Įkurtas 1993 m. Publikuoja chirurgijos srities straipsnius.
Vilniaus universiteto leidykla / Vilnius University Press
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Autorių teisės (c) 2026 Authors https://creativecommons.org/licenses/by/4.0
Diagnostiniai iššūkiai diferencijuojant daugybinius pirminius plaučių navikus ir plaučių metastazes: klinikinis atvejis
<strong class="boldas" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <em class="italic" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Įvadas.<em class="italic" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Klinikinėje praktikoje vis dažniau susiduriama su daugybiniais pirminiais plaučių navikais, nes gerėja vaizdinių tyrimų galimybės, ilgėja pacientų išgyvenamumas ir apie šią ligą žinoma daugiau. Daugybinių pirminių plaučių navikų ir intrapulmoninių metastazių diferenciacija, turinti tiesioginę įtaką nustatant ligos stadiją ir parenkant gydymo strategiją, išlieka iššūkiu. <em class="italic" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Klinikinis atvejis. <span lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">72 m. pacientui, daug metų rūkančiam, atsitiktinai nustatytas darinys kairiajame plautyje ir du papildomi dariniai dešiniajame plautyje. Pirminiai radiologiniai ir histologiniai tyrimai parodė atskirus pirminius nesmulkiųjų ląstelių plaučių navikus, todėl atlikta kairioji viršutinė lobektomija ir dviejų dešiniojo plaučio židinių pleištinė rezekcija. Histologinis tyrimas atskleidė pleomorfinę karcinomą kairiajame plautyje, plokščialąstelinę karcinomą dešiniojo plaučio S9 segmente ir adenokarcinomą S2 segmente. Vėliau, tyrimo rezultatus pakartotinai įvertinus tarpdisciplininei komandai, dešiniojo plaučio plokščialąstelinės karcinomos židinys pripažintas kairiojo plaučio naviko metastaze. Pacientui skirta adjuvantinė chemoterapija. Vyras stebėtas 4,5 metų. Recidyvo ar ligos atsinaujinimo požymių nenustatyta. <em class="italic" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Išvada.<em class="italic" lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span lang="lt-LT" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Klinikinis atvejis pabrėžia daugybinių pirminių plaučių navikų diagnostikos sudėtingumą ir daugiadalykio vertinimo būtinybę, integruojant vaizdinius, histopatologinius ir molekulinius tyrimus. Tiksli diferenciacija būtina siekiant tinkamiausio gydymo.
Blauzdinio nervo švanoma: klinikinis atvejis ir literatūros apžvalga
<em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Įvadas.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Švanomos yra dažniausi gerybiniai periferinių nervų dangalų navikai. Jie auga<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> lėtai<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">, dažnai nesukeldami jokių simptomų. Švanomų supiktybėjimas itin retas, pasireiškia tik 1<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> proc.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> pacientų. Periferinių nervų navikams diagnozuoti taikomi vaizdiniai tyrimai: MRT ir ultragarsas. Biopsija atliekama tik esant neaiškiai klinikinei diagnozei ir yra susijusi su blogesnėmis pooperacinėmis išeitimis. Esant indikacij<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">ų,<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> švanomos šalinamos radikaliai chirurginiu būdu. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Klinikinis atvejis.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Straipsnyje pristatomas 36<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">m. vyro, kuriam diagnozuota gerybinė periferinio nervo švanoma, klinikinis atvejis. Pacientas iš pradžių tirtas ortopedo traumatologo. Diagnozei nustatyti atlikta MRT, po jos, net ir įtariant švanomą, – biopsija. Pacientą konsultavus plastinės ir rekonstrukcinės chirurgijos gydytojui,<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> dėl didelės piktybėjimo rizikos<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> nuspręsta masyvų naviką pa<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">šalinti<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> chirurginiu būdu. Po operacijos atlikus histopatologinį naviko ištyrimą, nustatyta, kad, remiantis MRT vaizdais, <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">įtarta naviko vidinė nekrozė yra hematoma, tikėtina<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">, atsiradusi po biopsijos. Po operacijos pacientui papildom<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">ų<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> neurologini<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">ų sutrikimų <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">nenustatyta. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Išvados.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Galima teigti, kad švanomos turėtų būti diagnozuojamos kliniškai, remiantis instrumentiniais tyrimais: MRT ir ultragarsu. Vaizdiniais tyrimais įtariant švanomą, biopsija diagnozei patvirtinti nerekomenduotina. Efektyvus pirmojo pasirinkimo gydymo būdas – radikali švanomos ekscizija. Esant neurologini<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">ų<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> simptom<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">ų, pasireiškus <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">skausmui, navikui greitai augant ar įtariant jo supiktybėjimą, navikas šalintinas radikaliai chirurginiu būdu.
