28 results on '"Andrzej, Gołębiewski"'
Search Results
2. Transanal Endorectal Pull-Through for Hirschsprung’s Disease: Complications and Lessons from Our Practice and the Literature
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Andrzej Gołębiewski, Stefan Anzelewicz, Daria Sosińska, and Monika Osajca-Kanyion
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Hirschsprung’s disease ,transanal endorectal pull-through (TEPT) ,paediatric surgery ,postoperative complications ,long-term outcomes ,Pediatrics ,RJ1-570 - Abstract
Background/Objectives: Hirschsprung’s disease (HD) is a congenital disorder characterised by the absence of ganglion cells in the distal bowel, resulting in functional obstruction. The transanal endorectal pull-through (TEPT) procedure, a minimally invasive approach, aims to treat HD by removing the aganglionic segment. This study assessed the feasibility, safety, and efficacy of single-stage TEPT in paediatric patients, focusing on postoperative complications, bowel function, and quality of life. Methods: A retrospective cohort study was conducted on 150 children who underwent single-stage TEPT from January 2005 to December 2023 at the Medical University of Gdansk. Data were collected from medical records, including demographics, preoperative assessments, surgical details, postoperative management, and follow-up outcomes. Statistical analyses were performed using Microsoft Excel 365 and the programming language Python 3.12. The mean age at surgery was 13 months, with a male-to-female ratio of 2.75:1. The mean operative time was 129 min, and the mean hospital stay was seven days. Results: Postoperative complications included anastomotic leak (4%), wound infections (15%), and enterocolitis (26%). Redo surgeries were required in 18% of cases due to persistent constipation and obstructive symptoms. This article includes a comprehensive review of the literature. Conclusions: TEPT demonstrates a favourable safety profile and efficacy in treating HD, though significant concerns include complications such as enterocolitis and the need for additional surgeries. Surgical expertise and thorough preoperative and postoperative management are crucial to optimising patient outcomes.
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- 2024
- Full Text
- View/download PDF
3. Insights into Kidney Dysplasia in Duplex Kidneys: From Radiologic Diagnosis to Histopathologic Understanding
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Dominik Świętoń, Kamil Buczkowski, Piotr Czarniak, Andrzej Gołębiewski, Małgorzata Grzywińska, Mariusz J. Kujawa, Susan J. Back, Maciej Piskunowicz, and Ewa Iżycka-Świeszewska
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kidney dysplasia ,magnetic resonance urography ,CAKUT ,Biology (General) ,QH301-705.5 - Abstract
Duplex kidney is a urinary tract anomaly commonly associated with a wide range of primary and secondary parenchymal structural abnormalities. We present a unique comparison of US and MRI findings with histopathology following partial resection of duplex kidneys due to nephropathy. We examined a group of 21 children with duplex kidneys who were qualified for heminephrectomy (24 kidney units (KU)). All patients underwent US and MRI prior to the surgery. The imaging results were compared with histopathologic findings. In 21/24 KU, dysplastic changes were found on histopathology, including all with obstructive nephropathy and 7/10 specimens with refluxing uropathy. The loss of corticomedullary differentiation on US and increased signal on T2-weighted images (T2WI) on MRI were the imaging findings that best correlated with fibrosis. In children with megaureter, there were no statistical differences in histopathological findings between primary megaureter, megaureter with ureterocele, and megaureter with ectopia (p > 0.05). The extent of dysplasia of the affected pole correlated negatively with residual function in MRI. Kidney dysplasia and inflammation in the kidney with obstructive nephropathy are the most important histopathologic findings of this study. US is a valuable screening tool, and MRI enables morphologic and functional assessments of the nephropathy in duplex kidneys.
