditis (2 patients). CONCLUSIONS: 1. Thyroiditis is a rare case in patients operated on for goiter. 2. The most frequent pathological finding is Hasimoto disease.
    No preview · Article · Feb 2002 · Przegla̧d lekarski
  • Jerzy Jamski · Wojclech Wierzchowski · Marcin Graca
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    ABSTRACT: A case of malignant hemangioendothelioma, developing in a goiter of a 52-year-old woman is presented. This bleeding tumor of the thyroid gland has caused four operations within one month. Histologically, the tumor was composed of widely dilated, ramifying and intercommunicating vascular spaces lined by atypical malignant endothelial cells. Positive immunohistochemical reactions with endothelial markers including factor VIII-related protein, and CD34 and non reactivity with epithelial membrane antigen (EMA) and thyroglobulin, confirmed the endothelial origin of this tumor.
    No preview · Article · Feb 2002 · Przegla̧d lekarski
  • J. Jamski · M. Barczyński · S. Cichoń
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    ABSTRACT: Aim of the study at discussing contemporary surgical techniques employed in the treatment of thyroid cancer (TC), as well as changes in management tactics observed recently in thyroid cancer surgery. Material and methods. Experience in the surgical treatment of TC is based upon more than 520 patients operated in a single center of endocrine surgery over the past 20 years. The retrospective analysis included 218 TC patients operated between-1980 and 1995, while 302 TC patients operated after 1995 were analyzed prospectively. The authors focused on the percentage of primary radical thyroidectomies, including low and high risk factors before 1995, as well as on primary and delayed secondary radicalized procedures (complete thyroidectomy), as a rule performed after 1995. Analysis also included the prevalence of surgical complications, such as recurrent laryngeal nerve damage, as well as postoperative hypoparathyroidism. Results. Surgical frequency due to thyroid cancer increased steadily from 5.11% in the eighties to 9.30% over the last 5 years. In the latter period, secondary radicalized procedures accounted for 26.49% of all TC operations, with 70% being early secondary radicalized procedures. The introduction in 1995 of elective total thyroidectomy in case of differentiated TC resulted in a slight, but non-significant increase of complications (p=0.063). Conclusions. The current radical surgical management of thyroid carcinoma is based on a total thyroidectomy combined with an elective lymphadenectomy in medullary TC or a selective lymphadenectomy in differentiated thyroid carcinoma. Primary radical procedures are not associated with an increased complication rate in comparison with subtotal thyroidectomies.
    No preview · Article · Jan 2002
  • J Jamski · M Graca · P Orlicki
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    ABSTRACT: The authors presented 4 cases of primary malignant neoplasm of the intestine caused by small intestine obstruction. These patients underwent emergency surgery. In all cases, a segmental resection of the intestine was performed. There were two cases of adenocarcinoma and two cases of carcinoid. Three patients were complementarily treated using chemotherapeutics. One of them died two years post operation. The last three patients survived 0.5-5 years post operation.
    No preview · Article · Feb 2001 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek · T Rogula
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    ABSTRACT: The paper presents the rules of surgical treatment in medullary carcinoma of the thyroid gland based on own experience and survey of literature. Changing trends in diagnostic and therapeutic approach were described. The results achieved encouraged authors to find some conclusions. Long term results of therapy depend mostly on stage of disease in time of initial surgery, radicality of primary operation and further supportive treatment. Systematic follow-up after surgery makes it possible to early detect the recurrence and has an influence on survival rate. In cases of poorly differentiated medullary thyroid cancer even radical surgical procedure followed by the appropriate supportive treatment results in a not satisfactory survival.
    No preview · Article · Feb 2001 · Wiadomości lekarskie (Warsaw, Poland: 1960)
  • M Barczyński · J Jamski · S Cichoń · W Sułowicz
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    ABSTRACT: The most common metastatic tumour of the thyroid gland which is clinically revealed is renal clear cell carcinoma (RCCC). Our clinical experience in cases of RCCC metastases into thyroid gland is reviewed in terms of the history of the disease, obligatory diagnostic procedures, surgical management and outcome prognosis. We believe that all the patients with even a remote RCCC history require systematic follow-up including thyroid gland as metachronic metastatic disease can occur many years after primary surgery. Clinical diagnosis and ultrasound of the thyroid gland is essential in selection for surgical treatment. Confirmation of malignancy in FNA (fine needle aspiration) in often difficult regarding concomitant multinodular goitre. Enlargement of a single thyroid nodule except L-thyroxin therapy for 3-6 months is a sufficient indication for surgical treatment, not depending on FNA result, particularly when a suspected nodule becomes bigger than 30 mm in diameter.
    No preview · Article · Feb 2000 · Przegla̧d lekarski
  • J Jamski · M Graca · M Trystuła
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    ABSTRACT: The authors presented 6 cases of malignant neoplasms of intestine. Five of them were undergone emergency surgery, while one elective, due to complaints notified previously for a longer time. In all cases a segmental resection of intestine was done. Two patients were complementarily treated using chemiotherapeutics. Three patients survived 2-5 years after the operation. The last three patients are under the further follow up.
    No preview · Article · Mar 1999 · Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego
  • M Graca · J Jamski · G Pałka · K Krzesiwo-Stempak
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    ABSTRACT: The paper presents clinical signs, diagnosis, treatment and therapeutic results in the group of patients with a primary gastrointestinal lymphomas. All of the patients had a surgical procedure: 5 of them were operated on according to a fixed plan and 3 had an emergency operation. 6 patients were subjected to chemotherapy and radiotherapy. The patients were analyzed along with the obtained therapeutic results.
