Tomasz Kościński's research while affiliated with Poznan University of Medical Sciences and other places
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Publications (45)
A pancreaticopleural fistula is a rare cause of pleural effusion. It is a complication of chronic or acute pancreatitis. It is rarely formed to the right or both pleural cavities. Diagnosis and proper treatment often turn out to be difficult and require the cooperation of a multidisciplinary team. The authors present the case of a 59-year-old patie...
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...
Objectives: This report describes results of posterior vaginal wall prolapse and rectocele treatment performing tension free reconstruction method with polypropylene mesh implantation.
Material and methods: In years 2001 to 20015, 71 female patients in age of 42–82 years were surgically treated. Besides difficult emptying they complained of feeling...
Introduction. A rectocele is a hernation of the rectum into the vaginal lumen developing as a consequence of weakness of the rectovaginal septum. It affects about 18% of women after childbearing age. Symptoms associated with a rectocele include constipation, vaginal fullness or heaviness, feeling of a bulging mass within vagina, incomplete stool ev...
Pacjent lat 60, przyjęty do szpitala z powodu ostrego niedokrwienia kończyny dolnej prawej z martwiczymi zmianami po stronie grzbietowej i zewnętrznej stopy. Zmiany martwicze o szybko postępującym charakterze - owrzodzenia III/IV stopień według klasyfikacji Wagnera. Pacjent choruje na cukrzycę typu drugiego oraz na nadciśnienie tętnicze. Chory pali...
Anatomical and functional results of a modified sacral perineocolporectopexy for extreme forms of complex pelvic organs prolapse.
Between 2005 and 2010, 10 women aged 47-75 years were treated by abdomino-perineal implantation of polypropylene mesh for modified sacral perineocolporectopexy and subsequently followed-up. They were suffering from enter...
Background
Giant condyloma acuminatum or Buschke - Loewenstein tumor is a very rare disease usually located in the genital, anorectal, and perianal regions. It is locally invasive but in mostly cases displays a benign cytology on preoperative tissue sampling. Because of its low incidence little is known about treatment outcomes. Complete surgical e...
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...
Introduction:
Monitoring the response to biological treatment in Crohn's disease (CD) is a very important element of the therapeutic optimisation.
Aim:
To evaluate the usefulness of measuring calprotectin, lactoferrin, and myeloperoxidase in stool as markers of long-term clinical and endoscopic response to anti-tumour necrosis factor α (anti-TNF...
Vaginal cancer is one of the least common reproductive tumors in women; in Poland it constitutes only 1–4% of them.
It is found primarily in elderly patients with the mean age at diagnosis of approximately 70 years. Because of a similar
clinical presentation and histological structure, vaginal cancer can be mistaken in its early stages for infiltra...
Unlabelled:
Mesh biomaterials have become the standard in the treatment of hernias, regardless the location. In addition to the obvious advantages of the methods based on implantable biomaterials, one should be aware of the possible complications, such as their migration to the abdominal organs.
Material and methods:
The study group comprised pa...
Proctocolectomy with ileal pouch-anal anastomosis (IPAA) was performed in ulcerative colitis (UC) for emergent or urgent indications in three stages. Since the three-step procedure imposes enormous demands on a patient, there was an attempt to introduce primary IPAA for urgent indications. The aim of this study was to compare early complications af...
Aim: Evaluation of results of the redo operations performed for recurrent rectal prolapse. Material and methods: This study entered 16 patients after redo surgery for recurrent rectal prolapse between 1998 and 2010. There were 14 female and 2 male patients aged from 42 to 92 (mean age 69 years). Primary abdominal rectopexy was performed in 5 patien...
The authors present a case of 58 years old woman suffering from complex pelvic floor pathology diagnosed with rectal prolapse, genitary organs prolapse, descending pelvic floor, rectocele and enterocele as well as advanced diverticular disease of the left colon. She suffered from chronic constipation. The surgery consisted of left hemicolectomy, hy...
The authors present a patient suffering from malignant peritoneal mesothelioma. Differential diagnosis has become the major concern in the fatally ill patient. Pain, increasing abdominal girth, anorexia and weight loss, and recurrent ascites are the most frequent presenting symptoms. In this patient, fever of unknown origin was a clinical mask of m...
The authors present a 32-year-old male patient with incarceration of a recurrent esophageal hiatal hernia after laparoscopic repair. A life-threatening strangulation of the stomach and the transverse colon occurred within a few days after the operation. Relapse of hiatal hernias amounts to almost half of early complications characteristic for the l...
The procedure of restorative proctocolectomy is associated with a complete removal of the colon and slight reduction of ileum length, which together can lead to systemic shortages of trace elements. Inflammatory changes in the pouch mucosa may also have some impact. However, there is no data on trace elements in pouchitis. Therefore, in the present...
