https://www.zurnalai.vu.lt/lietuvos-chirurgija/gateway/plugin/WebFeedGatewayPlugin/atom
Lietuvos chirurgija
2024-03-07T08:24:14+00:00
Narimantas Evaldas Samalavičius
narimantas.samalavicius@gmail.com
Open Journal Systems
<p>Įkurtas 1993 m. Publikuoja chirurgijos srities straipsnius.</p>
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/33509
Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas
2024-03-07T08:29:19+00:00
Kipras Sasnauskas
Robert Vrublevski
Povilas Masionis
Sigitas Ryliškis
<p class="ISSN-abst-vidus" 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;" xml:lang="en-US"><span xml:lang="lt-LT">Intratorakalinis žastikaulio galvos išnirimas – trauma, kuri retai aprašoma dėl didelio mirštamumo, todėl nėra aiškiai sutariama, kaip šią traumą patyrusį pacientą reikėtų</span><span xml:lang="lt-LT"> gydyti. Straipsnyje aptariamas sėkmingo gydymo atvejis, apžvelgiama mokslinė literatūra. Į gydymo įstaigą dėl lūžusio žastikaulio pristatytas avariją patyręs pacientas. Atlikus rentgeną, nustatyta krūtinės ląstoje įstrigusi žastikaulio galva. Žastikaulio galvą pašalinus iš krūtinės ląstos ir protezavus, pacientas išrašytas gydytis ambulatoriškai, nesant komplikacijų.</span></p> <p class="ISSN-abst-vidus" 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;" xml:lang="en-US">Mokslinėje literatūroje aprašyta keletas atvejų, kai pacientai, dažniausiai patyrę didelės jėgos sukeltą traumą, pristatyti į gydymo įstaigą rankai esant abdukcinėje pozicijoje. Visais atvejais trauma gydyta šalinant žastikaulio fragmentą iš krūtinės ląstos ir protezuojant glenohumeralinį sąnarį. Kai kurie tyrėjai siūlo tam tikrais atvejais palikti žastikaulio fragmentą krūtinės ląstoje, kiti rekomenduoja žastikaulio fragmentą visada pašalinti. Minėtų sprendimų aiškių indikacijų nėra.</p> <p class="ISSN-abst-vidus" 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;" xml:lang="en-US">Straipsnyje pristatomu atveju komplikacijų nenustatyta, tačiau tokios traumos kelia didelį pavojų kraujotakai ir nervinei sistemai. Vis dėlto kol kas aprašytų klinikinių atvejų nepakanka, kad būtų galima nustatyti tinkamą metodologiją šiai traumai gydyti.</p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Kipras Sasnauskas | Robert Vrublevski | Povilas Masionis | Sigitas Ryliškis
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34801
Iatrogenic Tracheal Rupture after Endotracheal Intubation: A Case Report
2024-03-08T14:03:10+00:00
Silvana Kraleva
Tatjana Trojikj
Darko Talevski
Dola Malefski
Gordana Bozinovska Beaka
<p class="ISSN-abst-virsus" 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;" xml:lang="en-US">Iatrogenic tracheal rupture is very rare condition and has a lot off causes (intubation, tracheostomy, bronchoscopy, esophagectomy), but orotracheal intubation is the most common. Diagnosis is based on the occurrence of symptoms that are not specific but highly suggestive: subcutaneous emphysema, respiratory insufficiency, pneumothorax, and hemoptysis. The appearance of subcutaneous emphysema as a first sign plays a main role for early diagnosis and rapid appropriate treatment. Diagnostic confirmation is possible by chest<span xml:lang="ar-SA"> </span>X-ray, thoracic computed tomography and bronchoscopy which confirmed the size and site of the lesion. Treatment can be conservative, in patients with small ruptures, less than 2<span xml:lang="ar-SA"> </span>cm, and surgical in the majority of ruptures over 2<span xml:lang="ar-SA"> </span>cm in length.</p> <p class="ISSN-abst-vidus" 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;" xml:lang="en-US">Our case report presents an iatrogenic post-intubation tracheal rupture treated conservatively. Our patient was a 71-year-old woman, admitted in our hospital with fracture of right humerus for elective surgery. Her medical history was only arterial hypertension. She underwent general anesthesia, intubated with flexible ET tube, positioned in beach-chair position after introduction, and no complication occurred during surgery. 18<span xml:lang="ar-SA"> </span>hours after surgery, after severe coughing, she suddenly developed subcutaneous emphysema of the facial, neck and upper anterior chest. Tracheal rupture was confirmed with a thoracic computed tomography and tracheobronchial fiber endoscopy. It showed a posterior tracheal transmural rupture 1<span xml:lang="ar-SA"> </span>cm long, located 4<span xml:lang="ar-SA"> </span>cm above the carina, covered with small tissue that opened in inspirium. Conservative treatment with antibiotic cover was performed, and the patient was discharged home in good condition, fourteen days after the initial injury.</p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34799
Transanal Hemorrhoidal Dearterialization (THD): A Single Center Experience on 100 Consecutive Cases
2024-03-08T14:00:19+00:00
Aleksandar Mitevski
Vladko Cvetanovski
Petar Markov
Ilija Milev