    No preview · Article · Feb 1999 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek
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    ABSTRACT: The paper presents diagnosis and treatment of anaplastic thyroid cancer based on the own experience and literature review. There were presented up to date diagnosis and treatment which included radical thyroidectomy and radio-, chemio-, and hormonotherapy. The results of radical thyroidectomy and teleradiotherapy in anaplastic thyroid carcinoma are not satisfactory.
    No preview · Article · Feb 1999 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek
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    ABSTRACT: The paper presents up to date knowledge about oncocytic neoplasms (Hürtle cell tumor). The following paper is based on the biggest study group in Poland. Most of these tumors were benign. The histopathological diagnosis was usually very difficult. The authors pointed out that the most important problem in the treatment process was the histopathological examination. Even intraoperative pathological diagnosis is not discriminative for the diagnosis. All diagnoses were based on paraffin-embedded samples examination. In the authors' opinion treatment process should be individualised according to all clinical and histopathological results.
    No preview · Article · Feb 1999 · Przegla̧d lekarski
  • P Orlicki · J Jamski · M Graca · K K Stempak
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    ABSTRACT: Since 1986 till 1996 in the Third Department of Surgery of the Collegium Medicum of the Jagiellonian University in Cracow, nine patients with biliary ileus were operated. Initial diagnosis, additional tests results, concomitant diseases, kinds of operative procedures and complications were analysed. Biliary ileus is still generally recognized during operation. Endoscopy, X-ray examination with contrast, ultrasound, and computed tomography are worth recommendation in preoperative diagnosis. Early decision about operative treatment and application of antibiotic prophylaxis may have an influence on improvement of treatment results.
    No preview · Article · Feb 1999 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek
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    ABSTRACT: In the paper we present the group of 3 patients with neurilemmoma. Patients were operated on because of simple nodular goiter transformed into the thyroid carcinoma. In all cases final diagnosis was based on postoperative paraffin-embedded tissues. In the authors' opinion modern imaging technics strictly allows to formulate the preoperative diagnosis. Total resection with special attention paid to the postoperative examination including ultrasound diagnostics improve survival.
    No preview · Article · Feb 1998 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek
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    ABSTRACT: The paper presents one case with diagnosed the primary extra-nodular Hodgkin's disease in the thyroid gland. Patient was operated on. Hodgkin's disease was diagnosed postoperatively in the paraffin-embedded tissues. In authors' opinion progress in the imaging technics with fine-needle aspiration biopsy allows to formulate diagnosis, and treatment which includes chemo- and radiotherapy, improves survival.
    No preview · Article · Feb 1998 · Przegla̧d lekarski
  • J Jamski · M Barczyński · J Ryś · A Konturek
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    ABSTRACT: The paper presents clinical signs, diagnosis, treatment and therapeutic results in the group of 10 patients with at primary malignant lymphoma of the thyroid gland. There were presented up to date methods of diagnosis and treatment with includes chemio- and radiotherapy. In authors opinion progress in imaging technics cyto- and histopathology, and potentiality of complex treatment allows us to avoid from surgery in most cases of malignant lymphoma of the thyroid.
    No preview · Article · Feb 1997 · Przegla̧d lekarski
  • J Jamski · M Barczyński · A Konturek
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    ABSTRACT: We preset three patients operated on at our hospital with diagnosed metastasis clear cell carcinoma of the kidney to the thyroid gland 5, 6, and 9 years after nefrectomy. Patients were operated on because of nodular goiter and metastases were diagnosed intraoperatively (frozen section) at two cases and postoperatively in the remaining care (diagnosis made by pathologist-microscopic examination). A radical thyroidectomy was employed without chemio- or radiotherapy which is now recommended as a method of treatment of clear cell carcinoma metastasis.
    No preview · Article · Feb 1997 · Przegla̧d lekarski
  • M Barczyński · J Jamski · J Silczuk
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    ABSTRACT: The authors present an analysis of the material of 84 patients operated on in the years 1979-1992 for non-malignant recurrent goitre. The method of management and treatment results are presented. The schema of management is also described in prevention of goitre recurrences, involving correctly performed operation, periodical control examination, and routine postoperative administration of thyroid preparations. The use of hormonal prophylaxis (L-Thyroxin) in suppressive doses, under TSH control seems to have a significant influence on the reduction of the number of recurrences.
    No preview · Article · Aug 1994 · Wiadomości lekarskie (Warsaw, Poland: 1960)
  • J Silczuk · J Jamski · S Cichoń
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    ABSTRACT: Among acute diseases of the abdominal organs acute appendicitis is the most frequent cause of emergency laparotomies. In women the most frequent cause of preoperative diagnostic errors are diseases of the reproductive system. The material analysed by the authors was a group of 865 patients operated on with the diagnosis of acute appendicitis in the I Department of Surgery in the period 1964-1973 and in the III Department of Surgery, Medical Academy in Cracow in the years 1974-1986. In this material from two teaching hospital departments and from two different time periods similar proportions of diagnostic errors (12.7% and 13.4%) were found, and during the operation similar types of pathological changes were noted in the reproductive system. The authors stress the analysed diagnostic difficulties and point out that exploratory laparotomy is safest for the patient.
    No preview · Article · Jun 1989 · Wiadomości lekarskie (Warsaw, Poland: 1960)