[Dilemmas of the reconstruction of the major pelvic artery due to infectious aortic graft complication]. / A medencei veroér helyreállításának dilemmái szeptikus aortagraft esete kapcsán.

INTRODUCTION: In the pelvic region thrombendarterectomy and bypass procedures are the most commonly performed procedures to treat peripheral artery occlusive diseases with chronic, severe circulation failure caused by atherosclerosis. Biologic and synthetic grafts can also be used in bypass surgeries. Application of synthetic grafts can acutely increase the development of the infectious graft complication and its mortality is still between 70 and 75% in pelvic processes. We describe the difficulties and dilemmas of an infectious aortobifemoral graft. CASE PRESENTATION: 58-year-old female patient with right lower limb trophic ulcer underwent a DSA examination showing a bilateral iliac occlusion and aortobifemoral bypass surgery with Dacron graft implantation was performed. Re-occlusion and infection of the graft led to an in situ silver Dacron graft replacement. Due to the one-sided re-occlusion, a femoro-femoral crossover bypass surgery applying silver graft was performed. Despite the previously described procedures the infectious process got worse and autologous deep vein reconstruction was required beside the removal of the infectious synthetic grafts at the same time. DISCUSSION: There are local and extraanatomical solutions to reduce infectious graft complication. In pelvic infections bypass surgeries using autologous deep vein can show the best results. This procedure is the trustworthiest but also the most straining technique due to the extension of surgical time and increased blood loss. The proper surgical strategy should be selected on individual bases including cardiopulmonary load ability, patient age and technical/infrastructural possibilities.

Introduction of the microwave thermoablation (MWA) method to hemorrhoid surgery / A microwave termoablációs (MWA) módszer bevezetése az aranyeresség sebészetébe

Abstract: In addition to the traditional surgical options for hemorrhoid disease, newer treatment methods are evolving along the principle of reducing the burden on patients and providing similar or better healing. Thermo-based systems achieve the desired effect with less physical destruction. In this paper, we discuss the results of hemorrhoid surgery performed with laser and microwave devices. Patients and methods: We compare the results of 26 operations done with laser fibers and 14 operations using microwave rigid antennas. Results: In both groups, the average complaint-free period developed within 2 weeks, no significant difference was found between the two methods. Discussion: As we are always looking for new methods and surgical solutions, an option we are testing now indicates that thermal treatment can provide a quick and complete cure without the need for complicated safety requirements of laser interventions.

[Long-term results of open tension-free or tension repair of inguinal hernias--retrospective study]. / A nyitott, feszülésmentes, illetve feszülés mellett végzett lágyéksérvmutét hosszú távú eredményei--retrospektív vizsgálat.

UNLABELLED: Authors discuss long-term results of inguinal hernia repairs. Patients were asked to fill in a questionnaire to compare five-year outcomes after tension-free and non-mesh inguinal hernia reconstructions. RESULTS: the trial is based on the assessement of 155 patients' replies. Recurrence rate in tension-free (TF) cases is 3.4% (4/116), while in suture repair (non-mesh - NM) group is 12.8% (5/39). The ratios of totally symptom-free patients are 83% (97/116 - TF) and 89% (35/39 - NM). Severe chronic pain occurred in 1.7% (2/116 - TF) and 7.7% (3/39 - NM). Early return to normal activity was 34% (39/116 - TF) and 29% (11/39 - NM). CONCLUSION: Based on this retrospective study Lichtenstein repair is superior to non-mesh open inguinal reconstruction, as regards recurrence rates, but chronic pain and recovery time show similar long term results in both groups, which is different from the relevant published literature.