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- 2024
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- View/download PDF
4. Laparoscopic nephron-sparing surgery and laparoscopic nephrectomy for Wilms’ tumor
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Maciej Murawski, Joanna Stefanowicz, Marcin Łosin, Andrzej Gołębiewski, and Piotr Czauderna
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laparoscopy ,nephron-sparing surgery ,wilms’ tumor ,Medicine - Published
- 2022
- Full Text
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5. Laparoscopic resection of liver tumors in children
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Maciej Murawski, Andrzej Gołębiewski, Piotr Czauderna, Ewa Iżycka-Świeszewska, Katarzyna Sinacka, Irena Zabolska, and Marcin Łosin
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Benign tumor ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Laparotomy ,Biopsy ,medicine ,Hepatectomy ,Humans ,Hamartoma ,Laparoscopic resection ,Child ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Liver Neoplasms ,Vascular malformation ,Focal nodular hyperplasia ,Infant ,General Medicine ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
Background Laparoscopy for the resection of liver tumors in children has remained undeveloped in comparison to adults. Most of the indications for pediatric laparoscopic hepatic surgery have been limited to diagnostic laparoscopy (biopsy). Over the past ten years, however, laparoscopic liver resections for pediatric hepatic diseases have been performed successfully, and many case reports have been published. Methods The authors report 6 cases of laparoscopic hepatic resection of benign tumors in children. The most important aspects of surgical technique are presented. There were 3 boys and 3 girls, with age between 4 months and 16 years. The lesions were located in the following segments: II and III (4 patients), I (1), V (1). The maximum tumor size was 7 cm. Results One anatomical (left bisegmentectomy) and 5 nonanatomical resections were performed. Conversion to laparotomy was necessary in 1 patient owing to bleeding from the posterior branch of the right hepatic artery. There were no postoperative complications and patients were discharged on postoperative day 4, 5, 5, 5, 7 and 3 accordingly. The postoperative pathology of the specimens confirmed their benign nature: infantile hemangioendothelioma (1), nested stromal epithelial tumor (1), focal nodular hyperplasia (3), mixed benign tumor (hamartoma + vascular malformation) (1). Conclusions This report demonstrates the feasibility of a laparoscopic hepatic resection in children. On the other hand, laparoscopic liver resection is challenging and teamwork and specific training are necessary.
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- 2021
6. A Prospective Randomized Controlled Trial of Single-Port and Three-Port Laparoscopic Appendectomy in Children
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Andrzej Gołębiewski, Stefan Anzelewicz, Piotr Czauderna, Dominika Lubacka, and Agnieszka Wiejek
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Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Operative Time ,Surgical Wound ,law.invention ,Port (medical) ,Randomized controlled trial ,law ,Appendectomy ,Humans ,Medicine ,Postoperative Period ,Prospective Studies ,Child ,Intraoperative Complications ,Laparoscopy ,Pain, Postoperative ,medicine.diagnostic_test ,Interleukin-6 ,business.industry ,Length of Stay ,Appendicitis ,Conversion to Open Surgery ,Surgery ,Analgesics, Opioid ,C-Reactive Protein ,Wound Infection ,Female ,business - Abstract
Background: This study aimed to evaluate single-port laparoscopic appendectomy (SPLA) in comparison with three-port laparoscopic appendectomy (3PLA) in children about the extent of surgica...
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- 2019
7. Cushing’s syndrome as a rare manifestation of adrenal tumours in infants – case report
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Dorota Birkholz-Walerzak, Maciej Piskunowicz, Andrzej Gołębiewski, Michalina Jezierska, Aleksandra Janecka, Jagoda Badurowicz, Dominik Świętoń, and Joanna Stefanowicz
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Pediatrics ,medicine.medical_specialty ,S syndrome ,business.industry ,Pediatrics, Perinatology and Child Health ,medicine ,Adrenal tumours ,business - Published
- 2019
8. Single incision laparoscopic surgery cholecystectomy in children – preliminary experience
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Andrzej Gołębiewski, Piotr Czauderna, and Marcin Łosin
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cholecystectomy ,laparoscopy ,SILS ,paediatric surgery ,Medicine - Abstract
Introduction: Laparoscopic cholecystectomy has become the gold standard for cholecystectomy, since Mouret introducedit in 1987. In 1997 Navarra described “one incision” cholecystectomy, but only recently has single incisionlaparoscopic surgery (SILS) gained wider acceptance, mostly due to technological developments. The primary goals ofSILS are avoidance of visible scarring and minimizing surgical trauma.Aim: We present our first experience of 3 cases of children (2 females, 1 male; ages 2.5-17 years) treated with SILScholecystectomy.Methods and results: One child had undergone previous open left adrenalectomy for neuroblastoma. We used a CovidienSILS Port in one case and 3 single-use low-profile ports in the others. Percutaneous stay suture was used to suspendthe gallbladder, and standard cholecystectomy was performed using 1 straight and 1 disposable articulatinginstrument. There were no postoperative complications. Average operating time was 70 min. Hospital stay varied from2 to 4 days.Conclusion: Our early experience with SILS cholecystectomy in children suggests that it is safe and effective, but furtherstudies and greater numbers will be required to investigate the potential benefits of this approach.
