Notes

Connection between breastfeeding proper care throughout fast-track surgical treatment in postoperative pain, psychological condition, and affected individual total satisfaction together with breastfeeding pertaining to glioma.
Longer operative time was needed for patients with bulky tumors and invasive tumors. Mediastinal tumors with large size or invasion should not be contraindicated for VATS. The prognosis of such patients treated with VATS was comparable to that of traditional open surgery.

VATS is a safe and effective procedure for large and invasive mediastinal tumors.
VATS is a safe and effective procedure for large and invasive mediastinal tumors.
There are several options for vessel-sparing anastomotic procedures that allow one to avoid disturbances in the normal blood supply to the spongy body and successfully perform plastic surgery of distal urethral strictures.

To perform a comparative analysis of the effectiveness of reconstructive surgical treatment of strictures of the bulbo-membranous urethra with anastomotic surgery with and without vessel-sparing.

A prospective study was carried out on 28 patients with a diagnosis of stricture of the bulbo-membranous urethra who underwent treatment in the period 2012-2018 in the conditions of a urological hospital of Irkutsk City Clinical Hospital No. 1. Anastomotic urethroplasty was performed using one of two methods with full mobilization of the spongy body bulb and a vessel-sparing method when the spongy body does not intersect.

The effectiveness of the classical method of anastomosing EPA-TWW ((excision and primary anastomosis urethroplasty (Turner-Warwick) and excision and Jordan's technique of complications during anastomotic surgery with or without vessel-sparing. However, an unformalized assessment demonstrates the best state of erectile function in patients after vascular-preserving surgery.
Transurethral resection of bladder tumour (TURBT) is one of the most commonly performed urologic procedures. Because of the shortcomings of conventional TURBT, the en-bloc resection concept was created.

To analyse the influence of en-bloc technique on surgical and oncological outcomes of TURBT performed with electric current.

This non-randomized, prospective controlled multicentre study enrolled 427 consecutive patients undergoing TURBT performed by five experienced endourologists in five academic institutions. Choice of procedure was at the discretion of the surgeon. The vast majority of patients underwent monopolar resection. The en-bloc procedure was performed with Collin's knife or the classic resection loop. Study end-points were surgery, catheterization and hospitalization time, presence of muscularis propria (MP) in the specimen and 3-month recurrence-free survival (RFS).

The study included 427 (274 conventional TURBT vs. 153 en-bloc) patients with mean age of 69 years (range 18-99). There were more cases with MP present in the specimen in the en-bloc group (91.3% vs. LB100 75.5%; p < 0.001). Surgery and hospitalization times were statistically shorter in the en-bloc group (both p < 0.05). A borderline significant difference was noted when the number of residual tumours in reTURBTs was analysed, with fewer cases of residual tumour in the en-bloc group (p = 0.051). RFS at 3 months was higher in the en-bloc group (88.4% vs. 80.1%; p = 0.027). After propensity score matching, differences in MP presence, hospitalization time and 3-month RFS status remained statistically significant.

When compared to conventional TURBT, en-bloc resection of bladder tumour is associated with higher percentage of MP presence in histopathological specimen, higher 3-month RFS and shorter hospitalization time.
When compared to conventional TURBT, en-bloc resection of bladder tumour is associated with higher percentage of MP presence in histopathological specimen, higher 3-month RFS and shorter hospitalization time.
Enhanced recovery after bariatric surgery (ERABS) and other fast track protocols are currently being implemented in bariatric surgery. This approach has several benefits. However, early complications may occur and require urgent re-hospitalization and management. Gastrointestinal (GI) bleeding following bariatric surgery remains one of the most serious complications requiring endoscopic treatment.

To evaluate the potential influence of early endoscopic intervention on bariatric patients' management.

A clinical database was searched for patients undergoing endoscopic treatment because of GI tract bleeding following bariatric surgery under the ERABS protocol. 14 out of 1431 patients operated on were identified and their data were extracted for the purposes of this study. Patients readmitted to the hospital due to developing GI tract bleeding (group 2) were compared with patients undergoing endoscopic intervention during the initial stay (group 1), for the same purpose.

We found no statistically significant differences in hemoglobin level or length of hospital stay before endoscopy between groups. Based on the analyzed data, the percentage of GI bleeding in patients operated on under the ERABS protocol in our center is 0.97% (n = 14). The rate of early (up to 30 days) readmissions due to GI tract bleeding is 0.4% (n = 5) with an overall early readmission rate of 0.91% (n = 13) in the study period since the ERABS protocol was implemented.

Long-term effects (% total weight loss, %TWL) of bariatric surgery do not depend on the need of early endoscopic intervention and rehospitalization. Endoscopic intervention is a safe treatment modality, not associated with risk of reoperation or complications.
Long-term effects (% total weight loss, %TWL) of bariatric surgery do not depend on the need of early endoscopic intervention and rehospitalization. Endoscopic intervention is a safe treatment modality, not associated with risk of reoperation or complications.
Although laparoscopic Roux-en-Y gastric bypass (RYGB) is still widely accepted as a valid procedure in the treatment of obesity and type 2 diabetes mellitus (T2DM), there continues to be a significant controversy about how long the Roux and biliopancreatic limb should be bypassed for optimum results.

