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Background/Aim. In colon and rectal cancer surgery, resection is considered radical when circumferential, proximal and distal resection margins are without the presence of tumor cells. Concept of total mesorectal excision in rectal surgery involves complete removal of the tumor with mesorectal fascia which surrounds lymph nodes, lymphatics and blood vessels. The aim of this study was to determine whether laparoscopic approach provides all parameters of oncological radicality as open surgery of colorectal cancer. Methods. The study included 122 patients with carcinoma of colon and rectum, divided into two equal groups: patients operated on by laparoscopic and those operated on by open approach. In colon surgery we analyzed proximal and distal resection margins, and the number of removed lymph nodes, and in rectal surgery: proximal, distal and circumferential resection margins, and the number of removed lymph nodes. Results. Both groups were comparable in age, sex, American Society of Anesthesiologists (ASA) score, tumor localization, tumor size, and type of surgical operation performed. According to localization of the tumor, the most commonly performed operation was anterior resection of the rectum (60.7% vs. 59%). There was no case of the tumor involvement of the distal margin. Average proximal distance from the tumor on the fixed specimen was 100 vs. 120 mm with statistical significance (p < 0.001). Distal margins were not significantly different, 40 mm in both groups (p = 0.143). In two cases we had circumferential resection margin (CRM) of 1 mm (7.7%) in the laparoscopic group, and in three cases operated conventionally CRM was 1 mm (8.8%). The average number of removed lymph nodes was 15 vs. 16, respectively. Length of hospital stay for patients assigned to the laparoscopic surgery was significantly shorter than for patients operated on by the open approach. Concerning postoperative complications, no significant difference was found between groups. The overall postoperative morbidity was 18% vs. 21.3%, respectively. Conclusion. With laparoscopic approach it is possible to provide all parameters of oncological radicality similarly to the open surgery of colorectal cancer.

Background/Aim. During drilling implant sites, mechanical energy is converted into thermal one resulting in transient rise in temperature of surrounding bone. The temperature of 47°C exeeding one minute impairs osseointegration, compromises mechanical properties of the local bone and could cause early implant failure. This in vitro study aimed to assess the effect of surgical drill guide and temperature of irrigans on thermal changes of the local bone during drilling implant sites, and to test the influence of irrigans temperature on the temperature of surgical drill guide. Methods. A total of 48 specimens obtained from bovine ribs were randomly allocated to four experimental conditions according to the 2 x 2 factorial design: drill guide (with or without) and saline (at 25°C or 5°C). Real-time infrared thermography was used as a method for temperature measurement. The primary outcome was bone temperature change during drilling implant sites measured at 3 osteotomy depths, whereas the second one was change in the temperature of the drill guide. Data were analyzed by Brunner and Langer nonparametric analysis and Wilcoxon test. Results. The effect of drill guide on the changes of bone temperature was significant at the entrance of osteotomy, whereas the effect of saline temperature was significant at all osteotomy levels (p < 0.001). No significant interaction was found (p > 0.05). Guided surgery and irrigation with saline at 25°C were associated with the highest bone temperature increase. Increase in drill guide temperature was significantly higher when saline at 25°C was used (p < 0.001). Conclusion. Guided implant site preparation generates higher temperature of the local bone than conventional drilling, not exceeding the threshold for thermal bone necrosis. Although saline at room temperature provides sufficient heat control during drilling, cooled saline is more effective regardless the use of surgical drill guide.

Introduction. Esophageal fibrovascular polyps are rare, benign, intraluminal, submucosal tumor-like lesions, characterized by pedunculated masses which can demonstrate enormous growth. The most frequent symptoms are dysphagia, vomiting and weight loss. Fibrovascular polyps with long stalks can regurgitate into the airways and cause asphyxia. Esophageal inflammatory pseudotumor is extremely rare lesion accompanied with various systemic manifestations as fever, anemia and thrombocytosis. Case report. We presented a 29-year-old man complaining of a long-lasting fever and dysphagia. He was found to have huge pedunculated submucosal tumor of esophagus, surgically completely resected. Histopathological examination showed that this giant tumor, 24 x 9 x 6 cm, was a fibrovascular polyp. The postoperative course was uneventful. The preoperative fever, anemia and thrombocytosis disappeared and did not recur in the postoperative course. Conclusion. We reported a patient with giant esophageal pedunculated tumor with clinical manifestations of inflammatory pseudotumor and histopathological picture of fibrovascular polyp, that we have not found described in the literature before.

Background/Aim. Different types of dental restorations are used for the therapy of unilateral free-end saddle edentulism. Unilateral complex partial denture is one of the indications for the Kennedy class II partial edentulism. The abscence of major connector and denture plate is an advantage compared to the conventional restorations, because of better comfort and shorter period of adaptation. The aim of the study was to analyse the influence of free-end saddle length change on the behaviour of unilateral complex partial denture supporting structures. Methods. Stress levels of the canine and the first premolar as retentional teeth and the attachments were tested under the influence of physiological forces with the loading point shifting distally in relation to the saddle length change. A virtual real size 3D model of the fixed part of the restoration (the canine and the first premolar with milled crowns) was created using the CATIA computer program. It was connected to the mobile part of partial denture with the SD snap in latch attachment. Mobile part of the restoration was designed in the region of 2, 3 and 4 lateral teeth (second premolar, first, second and third molar). By using the finite element method (FEM) stress levels analysis was performed under the load of physiological forces of 150 N in the free-end saddle teeth zone. Results. The results of analysis show that physiological forces cause a different stress distribution on the abutment teeth and the attachment, depending on the saddle length. Conclusion. The stress level values obtained for the abutment teeth as well as the attachment are far lower than the marginal ones. The behaviour of the system changes under this defined stress, but no plastic deformation occurs.

Bacground/Aim. Retentive force of removable partial denture (RPD) directly depends on elastic force of stretched retentive clasp arms (RCAs). During deflection RCA must have even stress distribution. Safety factor is the concept which can be applied in estimating durability and functionality of RCAs. This study was based on analyzing properties of clasps designed by conventional clasp wax profiles and defining the optimal shapes of RCAs for stress distribution and safety factor aspects. Methods. Computer-aided-design (CAD) models of RCAs with simulated properties of materials used for fabrication of RPD cobalt-chromium-molybdenum (CoCrMo) alloy, commercially pure titanium (CPTi) and polyacetale were analyzed. Results. The research showed that geometrics of Rapidflex profiles from the BIOS concept are defined for designing and modeling RCAs from CoCrMo alloys. I-Bar and Bonihard clasps made from CPTi might have the same design as Co- CrMo clasp only by safety factor aspect, but it is obvious that CPTi are much more flexible, so their shape must be more massive. Polyacetale clasps should not be fabricated by BIOS concept for CoCrMo alloy. A proof for that is the low value of safety factor. Conclusion. The BIOS concept should be used only for RCAs made of CoCrMo alloy and different wax profiles should be used for fabricating clasps of other investigated materials. The contribution of this study may be the improvement of present systems for defining the clasps shapes made from CoCrMo alloys. The more significant application is possibility of creating new concepts in defining shapes of RCA made from CPTi and polyacetale.