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- 2010
9. Single incision laparoscopic adrenalectomy – initial experience
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Marcin Łosin, Piotr Czauderna, Andrzej Gołębiewski, and Joanna Stefanowicz
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adrenalectomy ,laparoscopy ,SILS ,paediatric surgery ,Medicine - Abstract
A laparoscopic approach to the adrenal gland was introduced in 1992. Since then many studies on adult populationsevaluating the safety and results of laparoscopic surgery have been published. A laparoscopic approach to adrenalsurgery in children still remains challenging. During the last 20 years we have observed a tendency to minimize surgicaltrauma that challenged many surgeons to seek new approaches in laparoscopic surgery. Single incision laparoscopicsurgery (SILS), in which all instruments are placed through a single, small incision, might be a step towards lessinvasive surgical procedures. We present two cases of paediatric patients treated in our department with single incisionlaparoscopic adrenalectomy (SILA). According to our best knowledge this report includes the first such procedureperformed in Poland.
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- 2010
10. Preoperative planning in paediatric liver tumour surgery - a literature review
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Agnieszka Niemirycz-Makurat, Stefan Anzelewicz, Dominika Kościuszko, Piotr Czauderna, and Andrzej Gołębiewski
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Computer-assisted surgery ,medicine.medical_specialty ,Preoperative planning ,Tumour surgery ,business.industry ,General surgery ,medicine.medical_treatment ,medicine ,business - Published
- 2021
11. A unique defect - persistent posterior cloaca: An example of staged genito-urinary and digestive tract reconstruction with an alternative vaginal creation using the urinary bladder wall
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Andrzej Gołębiewski, Anna Bryks-Laszkowska, Piotr Czauderna, Mariusz Sroka, and Leszek Komasara
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medicine.medical_specialty ,Megaureter ,Urology ,medicine.medical_treatment ,Urinary Bladder ,030232 urology & nephrology ,Pubic symphysis ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Cloaca ,Colon, Sigmoid ,Ileum ,medicine ,Humans ,Abnormalities, Multiple ,urogenital system ,business.industry ,Infant, Newborn ,Colostomy ,Sigmoid colon ,Anatomy ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Neck of urinary bladder ,Treatment Outcome ,medicine.anatomical_structure ,Cloaca (embryology) ,Urogenital Abnormalities ,030220 oncology & carcinogenesis ,Vagina ,Female ,Ureter ,business - Abstract
We present a case of a girl with an extremely rare, posterior type of persistent cloaca, which was associated with other abnormalities, including an undeveloped vulva and vagina, agenesis of the right kidney, secondary obstructive megaureter, unicornate uterus, persisted tailgut, sacral bone hypoplasia, and pubic symphysis hypertrophy. An operative approach was as follows: (i) colostomy and ureterocutaneostomy; (ii) creation of an ileal conduit with antirefluxing uretero-ileal anastomosis, and then creation of a continent catheterizable ileal reservoir; (iii) anastomosis of sigmoid colon to rectal stump; and (iv) vaginal and external genital reconstruction. Because of abnormal anatomical conditions where the uterus was situated adjacent to the open, incompetent bladder neck, we decided to create a vagina using the bladder wall instead of the bowel segment.
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- 2017
12. Laparoscopic Adrenalectomy in Children
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Andrzej Gołębiewski, Piotr Czauderna, and Marcin Losin
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medicine.medical_specialty ,education.field_of_study ,medicine.anatomical_structure ,Laparoscopic adrenalectomy ,business.industry ,Adrenal gland ,General surgery ,Population ,Gold standard ,Adult population ,Medicine ,business ,education - Abstract
Laparoscopic approach to the adrenal gland was introduced in 1992; since then laparoscopic adrenalectomy (LA) becomes a gold standard in adult population, and many studies evaluating safety and results have been published [1–3]. In contradistinction to adult population, LA remains still challenging in children population despite the fact that it was first performed in a child over 20 years ago [4, 5].
