[Enhanced Recovery Program in colorectal surgery]. / "Enhanced recovery after surgery" bevezetése a vastagbél sebészetében.

INTRODUCTION: Enhanced recovery after surgery (ERAS) programme has been described and practiced for twenty years in the perioperative management of colorectal patients. ERAS is a complex, evidence based strategy which proved to be extremely effective when linked to laparoscopy in reducing morbidity, length of hospital stay, as well as reducing cost of colorectal service. AIMS: We gradually adapted elements of ERAS protocol along with laparoscopy in the colorectal surgical treatment at a county hospital from 2013. This study reports a retrospective clinical audit of ERAS programme of two years, between 2015-2016. METHODS: In this timeframe we compared clinical results of traditional and ERAS perioperative colorectal management protocols. The two groups were assessed on the basis of demographic, cancer-related parameters and clinical outcomes. RESULTS: Over the two years of audit we treated 130 patients under "traditional" and 84 cases according to ERAS protocol. Mean length of hospital stay was 8 and 6 days median, respectively. Earlier discharge in the ERAS group did not cause any increase in the readmission rates. Morbidity (Clavien-Dindo grade 2 or more) was found to be less in ERAS group: 8,3% vs. 27,4%. ERAS programme success rate, characterized by discharge by 7th postoperative day, was over 70%, keeping well with rates of the experienced centres of ERAS. CONCLUSION: Therefore we can report a successful introduction of ERAS programme for colorectal service in a Middle-Eastern European county hospital. Based on the favourable outcome results of the retrospective audit we have extended ERAS protocol as first choice perioperative scheme for each elective colorectal case from the beginning of 2017.

[New perspectives in rectal cancer surgery: Transanal total mesorectal excision. Initial experiences]. / Új távlatok a végbélrák sebészetében: Transanalis teljes mesorectum excisio. Kezdeti eredményeink.

INTRODUCTION: Colorectal cancer is the second most frequent cause of oncologic mortality. Its key prognostic factors are operability and surgical quality. Total mesorectal excision is the gold standard of rectal cancer surgery, however, it is hardly achievable with the laparoscopic technique in a number of cases due to anatomical issues. Transanal total mesorectal excision (TaTME) is a new operative concept, which may address this technical problem. AIM: We aimed to present the initial Hungarian experiences with the new technique. METHOD: Retrospective analysis of clinical data of the first year case series at two Hungarian centers initiating the technique. RESULTS: A total of 17 transanal total mesorectal excision (TaTME) operations were performed at two centers. Major perioperative complications happened in two cases. There was no 30-day mortality. CONCLUSIONS: Early Hungarian experiences with transanal total mesorectal excision (TaTME) give hope of a brand new era of rectal cancer surgery. Orv Hetil. 2018; 159(1): 16-22.

Measurement of residual solvents in a drug substance by a purge-and-trap method.

The purge-and-trap (P&T) gas extraction method combined with gas chromatography was studied for its suitability for quantitative residual solvents determination in a water-soluble active pharmaceutical ingredient (API). Some analytical method performance characteristics were investigated, namely, the repeatability, the accuracy and the detection limit of determination. The results show that the P&T technique is--as expected--more sensitive than the static headspace, thus it can be used for the determination of residual solvents pertaining to the ICH Class 1 group. It was found that it could be an alternative sample preparation method besides the static headspace (HS) method.