The insulin-like growth factor (IGF)-1 gene consists of 6 exons resulting in the expression of 6 variant forms of mRNA (IA, IB, IC, IIA, IIB and IIC) due to an alternative splicing. The mechanisms of IGF-1 gene splicing and the role of local expression manifested by IGF-1 mRNA variants in colorectal carcinoma (CRC) have not been extensively investi...
The authors present epidemiology etiology pathophysiology management, and treatment of constipation including proper qualification for surgery. Constipations can be divided into more common - primary and less frequent - secondary The latter may occur due to organic lesions of the large bowel, in the course of metabolic and endocrine disorders, or n...
THE AIM OF THE STUDY was to evaluate the results of the treatment of internal hemorrhoids and anal mucosal prolapse using elastic band ligation and to compare this method to chosen surgical procedures.
The study included 648 patients (363 males and 285 females). 474 patients were treated using an elastic band ligature and 174 patients underwent sur...
THE AIM OF THE STUDY was to present and compare own results of abdominal rectopexy performed with absorbable and nonabsorbable materials used in surgical repair of rectal prolapse.
In the years 1991-2009, 50 patients were operated on for rectal prolapse. The first 8 patients (group I) were operated using absorbale polyglycolic acid mesh. The next 4...
Vacuum-assisted closure (VAC) therapy is a widely acknowledged method for chronic and traumatic wound healing. The feasibility of VAC therapy used for the treatment of intestinal fistulas is still a subject of debate. Complex postoperative wounds pose significant therapeutic problems, especially when there are several fistula openings in the wound...
Available data indicates potential effectiveness of prebiotic therapy in alleviating inflammation and prolonging the remission in inflammatory bowel disease. Documented successes of such therapies were the basis for this study. So far, there is no data related to the effectiveness of inulin application in symptomatic or severe pouchitis in humans o...
The aim of the study was to present different methods of reconstruction in case of rectovaginal septum defects, considering female patients with impaired colorectal voiding. Material and methods. During the period between 2001 and 2010, 39 female patients, aged between 42 and 75 years (mean age-58 years) were subject to surgical intervention. Patie...
The aim of the study was analysis of an anal sphincter function in patients before and after surgery for rectal prolapse. Material and methods. Between 1987 and 2005, 49 patients underwent operations for rectal prolapse. The anal sphincter function was analyzed in 17 of these patients. Abdominal approach surgery was performed in 13 patients; this i...
Rectovaginal fistulas account for less than 5% of all anorectal fistulas. They may occur as a result of obstetrical injuries, inflammatory bowel diseases, or pelvic cancer irradiation. The aim of the study was to describe the results of different methods of surgical treatment according to the etiology and localization of rectovaginal fistulas. Mate...
Background: Constipation is a major public health concern afflicting our society. Its underlying cause frequently remains unknown, making difficult the choice of the best conservative treatment or deciding about surgical intervention. Apart of a detailed medical history and careful physical examination, a comprehensive array of diagnostic tests is...
Aim of the study was to evaluate the effects of surgical treatment for recurrent rectal prolapse. Material and methods. The study group comprised seven female patients, aged between 37 and 92 subjected to treatment during the period between 1998 and 2005. Initial treatment consisted of rectal resection, according to Mikulicz's technique (two patien...
Rectal prolapse is defined as protrusion of all the rectal layers from the anal canal. It is differentiated from anal prolapse and internal intussusception. Ethiopathogenesis of recal prolapse is rather complex and only thorough knowledge and understanding of this condition may provide successful surgical treatment. In the beginning of the 20th cen...
The aim of the study was to compare the results of treatment by local excision of two different clinical stages of the rectal cancer.
Fifty-eight patients with early rectal carcinoma were operated on during the last 26 years using different methods of local excision. The carcinomas were initially assessed as not-exceeding the muscularis layer of th...
Aim of the study was to present the development of methods and results of local rectal carcinoma excisions during the last 26 years. Material and methods. The study group comprised 58 patients with rectal carcinoma initially assessed as non-infiltrative. The tumors, localized 12 cm from the anus margin, were removed by means of "parachute" excision...
The authors describe physiopathology of rectocele, its symptomatology and influence on the defecation and the anal function. Endoanal technique of rectocele repair is presented. This method of surgical treatment has been used in 11 women. Normal defecation has been regained in 8 patients. Three patients complained of rectal and perineal pain and ha...
The authors describe overlapping sphincteroplasty for the reconstruction of injuried anal sphincters. This technique was applied for obstetric, surgical and traumatic injuries i 57 patients. Both anal sphincters were injuried in 37 cases. A single damage of the external sphincter was observed in 20 cases. The anal sphincteric function has been eval...
Transanal Endoscopic Microsurgery (TEM) was introduced to clinical practice by Buess in 1983. After several years of gaining experience technique has been used for the excisions of rectal tumours. TEM enables excisions of the tumours localised in the rectum and distal portion of the sigmoid colon from 5 to 25 cm from the anal verge. Until now 13 pa...