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- 2019
13. Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option
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Leszek Komasara, Piotr Czauderna, Andrzej Gołębiewski, Joanna Stefanowicz, and Anna Bryks-Laszkowska
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Urinary Diversion ,Cystectomy ,Stoma ,03 medical and health sciences ,0302 clinical medicine ,Rhabdomyosarcoma ,medicine ,Humans ,Radical surgery ,Child ,Prostatectomy ,Genitourinary system ,business.industry ,Urinary Reservoirs, Continent ,Urinary diversion ,Prostatic Neoplasms ,Vaginectomy ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,business - Abstract
Objectives To present versatile surgical reconstructive techniques and their outcomes in pediatric patients with genitourinary rhabdomyosarcoma. Methods We retrospectively analyzed the oncological and urological outcomes of seven patients treated between 1992 and 2014 according to the Cooperative Weichteilsarkom Studiengruppe protocols. Intergroup Rhabdomyosarcoma Study staging: local, six patients; and IV, one patient. Histology: embryonal, five patients; unclassified, one patient; triton tumor one patient. Surgical treatment included: cystectomy, uterectomy and partial vaginectomy, one patient; radical cystectomy, two patients; cystectomy, one patient; cystectomy with partial prostatectomy, one patient; partial cystectomy, one patient; and partial prostatectomy, one patient. Results All patients were alive in complete remission at last follow up. In four cases, ileal conduit with ureteral reimplantation with serous-lined extramural tunnel (Abol-Enein technique) was carried out, which was followed by conversion into ileal continent bladder with continent appendiceal stoma for clean intermittent catheterization in three patients. In one boy, partial cystectomy and continent reconstruction was carried out during a single surgical procedure. One child with incontinent urinary diversion is still awaiting a continence solution. One child after partial prostatectomy is continent without any voiding disturbances. Conclusions The timing and extent of radical surgery for treatment of genitourinary rhabdomyosarcoma depend on the local anatomical conditions, and the response to previous chemo- and radiotherapy. Cystectomy followed by various reconstructive techniques still remains an important option in the local treatment.
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- 2016
14. A Review on Surgical Techniques and Organ Sparing Procedures in Bladder/Prostate Rhabdomyosarcoma
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Stefan Anzelewicz, Piotr Czauderna, Andrzej Gołębiewski, and Leszek Komasara
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Male ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Urinary system ,Prostate Rhabdomyosarcoma ,Rhabdomyosarcoma ,medicine ,Humans ,Urologic surgery ,Child ,Urinary Tract Physiological Phenomena ,Chemotherapy ,business.industry ,Genitourinary system ,Prostatic Neoplasms ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Radiation therapy ,Organ sparing ,Urinary Bladder Neoplasms ,Pediatrics, Perinatology and Child Health ,Female ,business ,Organ Sparing Treatments - Abstract
The treatment outcomes in children with bladder/prostate rhabdomyosarcoma (B/P RMS) have considerably improved in the past few decades. Current protocols incorporate chemotherapy, radiotherapy, and surgery (radical or organ sparing). Using this multimodal and multidisciplinary approach, the cure rates for nonmetastatic RMS have gradually increased from 25% in the 1970s, and 70% in the 1990s, to over 80% in the 2000s. Surgery plays a role not only in the diagnosis and management of all stages of B/P RMS, but also in the urinary reconstruction and long-term follow-up. Furthermore, the tendency to avoid mutilating surgery and to preserve functional genitourinary tract has been noticeable. Authors describe the current status and future surgical treatment approaches and possibilities for patients with B/P RMS and how reconstructive urologic surgery in B/P RMS continues to evolve.
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- 2014
15. Laparoscopic Versus Open Upper Pole Heminephroureterectomy for the Treatment of Duplex Kidneys in Children
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Maciej Murawski, Leszek Komasara, Marcin Losin, Piotr Czauderna, and Andrzej Gołębiewski
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Nephrectomy ,Duplex Kidney ,Cohort Studies ,Humans ,Medicine ,Child ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Open surgery ,Ultrasound ,Age Factors ,Infant ,Length of Stay ,Confidence interval ,Surgery ,Treatment Outcome ,Dimercaptosuccinic acid ,Child, Preschool ,Feasibility Studies ,Operative time ,Female ,Kidney Diseases ,Ureter ,business ,medicine.drug - Abstract
