Lietuvos chirurgija 2019-08-22T21:27:54+03:00 Aloyza Audra Lukšienė Open Journal Systems <p>Founded in 1993. Publishes scientific surgical articles written by Lithuanian and foreign authors.</p> Editorial Board and Table of Contents 2019-07-09T19:34:26+03:00 Narimantas Evaldas Samalavičius 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Author Guidelines and Bibliographic Data 2019-07-09T19:34:25+03:00 Narimantas Evaldas Samalavičius 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Mayo Clinic Days in Klaipėda 2019 2019-07-09T19:34:25+03:00 Narimantas Evaldas Samalavičius 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Pathophysiology of severe traumatic brain injury and management of intracranial hypertension 2019-08-22T21:27:54+03:00 Raimondas Juškys Vaiva Hendrixson <p><span class="None">It is well recognized that severe traumatic brain injury causes major health and socioeconomic burdens for patients their families and society itself. Over the past decade, understanding of secondary brain injury processes has increased tremendously, permitting implementation of new neurocritical methods of care that substantially contribute to improved outcomes of such patients. The main objective of current treatment protocols is to optimize different physiological measurements that prevent secondary insults and reinforce the ability of the brain to heal.&nbsp;</span><span class="None">The aim of this literature review is to uncover the pathophysiological mechanisms of severe traumatic brain injury and their interrelationship, including cerebral metabolic crisis, disturbances of blood flow to the brain and development of edema, putting emphasis on intracranial hypertension and its current management options.</span></p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Preoperative rehabilitation in abdominal surgical oncology: the new standard for patient preparation for surgery? 2019-08-22T21:27:47+03:00 Augustinas Baušys Justė Maneikytė Kęstutis Strupas Ieva Šakalienė <p>This paper shortly introduces preoperative rehabilitation as a new technique to prepare the patient for oncological surgery. First results of the clinical trials seem promising, because preoperative rehabilitation may increase the physical capacity of the patient, improve postoperative quality of life and even decrease the postoperative morbidity. Although, it remains unclear if preoperative rehabilitation could be beneficial before every surgery or only in case of major surgery. Therefore, before implication to the daily clinical practice, this new method has to be investigated in well designed clinical trials to determine the indications and to establish the optimized protocol of the preoperative rehabilitation.</p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## The Department of Faculty Surgery soon will be celebrating 80 years since its establishment in Kaunas Vytautas Magnus University: historical overview of the Department of Faculty Surgery in Kaunas 2019-08-22T21:27:40+03:00 Vytautas Zykas Donatas Venskutonis Žygimantas Vaičys <p>Department of Faculty Surgery in Kaunas was established in 1940 in Vytautas Magnus University. At that time the Dean of Medical Faculty and temporary chief of Surgery Department professor Vladas Lašas reorganized it by splitting and establishing two surgical departments – so called Faculty and Hospital Surgery. The Department has been renamed several times in subsequent years: until 1982 it continued to be Department of Faculty Surgery, in 1982–1992 was renamed to 2nd Surgery Department, in 1992–1998 carried the name of 2nd Surgery Clinic. This article offers an overview about prominent surgeons, who educated further generation of surgeons and created academic surgery, such as prof. V. Kanauka, prof. V. Lašas, A. Stropus, assoc. prof. J.&nbsp;Jaržemskas, assoc. prof.&nbsp;J.&nbsp;Karaliūnas, assoc.&nbsp;prof.&nbsp;J.&nbsp;Platūkis, prof. V. Zykas, prof. D. Venskutonis, also their collaborators and successors. The overview of academic, scientific progress as well as major contribution in the development of proctology in Lithuania is presented and includes the period until 1998 when Department underwent further reorganization by establishing new Department of General Surgery.</p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Results of esophageal cancer treatment at National cancer institute 2008–2017 years 2019-08-22T21:27:33+03:00 Sigitas Zaremba Renatas Aškinis Agota Piščikaitė Giedrė Smailytė Saulius Cicėnas <p><em>Introduction.</em>&nbsp;Esophageal carcinoma is the eighth most common cancer, and the sixth most common cause of cancer related deaths worldwide. Despite many advances in diagnosis and treatment, the 5-year survival rate for all patients with esophageal cancer ranges from 15% to 20%. Our aim was to analyze these patients results of operative, conservative and palliative treatment, determine the survival rate at the National Cancer Institute (NCI) since 2008 to 2017.&nbsp;<em>Methods.</em>&nbsp;From 2008 to 2017, 512 patients with esophageal cancer were treated in NCI. Patients received operative, palliative operative treatment, chemoradiotherapy, radiotherapy, chemotherapy or symptomatic treatment. Statistical analysis was performed using STATA 11 statistical software.&nbsp;<em>Results.</em>&nbsp;512 patients (mean age 61.8 years) were analyzed: 63 women (12.3%) and 449 men (87.7%). 