<p><em 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;" data-mce-fragment="1">Introduction. </em><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;" data-mce-fragment="1">Surgeons, using all available means for the treatment of the hemorrhoidal disease, must make compromises between the radicality of the potential surgical treatment (to prevent recurrence) and the maintenance of the postoperative functionality of the anorectum (avoiding stricture, anal fissures, incontinence, reduction of postoperative pain etc.). </span><em 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;" data-mce-fragment="1">Materials and methods.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">All patients treated with the THD method using a system manufactured by THD S.p.A., Correggio, Italy, consisting of a proctoscope equipped with a</span><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;" xml:lang="ar-SA" data-mce-fragment="1"> </span><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;" data-mce-fragment="1">Doppler probe and a light source was used to perform the operation. </span><em 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;" data-mce-fragment="1">Results.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">Out of 100</span><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;" xml:lang="ar-SA" data-mce-fragment="1"> </span><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;" data-mce-fragment="1">operated patients, 64 (64%) were men and 36 (36%) were women. 54</span><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;" xml:lang="ar-SA" data-mce-fragment="1"> </span><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;" data-mce-fragment="1">patients had third degree hemorrhoidal disease, 32 had fourth degree, 7</span><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;" xml:lang="ar-SA" data-mce-fragment="1"> </span><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;" data-mce-fragment="1">patients had fourth degree hemorrhoidal disease with active bleeding and 7</span><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;" xml:lang="ar-SA" data-mce-fragment="1"> </span><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;" data-mce-fragment="1">patients had second degree hemorrhoidal disease with active bleeding. In the follow-up period, anal fissure formation in two patients and prolapse of a hemorrhoidal node in a treated patient with fourth-degree hemorrhoidal disease were noted. </span><em 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;" data-mce-fragment="1">Discussion. </em><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;" data-mce-fragment="1">It is estimated that more than 50% of the general population will experience at least one episode of symptomatic hemorrhoids during their lifetime. Morphological and hemodynamic changes that occur in patients with hemorrhoidal disease is the finding of an increased diameter of the terminal branches of the superior rectal artery that supplies the hemorrhoidal nodes. These branches are 10–11 in number, of which ligation of up to six is allowed for effective treatment with the THD method. </span><em 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;" data-mce-fragment="1">Conclusion.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">If the THD technique is used according to the established standards, postoperative complications in patients in the form of fecal incontinence and chronic pain have not been described, which is also confirmed in our series. The absence of serious complications while addressing a hemorrhoidal disease at the level of the cause of its occurrence, makes the THD+mucopexy technique applicable in most cases. Correct manipulation of the instruments, precision in dearterization, mucopexy of the rectal mucosa and submucosa are imperative for achieving excellent results.</span></p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34798
Bedside Teaching in Undergraduate Surgical Education: A Pilot Study of Students’ Perspective
2024-03-07T08:29:20+00:00
Mohammed Alfehaid
<p><em 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;" data-mce-fragment="1">Background.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">Bedside teaching is an important tool in medical education. In recent years, studies have shown that this tool has witnessed gradual deterioration</span><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">due to various reasons. Hence this pilot study was conducted to assess the students’ perspective about this tool and suggest remedies for the deficiencies. </span><em 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;" data-mce-fragment="1">Methodology. </em><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;" data-mce-fragment="1">An anonymous questionnaire was designed and students were requested to register the response offline. Data was analysed and inferences made. </span><em 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;" data-mce-fragment="1">Results.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">Various deficiencies were highlighted by the students that require correction and improvement.</span><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">Unavailability of suitable patients is a significant barrier. Communication skills and understanding of infection control protocols had got improved in 84% and 94% students respectively. Half of the students were fully satisfied or satisfied with the overall conduct of the bedside teaching and the other half were either partially satisfied or dissatisfied. </span><em 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;" data-mce-fragment="1">Conclusion.</em><strong 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;" data-mce-fragment="1"> </strong><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;" data-mce-fragment="1">There is a need to improve bedside teaching in Undergraduate Surgery course. Simulation sessions need to be devised and enhanced. Faculty development sessions to train the teachers are required.</span></p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34797