To evaluate the safety and feasibility of laparoscopic upper pole heminephroureterectomy (HNU) in pediatric patients with duplex kidneys in comparison with open surgery.From 2007 to 2011, 27 patients underwent HNU. A dimercaptosuccinic acid (DMSA) isotope scan revealed hypofunctioning of ipsilateral moieties in all cases. The patients were divided randomly into laparoscopic HNU (LHNU) and open surgery HNU (OHNU) groups. LHNU was performed by the transperitoneal approach in 10 girls and 5 boys with a mean age of 33 months (range, 9-108 months). All procedures were performed using three or four ports. Open surgery was performed in 10 girls and 2 boys with a mean age of 29 months (range, 7-174 months) by the retroperitoneal approach in all cases. Follow-up included ultrasound and DMSA.Mean operative time in the LHNU and OHNU groups was 148 minutes (range, 100-220 minutes; 95% confidence interval [CI] 129-167 minutes) and 124 minutes (range, 100-150 minutes; 95% CI 115-133 minutes), respectively. In the LHNU and OHNU groups, mean analgesic requirement was 2.8 days (range, 2-4 days; 95% CI 2.4-3.2 days) and 3.7 days (range, 3-5 days; 95% CI 3.3-4.1 days), and mean hospital stay was 4.0 days (range, 2-8 days; 95% CI 3.2-4.8 days) and 5.1 days (range, 3-8 days; 95% CI 4.3-5.9 days), respectively. No intraoperative or major postoperative complications occurred. No conversion to open surgery was necessary in the LHNU group. Statistical analysis showed no statistical significant difference (P.05) in the operating time between groups, whereas differences in the mean hospital stay (P=.048) and analgesic requirements (P=.005) were significant. The function of the remnant pole was preserved in all patients. Follow-up ultrasound showed asymptomatic cystic structures in 1 patient.The laparoscopic upper pole HNU is a safe and feasible procedure, even in infants. It is associated with minimal morbidity, and the operative time is acceptable and not significantly longer in comparison with the open approach. LHNU reduces analgesic requirements and hospital stay. In our opinion it should be the preferred option for HNU in children.
- Published
- 2013
16. Editorial Comment to Transvesical laparoscopic surgery for double renal pelvis and ureter with or without ureterocele
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Andrzej Gołębiewski
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Laparoscopic surgery ,medicine.medical_specialty ,Ureterocele ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Kidney pelvis ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Ureter ,030220 oncology & carcinogenesis ,Medicine ,Humans ,Kidney Pelvis ,Laparoscopy ,business ,Renal pelvis - Published
- 2016
17. PEDIATRIC UROLOGY High efficacy of biofeedback therapy for treatment of dysfunctional voiding in children
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Przemysław Szcześniak, Michał Maternik, Andrzej Gołębiewski, Aleksandra Zurowska, Piotr Czarniak, Katarzyna Krzemińska, and Magdalena Drozyńska-Duklas
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medicine.medical_specialty ,Pelvic floor ,business.industry ,Urology ,medicine.medical_treatment ,Urethral sphincter ,Dysfunctional voiding ,Bladder capacity ,General Medicine ,Biofeedback ,Pharmacotherapy ,medicine.anatomical_structure ,medicine ,Physical therapy ,Biofeedback therapy ,Bladder diary ,business - Abstract
introduction. Dysfunctional voiding is a frequent condition in children associated with symptoms of incontinence. The aim of this study was to present the efficacy of biofeedback treatment on the resolution of clinical symptoms in a large cohort of children with urodynamically confirmed dysfunctional voiding. Material and methods. 81 children (75 girls and 6 boys) aged 6-18 years (mean: 10.32 ±3.17 yrs.) with a dysfunctional voiding pattern are presented. 74/81 (92.6%) of children were unresponsive to standard urotherapy and prior pharmacotherapy. Symptoms of bladder dysfunction were evaluated by questionnaire, bladder diary and an urodynamic study according to definitions and standards set by ICCS. The biofeedback training was planned for 2 months. Each session consisted of about 30 repeats of 5 s contraction and 30 s relaxation of pelvic floor muscles and external urethral sphincter. Biofeedback was performed together with standard urotherapy. results. 67 (82.72%) of the 81 children declared wetting during the day and 41 (50, 62%) – wetting during the night. 32/81 (39.5 %) children had increased voiding frequency and 43 (53.08%) had decreased bladder capacity. Following 2 months of biofeedback therapy daytime incontinence resolved in 34/67 (50.7%) children and nighttime incontinence in 22/41 (53.65%). A further 40,3% declared partial improvement in daytime and 26.7% in nighttime wetting. Conclusions. Biofeedback treatment is an effective therapeutic option for children with dysfunctional voiding. Pelvic floor therapy with biofeedback should be offered to children with dysfunctional voiding resistant to standard urotherapy.