25 patients (4.9%) had I stage cancer, II stage&nbsp;– 74 (14.4%), III stage&nbsp;– 258 (50.4%), IV stage&nbsp;– 155 (30.3%). The prevalent morphology&nbsp;– squamous cell carcinoma&nbsp;– 445 cases (86.9%) and adenocarcinoma&nbsp;– 48 cases (9.4%). There were 75 (14.6%) patients who underwent radical operations and 271&nbsp;– palliative operations. Chemoradiotherapy was applied in 97 (19.0%) patients, radiotherapy&nbsp;– 81 (15.8%), chemotherapy&nbsp;– 111 (21.7%), symptomatic treatment&nbsp;– 148 (28.9%). After radical operations, the rate of complications was 46.17% and mortality was 10.67%. The most common complication&nbsp;– fistula.<em>&nbsp;Overall survival:</em>&nbsp;1 y&nbsp;– 33.91%, 5&nbsp;y&nbsp;– 9.0%. Depending on the type of treatment, 5 y survival: after radical surgery&nbsp;– 26.53%, after chemoradiotherapy&nbsp;– 17.95%, after radiotherapy&nbsp;– 5.36%, after chemotherapy&nbsp;– 1.92%, after symptomatic treatment&nbsp;– 1.92%.&nbsp;<em>Conclusions.&nbsp;</em>In the radical surgical treatment group, the incidence of postoperative complications was 46.17% and mortality rate&nbsp;– 10.67%. In the palliative surgical treatment group, the incidence of postoperative complications was 4.5% and mortality rate&nbsp;– 0.7%. 5 year overall survival rate at the National Cancer Institute was 9.0%. Important influence on survival rate had treatment modality, stage of disease and size of primary tumor.</p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Short Term Postoperative Outcomes of Colostomy Closure 2019-07-09T19:34:22+03:00 Matas Pažusis Rūta Maželytė Kristina Buzaitė Žilvinas Saladžinskas <p><em>Introduction.</em><span class="char-style-override-6">&nbsp;</span>Colostomies are most often formed for patients diagnosed with colorectal malignancies. If colostomy is not permanent it could be closed after a certain period of time. Postoperative complications may include anastomotic leakage, ileus and wound infection.&nbsp;<em>Purpose.</em>&nbsp;To review the outcomes of colostomy closure during a short term follow-up period.&nbsp;<em>Methods.</em><span class="char-style-override-6">&nbsp;</span>A retrospective analysis of data form patients who underwent a colostomy closure surgery at the Section of the Surgery Department LSMU KK between 2012 through 2017 was carried out. The variables analysed were: age, characteristics of complications, number of hospitalisation days, reasons why the colostomy was formed, whether neoadjuvant treatment was given, timing before colostomy closure, whether resection was performed, type of resection, type of anastomosis, duration of surgery and characteristics of post operative period. Statistical data was analysed using Microsoft Excel program.&nbsp;<em>Results.</em><span class="char-style-override-6">&nbsp;</span>Medical records of 88 patients were analysed. The mean age of the patients was 56±1.6 (from 22 to 84). Surgeries performed because of the following reasons: sigmoid bowel cancer&nbsp;– 35 (39.8%), colon cancer&nbsp;– 11 (12.5%), large intestine diverticulosis&nbsp;– 20 (22.7%), abdominal trauma following car accident&nbsp;– 13 (14.8%), iatrogenic sigmoid bowel perforation after colonoscopy&nbsp;– 4 (4.6%), Crohn’s disease&nbsp;– 1 (1.1%), paraproctitis and ischiorectal abscess&nbsp;– 2 (2.3%), ischaemic colitis&nbsp;– 1 (1.1%), megacolon&nbsp;– 1 (1.1%).&nbsp;<br>Colostomies were closed in average after 10.13±2.14 months. Segmental resection was performed for 31 (36.5%) and marginal resection for 54 (63.5%) patients. The mean duration of colostomy closure surgery was 154.56±6.48 min. The mean duration of hospitalization was 9.43±0.62 days.&nbsp;69 (78.1%) patients experienced a good postoperative recovery. The mean length of hospitalisation for these patients was 7.78±2.42 days. 19 patients&nbsp;(21.9%)&nbsp;experienced post operative complications, which is why their mean length of hospitalization was&nbsp;15.05±9.58. Post operative complications were: irregular heartbeat&nbsp;4 (4.5%), seroma and hematoma 5 (5.7%), ileus 1 (1.1%), nausea 1 (1.1%), intestinal bleeding 1 (1.1%), anastomotic leakage 1 (1.1%), abdominal pain 1 (1.1%), fever 4 (4.5%), vesicorectal fistula formation 1 (1.1%).&nbsp;2 (2.3%) reoperations were performed. One relaparotomy was performed due to anastomotic leakage and one due to ileus. No deaths were recorded.&nbsp;<em>Conclusions.</em>&nbsp;1. Colostomies were closed in average after 10.13±2.14 months. 2. After colostomy closure 69 (78.1%) patients experienced a post operative recovery without complications. 3. Complications that most often occurred during post operative period were:&nbsp;fever 4 (4.5%),&nbsp;irregular heartbeat&nbsp;4 (4.5%), seroma and hematoma 5 (5.7%).</p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## A case report of desmoid type fibromatosis of the breast 2019-08-22T21:27:25+03:00 Lina Pankratjevaitė Ieva Ceslevičienė Lina Poškienė Algirdas Boguševičius <p><em>Background.</em>&nbsp;Desmoid type fibromatosis of the breast is a rare fibroblastic proliferative disease. It may be sporadic or associated with trauma, Gardner’s syndrome, etc. Desmoid tumour of the breast is a benign, locally aggressive disease. However, it does not metastasize.&nbsp;<em>Case report.&nbsp;</em>We report a case of a 65-year-old woman with right breast desmoid type fibromatosis.&nbsp;<em>Conclusions.&nbsp;</em>Diagnosis of breast desmoid tumour is difficult: clinically and radiologically it may mimic carcinoma. Definitive diagnosis is proved just by histopathological examination results. First choice treatment of breast fibromatosis is a radical surgical excision.</p> 2019-07-09T00:00:00+03:00 ##submission.copyrightStatement## Editorial Board and Table of Contents 2019-05-14T11:25:47+03:00 Narimantas Evaldas Samalavičius <p>[text in English and Lithuanian]</p> 2019-05-14T00:00:00+03:00 ##submission.copyrightStatement##