Autorių teisės (c) 2026 Gustas Jonaitis | Mykolas Udrys https://creativecommons.org/licenses/by/4.0
Hemorrhoidectomy with LigaSure – an Experience
<p class="ISSN-abst-virsus" lang="en-US" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Background. Hemorrhoidectomy using the LigaSure system (LS) is a recent addition to the surgical armamentarium. Aim. To prospectively evaluate the outcomes of LigaSure hemorrhoidectomy in terms of blood loss, postoperative pain, duration of hospitalization, post-operative complications, and patients’ satisfaction. Methods. The records of all the cases who underwent LigaSure hemorrhoidectomy for internal hemorrhoids from June 2019 to May 2025 were analyzed. Demographics, comorbidities, type of anesthesia, procedure time, the volume of blood lost, postoperative pain, duration of hospitalization, post-operative complications, and the feedback expressed by the patients. Results. Out of 140 patients, there were 108 males and 32 females, with a mean age of 39.3 years. 88 (62.9%) cases were managed for Goligher’s grade III, and 52 (37.1%) had grade IV internal hemorrhoids. The mean procedure time was 14.3±3.9 min, respectively. The mean volume of blood lost in the procedure was 13.7 ml. The pain VAS score ranged from 3 to 7 (mean 4.83±0.93) and gradually decreased over 7 postoperative days. The mean duration to return to normal routines of life was 13.8±2.7 days, and 76% of patients were either highly satisfied or satisfied. Conclusion. Haemorrhoidectomy using LigaSure is a safe and effective method for the management of grade III and IV hemorrhoids.
Optimizing the Management of Adhesions Following Abdominal Surgery: A Prospective Study
<em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Background.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Adhesive-related abdominal surgery remains a chronic issue in the surgical field and a significant source of long-term patient morbidity. These fibrotic bands can result in complications such as: intestinal obstruction, chronic abdominal or pelvic pain, infertility, and repeat surgical procedure. Multiple preventive strategies have been suggested; however, their application in day-to-day clinical practice is variable and inadequately standardized. We looked at whether a structured and multidisciplinary protocol that they co-created with the Departments of General Surgery and Gynecology can reduce the incidence of adhesion-induced complications. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Methods.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> We conducted a prospective trial of patients undergoing elective or emergency abdominopelvic procedures. There were two arms of the participants – regular care or advanced adhesion-control protocol. The protocol highlighted three central themes: 1) rigorous clinical practice and strict adherence to tissue-handling principles; 2) an algorithm-based selection and usage of adhesion-barrier materials; and 3) standard postoperative follow-up. The primary endpoint was the 12-month incidence of a composite outcome including all adhesion-related adverse events. Secondary endpoints were adhesive small-bowel obstruction (SBO), chronic abdominal pain, reoperation, length of hospital stay, and quality-of-life (QoL) scores. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Results. <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">310 patients were assessed with 155 individuals in each group. The demographic and clinical baseline characteristics were similar. The primary outcome of the composite was significantly less frequently reported in the protocol group compared to routine-care group (18.1% vs. 35.5%; absolute reduction in risk = 17.4%; 95% CI 10.2–24.6; p < 0.001). Prominent improvements are also noted in secondary outcomes: adhesive SBO (7.7% vs. 20.0%; p < 0.001), chronic pain (18.1% vs. 34.8%; p < 0.001) and reoperation (3.9% vs. 12.3%; p < 0.001). The intervention group had significantly shorter mean hospital stay (4.2 days vs. 6.5 days; p = 0.01). At 12 months, QoL assessments revealed higher physical-component scores (75.1±7.8 vs. 60.2±8.5; p < 0.001) and mental-component scores (35.0±3.5 vs. 33.0±4.0; p = 0.03). <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Conclusion.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">A consistent, evidence based, multidisciplinary protocol for adhesion prevention decreases both the frequency and severity of postoperative adhesion and the related complications. The collaborative approach improves not only the patients’ quality of life, but also makes appropriate investment in health services, so as this can fit into ordinary surgical procedures.