Unlabelled:
The aim of this study was to analyse the composition of the bacterial flora in 295 patients who underwent surgical treatment in our clinic throughout the period of 12 years. 448 specimens were bacteriologically examined. Bacterial pathogens were isolated from 390 (87.1%). Among aerobic bacteria, Enterococcus faecalis was the most often...
The authors discuss 56 patients operated for rectal cancer primarily estimated as noninvasive. Applied procedures were: local excision through stretched anus /46 cases/, Localio technique /6 cases/, rectotomy during a laparotomy /1 case/ and Transrectal Endoscopic Microsurgery /3 cases/. The patients were divided into 3 groups according to tumor's...
The integrity of stapled anastomoses was controled upon completion in 118 patients. Intraoperatively leakage was demonstrated in 10 cases. In 4 patients it was due to partial or total anastomosis dehiscence. In those cases the reconstruction of the low anastomosis had to be performed by hand suturing. The stumps were reanastomosed either from the a...
The aim of this study was to compare therapeutic efficacies of drugs which decrease portal pressure: octreotide (somatostatin analogue), vasopressin and balloon tamponade in cases of bleeding from esophageal varices. Octreotide was administered in 21 patients in continuous intravenous infusion of 50 μg/h for 48 h, vasopressin in 12 patients in the...
Streszczenie SŁOWA KLUCZOWE: gruczolak odbytnicy – rak odbytnicy – wycięcie przezodbytnicze – wskazania i technika – przezodbytnicza mikrochirurgia endoskopowa (TEM) Przezodbytnicze wycięcie łagodnych i wybranych przypadków złośliwych guzów odbytnicy jest obecnie zabiegiem powszechnie akceptowanym. Zastosowanie stereoskopowej techniki mikro-chirurg...
Citations
... Возникновение рецидивирующего гидроторакса у пациентов вызывает необходимость выполнения многочисленных повторных плевральных пункций. Такие пациенты, как правило, длительно лечатся в непрофильном терапевтическом стационаре в связи с ошибочной диагностикой причины гидроторакса (свищи обычно диагностируются только на 20−49 сутки) [2]. Вследствие неадекватного лечения изза неправильно установленного диагноза повышается опасность возникновения тяжелых осложнений, таких как эмпиема плевры, сепсис [13,14]. ...
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... But the implantation of the collagen mesh is never enough and relapses occur in 41% of patients within 3 years. Pelvicol is used as an additional strengthening of the rectovaginal septum in plastic surgery operation -colporrhaphy [40]. ...
... Insufficient tissue mobilization and excessive tension where the suture line and direct sutures meet in the vaginal and rectal walls, are the disadvantages of this procedure. A recurrence rate ranges from 30% to 84% (19,20). In our study most of the cases were low localized fiistulas and these were excised with rectal,vaginal and perineal approach. ...
... Rectocele is the most visible disturbance, classified on top of the list (5,6). Pelvic floor structure disturbances are usually complex (7,8,9). ...
... The Altemeier procedure is used to perform a full-thickness resection of the rectum and a part of the sigmoid colon (perineal rectosigmoidectomy). Additionally, it seems to be the procedure of choice for patients with an incarcerated, gangrenous rectal prolapse and a very good option for patients with a recurrence after the earlier perineal procedure [10,24]. In our series, all cases were electively operated on, and we used the Altemeier procedure in the majority of our recurrences with good results. ...
... Rectal prolapse is a difficult and rare clinical condition. The frequency of the abovementioned is estimated at 0.04-1% (1), which consists between 2 to 5.6% of adult patients subject to treatment due to proctologic disorders (2). Rectal prolapse consists in the retroanal canal dislocation of one or all layers of the large bowel wall. ...
... 16,17 Koscinski and Sekowska offered their patients with low RVF and anal sphincter injury a combined approach of anal sphincter reconstruction plus advancement flap for repairing the RVF. 18 In this series, combining RVF surgery with anterior anal sphincter repair didn't add to the failure rate (0%). Instead, there was marked improvement of postoperative psychological status of patients as a consequence of enhanced continence. ...
... A reduction in FL levels was confirmed in 2 small cohorts of patients effectively treated with anti-TNFα [56], steroids, mesalamine, or thiopurines [57]. A significant decrease from baseline FL levels was reported after 3 and 12 months of therapy in patients treated with anti-TNFα (p < 0.05), in parallel to CDAI and SES-CD (p < 0.05) [58]. S100A12 performed poorly at 14 weeks (AUC 0.70) as compared to FC (AUC 0.87), in discriminating between patients who remained in remission from those who experience a loss of response within a year during anti-TNFα [59]. ...
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... In the study by Brown et al., 10% of cases experienced recurrent prolapse [17]. Abdominal rectopexy is the method of choice for the treatment of rectal prolapse [18]. ...
... and three papers were excluded for being in languages other than 21 studies met the inclusion criteria and were incorporated into the review process (Table 1). 1,2,5,6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] The papers included mostly case reports and two small case series published from 1989 to 2020. ...
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