To assess the effect of a longer biliopancreatic limb (BPL) length on glycemic control after RYGB in T2DM patients.

Eighty-four patients with uncontrolled T2DM who underwent RYGB between May 2010 and April 2017 were collected from the prospectively designed database. Forty patients (S-BPL group) received BPL lengths ≤ 50 cm, including 30 cm (n = 1), 40 cm (n = 1), and 50 cm (n = 38). Forty-four patients (L-BPL group) received 100 cm BPL. Anthropometry, serum glucose and lipid metabolic parameters were measured at baseline and 1, 3, 6, 12, 24 and 36 months after surgery.

Comparing the two groups, there were no significant differences in anthropometric and biochemical measures, except the weight and body mass index, which were higher in the S-BPL group (85.91 ±20.32 vs. 76.25 ±16.99, p = 0.038; 31.87 ±6.61 vs. 28.7 ±4.29, p = 0.005) compared to the L-BPL group. The body weight, glucose and lipid metabolic parameters decreased over time and then remained essentially stable from the first year in both groups. Two years after surgery, the remission (HbA
% ≤ 6%) of T2DM was 31.2% in the S-BPL group and 37.5% in the L-BPL group (p = 0.685).

With consistent total small bowel bypass (AL + BPL) lengths, lengthening of the BPL from 30 to 100 cm did not affect the post-RYGB glycemic control and weight loss.
With consistent total small bowel bypass (AL + BPL) lengths, lengthening of the BPL from 30 to 100 cm did not affect the post-RYGB glycemic control and weight loss.
Laparoscopic surgery is not easily performed by junior surgeons who have limited experience.

To investigate the safety and feasibility of the first experience of junior surgeons with laparoscopic distal gastrectomy (LDG) who were trained in super high-volume centers.

Clinicopathological data from the first 85 LDG cases performed by three gastric cancer surgeons were collected. All three surgeons were trained for > 1 year in super high-volume centers. The surgical and postoperative outcomes of the first experiences of junior surgeons were compared with the short-term outcomes reported in a multicenter randomized controlled trial (Korean Laparoendoscopic Gastrointestinal Surgery Study, KLASS-01 trial), conducted by the KLASS group, which is composed of experienced surgeons who practice in a high-volume center.

A significantly greater number of older patients with longer operation times and lower estimated blood loss was observed for the junior surgeons than in the KLASS data. Although junior surgeons performed significantly more Billroth II anastomoses with D1+ lymph node dissection, there was no difference between the two groups in terms of hospital stay, number of retrieved lymph nodes, or postoperative morbidity.

The surgical outcomes of early gastric cancer managed by laparoscopic surgery performed by well-trained beginners were similar to the outcomes reported in the large-scale trial. Therefore, with regard to the surgical training system, training at super high-volume centers may be considered to provide some assurance in terms of surgical technique-related safety.
The surgical outcomes of early gastric cancer managed by laparoscopic surgery performed by well-trained beginners were similar to the outcomes reported in the large-scale trial. Therefore, with regard to the surgical training system, training at super high-volume centers may be considered to provide some assurance in terms of surgical technique-related safety.The COVID-19 disease continues to cause a global pandemic. The University Hospital in Krakow has been designated as one of the COVID-19 hospitals. To prepare for the pandemic we needed to implement strategies that would protect the health care workers, reduce in-hospital transmission, and provide optimal care for the patients. In the operating department, these preparations involve the cooperation of multiple teams and can pose significant difficulties. Here, we describe measures taken in response to the COVID-19 outbreak. These include, adjustments made in OR set-ups, modification of workflow and processes, and the introduction of adequate personal protective equipment. We believe that these containment measures are required in order to provide an adequate quality of care to COVID-19 patient and to minimise the risk of cross-infection to staff members and other patients.
One of the most significant challenges nowadays is to educate and predict the predispositions of young surgeons taking into consideration that every ability has its own learning curve.

To determine the influence of selected factors and examine the shape and the length of the learning curve in performing simple tasks on an endoscopic simulator.

Twenty students took part in 4 training sessions with a one-week break between sessions. They were training 12 min and performed three tasks at every session on the endoscopic simulator. To identify whether selected factors influence the time of completing tasks, the participants were asked to fill in questionnaires. All participants also completed the Minnesota Manual Dexterity Test (MMDT) to assess hand-eye coordination.

Our research reveals that regardless of activities performed in free time, the shape of the learning curve was logarithmic. Improvement after the fourth session ranged from 50% to 75%. Performing specific activities in the free time did not influence the results achieved on the simulator.
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