In Memoriam Marius Petrulionis (1987–2023)
2024-03-08T13:54:49+00:00
Tomas Poškus
<p>-</p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34796
In Memoriam Steffen Bülow (1943 04 03–2023 12 29)
2024-03-08T13:52:31+00:00
Hans Jorgen Nielsen
<p>-</p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/34795
Redakcinė kolegija ir turinys
2024-03-07T08:29:20+00:00
Narimantas Evaldas Samalavičius
<p>-</p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/33872
Neįprastas klinikinis atvejis: lipomos sąlygota Cheiralgia paresthetica
2024-03-07T08:29:20+00:00
Tomas Mačiulaitis
Aira Jucaitytė
Mindaugas Minderis
<p><em 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;" xml:lang="it-IT" data-mce-fragment="1">Cheiralgia paresthetica</em><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;" xml:lang="it-IT" data-mce-fragment="1"> (CP) – reta patologija, kurią sukelia paviršinio stipininio nervo kompresija. </span><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;" xml:lang="ar-SA" data-mce-fragment="1">Įprastai CP kliniškai būdingas </span><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;" data-mce-fragment="1">skausmingas deginimo pojūtis, lokalizuotas nugarinės ir stipininės plaštakos dalių projekcijoje. Mokslinėje literatūroje nurodoma įvairių šiai ligai būdingų etiologini</span><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;" xml:lang="ar-SA" data-mce-fragment="1">ų</span><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;" data-mce-fragment="1"> veiksnių. Dažniausiai tai veiksniai, provokuojantys veržimą riešo srityje, pavyzdžiui, antrankiai ar ankšti riešo srities aksesuarai. Simptom</span><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;" xml:lang="ar-SA" data-mce-fragment="1">ų</span><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;" data-mce-fragment="1"> taip pat gali sukelti stipinkaulio distalinio galo lūžiai, bukos traumos ar jatrogeniniai pažeidimai. Straipsnyje dalijamasi patirtimi diagnozuojant ir gydant lipomos sąlygotą CP. Lipoma – atipinė ir itin reta CP priežastis.</span></p>
2024-03-07T00:00:00+00:00
Autorių teisių (c) 2024 Tomas Mačiulaitis | Aira Jucaityte | Mindaugas Minderis
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/33732
Kepenų biopsijos sukeltas hemotoraksas – reta jatrogeninė komplikacija
2023-11-29T10:39:40+00:00
Diana Samiatina-Morkūnienė
Rūta Silickytė
Gabija Jankauskaitė
<p><span xml:lang="lt-LT">Kepenų biopsija – tiksliausias intervencinis tyrimas, diagnozuojant kepenų ligas. Remiantis Higienos instituto pateikta informacija, Lietuvoje 2022 m. atliktos 968 </span><span xml:lang="lt-LT">perkutaninės kepenų biopsijos. Vis dėlto iki šiol Lietuvos mokslinėje literatūroje nėra skelbiama duomenų apie šios procedūros komplikacijas. Užsienio mokslinės literatūros duomenimis, komplikacijų dažnis po šios procedūros siekia 2,4–9,5 proc. Dažniausiai pasireiškia nesunkios komplikacijos: hematomos, karščiavimas, skausmas biopsijos vietoje. Ypač retos komplikacijos: hemotoraksas, pneumotoraksas, krūtinės ląstos ir pilvaplėvės ertmės organų pažaida (dažnis siekia iki 0,04 proc. atvejų). Straipsnyje pristatoma itin reta komplikacija – kepenų biopsijos sukeltas hemotoraksas, kurio gydymo sėkmę aptariamu atveju lėmė ankstyva diagnostika ir laiku atlikta chirurginė intervencija.</span></p>
2023-11-29T00:00:00+00:00
Autorių teisių (c) 2023 Authors
https://www.zurnalai.vu.lt/lietuvos-chirurgija/article/view/33731
Antrojo pošlaplinio raiščio implantavimas dėl šlapimo nelaikymo, atlikus radikaliąją prostatektomiją, esant neefektyviai pirmojo raiščio implatacijos operacijai: klinikinis atvejis
2023-11-29T10:26:35+00:00
Aušra Černiauskienė
Ieva Rimaitė
<p><span xml:lang="lt-LT">Įtampos (stresinis)</span><strong xml:lang="lt-LT"> </strong><span xml:lang="lt-LT">šlapimo nelaikymas yra prostatos pašalinimo radikaliosios operacijos komplikacija. Atlikus radikaliąją prostatektomiją, esant lengvo ar vidutinio laipsnio šlapimo nelaikymui, dažnai pasirenkamas operacinis gydymas – implantuojamas pošlaplinis raištis. Išskirtini nereguliuojamieji (efektyvumas iki 73,7 proc.) ir reguliuojamieji raiščiai (efektyvumas iki 92 proc.). Straipsnyje aprašomas 62 m. vyro klinikinis atvejis. Pacientui dėl 2018 </span><span xml:lang="lt-LT">m. diagnozuotos prostatos karcinomos ir atliktos radikaliosios prostatektomijos nustatytas vidutinio laipsnio įtampos šlapimo nelaikymas. Nesant konservatyvaus gydymo efekto, 2020-02-27 kitoje gydymo įstaigoje transobturatoriniu būdu implantuotas nereguliuojamasis pošlaplinis raištis, tačiau šlapimo nelaikymas po operacijos išliko. Pacientą ištyrus 2023-03-25, implantuotas reguliuojamasis raištis – ATOMS sistema, šlapimo sulaikymas pagerėjo. 2023-05-03 ATOMS sistema papildyta. Šiandien pacientas gerai sulaiko šlapimą. ATOMS reguliuojamoji sistema yra efektyvus metodas vyrų šlapimo nelaikymui gydyti, esant neefektyviai pirmojo raiščio implantacijai.</span></p>
2023-11-29T00:00:00+00:00
Autorių teisių (c) 2023 Authors