© Borgis - Postępy Nauk Medycznych 3/2009, s. 226
Comment
The issues discussed in this edition of „Postępy Nauk Medycznych” constitute recapitulation of many years´ clinical activity and scientific interests of Professor Krzysztof Bielecki, long term Head of the General and Gastrointestinal Surgery Department of CMKP, who retired by the end of August 2008, but in no case parted with the Clinic. Professor Bielecki is a consultant in our Department and still conducts scientific, didactic and medical activity.
Operations of thyroid gland belong to a group of most often performed ones in the General and Gastrointestinal Surgery Department of CMKP. In many cases total strumectomy is necessary. Indications for that type of operations have been discussed in the article of Prof. I. Kozicki. What is extremely important upon performance thereof is the so-called anatomical preparation, i.e. visualization of external and recurrent laryngal nerves and, if possible, parathyroid glands. Such technique has impact on reduction of operation-related complications. In presented material only in one case vocal cord was permanently paralyzed, which constitutes as little as 0.32%. Hypoparathyroidism is the second major complication which concerns mainly patients after thyroid carcinoma operation (5.2%)
Disorders of gastro-esophageal junction are civilization-related and presently constitute significant percentage of diseases which patients report to doctors. Majority of them will be treated conservatively, however there is still a group which requires surgical treatment. When qualifying for an operation X-ray barium meal, gastroscopy, esophagial impedance and sometimes esophageal manometry are performed. The result of surgical treatment depends on proper qualification for an operation (on the basis of clinical picture and the aforementioned examinations) and on experience of the operating surgeon. Introduction of laparoscopic techniques has significantly increased the number of performed operations and thus resulted in wider experience of surgeons and satisfactory late results of operations.
Post-operative disturbances of the digestive tract motility have been the reason of surgeons´ concern for many years. The presented paper is an attempt to give answer to the aforementioned issue. Application of various operative techniques on an animal model has allowed a statement that discontinuation of the digestive tract as well as discontinuation of the Cajal cells net connected therewith result in bigger motility disturbances than in cases when integrity of the system is maintained. Conclusions resulting from the paper are of considerable practical value in day-to-day clinical work.
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