Mikropulsinė transsklerinė ciklofotokoaguliacija gydant glaukomą: literatūros apžvalga
<em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Įvadas.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Glaukoma yra lėtinė progresuojanti optinė neuropatija, kuri negydoma lemia negrįžtamą aklumą. Medikamentinis arba chirurginis akispūdžio mažinimas šiuo metu yra vienintelis įrodytas glaukomos progresavimą stabdantis gydymo būdas. Ieškant efektyvių, tačiau saugesnių lazerinės ciklodestrukcijos metodų, XXI a. glaukoma sergantiems pacientams pradėta taikyti mikropulsinė transsklerinė ciklofotokoaguliacija (MP-TSCPC), skirta akispūdžiui mažinti, slopinant akies skysčio gamybą krumplyne. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Metodai.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Mokslinės literatūros apžvalga, vertinanti ilgalaikį MP-TSCPC efektyvumą ir saugumą, atlikta „PubMed“, „Embase“, „Web of Science“ ir „Scopus“ duomenų bazėse. Į analizę įtraukta 19 publikacijų, paskelbtų 2010–2026 m. Analizuota 1 512 akių, kurioms atlikta MP-TSCPC. Vertintas intervencijos efektyvumas ir saugumas, esant ne trumpesniam kaip 12 mėn. stebėjimo laikotarpiui, analizuojant akispūdžio pokytį, antiglaukominių vaistų skaičiaus kitimą ir komplikacijų dažnį. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Rezultatai.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Visose publikacijose nustatytas statistiškai reikšmingas akispūdžio sumažėjimas nuo 1 sav. iki 12 mėn. atlikus MP-TSCPC. Vidutinis akispūdžio sumažėjimas po 12 mėn. svyravo nuo 27,1 proc. iki 48,6 proc., palyginti su pradinėmis reikšmėmis. Tyrimuose, kuriuose stebėjimo laikotarpis buvo ilgesnis, akispūdį mažinantis poveikis išliko iki 36 mėn. po intervencijos. 16 iš 19 publikacijų nustatytas reikšmingas antiglaukominių vaistų skaičiaus sumažėjimas. Dažniausiai registruotos lengvos ir laikinos pooperacinės reakcijos, kurių dažnis siekė iki 40 proc., o sunkios komplikacijos, tokios kaip cistinė geltonosios dėmės edema, užsitęsusi hipotonija ar akies obuolio sunykimas, buvo retos. Endoftalmito, simpatinės oftalmijos, tinklainės atšokos ar stiklakūnio kraujosruvos atvejų neregistruota. 10 iš 19 tyrimų reikšmingų pooperacinių regėjimo pokyčių nenustatyta. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Išvados.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> Mikropulsinė transsklerinė ciklofotokoaguliacija yra veiksminga ir saugi glaukomos gydymo intervencija, užtikrinanti reikšmingą ilgalaikį akispūdžio sumažėjimą ir mažinanti antiglaukominių vaistų poreikį.
mikropulsinė transsklerinė ciklofotokoaguliacija
Clinical Profile and Therapeutic Approaches for Gastric Lipoma: A Comprehensive Scoping Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Background.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Due to improvements in diagnostic imaging and the popularity of bariatric surgery, gastric lipoma (GL), a rare benign mesenchymal tumor, is becoming more widely recognized. Though open surgery has been the conventional method of management, the therapeutic scenario has changed considerably in the past ten years. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Objective.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">This scoping review intends to delineate the clinical features, diagnostic findings, and the management trends for gastric lipomas that were documented between 2016 and 2025. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Methods.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">A systematic search was carried out across many databases in accordance with PRISMA-ScR criteria. Eligible studies included case reports and series focusing on benign GLs in adult patients. Data extraction focused on demographics, symptomatology, tumor size, diagnostic modalities, and surgical outcomes. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Results.<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"> A total of 33 articles describing 35 cases were included. For cases with available demographic data, the median age was 63 years (range: 17–85), with a 2.5:1 male predominance. The most common presentation was gastrointestinal bleeding (68.6%), followed by gastric outlet obstruction (20.0%). Larger tumor size was generally related to symptomatic presentation in the reviewed literature; notably, all reported “giant” lesions (>4 cm) were symptomatic. The most common diagnostic methods were esophagogastroduodenoscopy (91.4%) and CT (80.0%). There was an apparent shift toward less invasive treatments, such as laparoscopic (20.0%), robotic (5.7%), and endoscopic (17.1%) procedures, all of which had successful results. <em class="italic" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Conclusion.<strong class="boldas" style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">In published cases, gastric lipomas >4 cm were predominantly symptomatic and necessitated intervention. There is a clear trend toward minimally invasive and parenchyma-sparing techniques. The absence of long-term follow-up data, however, continues to be a major knowledge gap. Furthermore, the development of prospective multi-institutional registries is crucial to better define the natural history and intervention thresholds for this disorder, since asymptomatic giant lesions are probably underestimated because of publication bias.
Prophylaxis and Management of Deep Vein Thrombosis in Surgical Patients ‒ a Narrative Review
<span style="color: #000000; font-family: 'Times New Roman'; font-size: medium; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;">Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), persists as a leading cause of preventable perioperative morbidity and mortality. Surgical patients are at variable and often substantial risk due to the synergistic effects of immobility, tissue injury, inflammation, and underlying comorbidities. Contemporary best practice is founded upon individualized risk assessment, the judicious application of pharmacological prophylaxis, primarily low-molecular-weight heparin (LMWH), and mechanical measures, coupled with a clear strategy for managing patients on chronic anticoagulation. For established VTE, direct oral anticoagulants (DOACs) have streamlined long-term management, though LMWH remains paramount in specific populations such as patients with cancer. This narrative review synthesizes current evidence and guidelines for the prevention and treatment of perioperative VTE, incorporating recent literature to inform clinical practice. Individualized prophylaxis guided by validated risk models and adherence to evidence-based protocols remains pivotal in reducing perioperative VTE morbidity and mortality.
International Colorectal Research Forum Vilnius 2026 with Korean Society of Coloproctology and International Society of University Colon and Rectal Surgeons Sessions