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- 2012
18. Laparoscopic surgical technique to facilitate management of high anorectal malformations – report of seven cases
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Piotr Czauderna, Andrzej Gołębiewski, Maciej Murawski, Marek Królak, and Marcin Łosin
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medicine.medical_specialty ,anorectal malformations ,Urology ,Fistula ,Anatomical structures ,laparoscopy ,lcsh:Medicine ,Rectum ,children ,Ureteral injury ,medicine ,Laparoscopy ,Pelvis ,Original Paper ,medicine.diagnostic_test ,laparoscopically assisted anorectal pull-through (LAARP) ,business.industry ,lcsh:R ,Gastroenterology ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Perineum ,medicine.anatomical_structure ,business ,Imperforate anus - Abstract
Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary.
- Published
- 2011
19. Podejrzenie wady wrodzonej układu moczowego – postępowanie u noworodka i niemowlęcia – część I: poszerzenie dróg moczowych
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Aleksandra Żurowska, Maria Roszkowska-Blaim, Anna Cieślak-Puchalska, Iwona Ogarek, Stanisław Warchoł, Anna Wasilewska, Michał Brzewski, Piotr Kaczmarek, Andrzej Gołębiewski, Piotr Adamczyk, Tomasz Koszutski, Marcin Tkaczyk, Emeryk Samolewicz, Katarzyna Kiliś-Pstrusińska, Lidia Hyla-Klekot, Piotr Czarniak, Paweł Kroll, Przemysław Sikora, and Piotr Gastoł
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zalecenia ,business.industry ,dzieci ,niemowlęta ,diagnostyka ,infant ,Pediatrics, Perinatology and Child Health ,wady wrodzone układu moczowego ,urinary tract malformation ,Medicine ,Pediatrics, Perinatology, and Child Health ,guidelines ,neonate ,Theology ,business - Abstract
StreszczenieNieprawidłowości dróg moczowych u płodu są jednym z najczęściej stwierdzanych odchyleń podczas wykonywanych prenatalnie badań ultrasonografi cznych. Bardzo istotne jest takie zaplanowanie postępowania u noworodka i niemowlęcia, aby odpowiednio szybko wyłonić i objąć właściwą opieką grupę dzieci wysokiego ryzyka zakażeń i postępu choroby nerek. Takie działanie wymaga współpracy wielospecjalistycznej i wspólnych dla pediatrów, neonatologów i lekarzy rodzinnych schematów postępowania. Niniejszy artykuł powstał na podstawie opracowanych przez Polskie Towarzystwo Nefrologii Dziecięcej i dotyczy działań, jakie należy podjąć u dziecka z prenatalnie wykrytym poszerzeniem dróg wyprowadzających mocz.AbstractMalformations of urinary tract in fetus are one of the most often abnormalities detected by prenatal ultrasound screening. It is of great importance to establish adequate diagnostic plan of postnatal evaluation and selection of patients at high risk of complications, urinary tract infections or kidney failure progression. Adequate diagnosis requires strict cooperation of specialists: paediatrician, neonatologist and family doctors with common guidelines. The paper is based on Guidelines of Polish Society for Paediatric Nephrology and concerns postnatal evaluation of dilatation of the urinary tract in fetus and newborn.
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- 2010
20. Laparoscopic single port surgery nephrectomy in a child – initial experience
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Andrzej Gołębiewski, Piotr Czauderna, and Anna Bryks-Laszkowska
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,medicine.medical_treatment ,laparoscopy ,Gastroenterology ,Obstetrics and Gynecology ,Laparoscopic nephrectomy ,Case Report ,Nephrectomy ,Surgery ,fluids and secretions ,Single port surgery ,nephrectomy ,medicine ,Laparoscopy ,business ,single port surgery technique ,Fixation (histology) - Abstract
The aim of the stucdy was to present technical aspects and possible intraoperative complications based on the first single port surgery (SPS) laparoscopic nephrectomy performed in our center. The SPS laparoscopic nephrectomy of the right kidney was performed using a transperitoneal access in a 4-year-old child due to a small nonfunctional kidney complicated by hypertension. The intraoperative course was complicated by rupture of the gall bladder wall after grasper removal without leakage of its contents into the peritoneal cavity. No postoperative complications occurred. The SPS nephrectomy appears to be an advantageous method in children which offers a good cosmetic effect. Other benefits require confirmation in further studies. Fixation of the gall bladder is a very helpful but risky maneuver.
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- 2012
21. The role of laparoscopy in the management of pediatric appendicitis: a survey of Polish pediatric surgeons
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Piotr Czauderna and Andrzej Gołębiewski
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medicine.medical_specialty ,Pediatrics ,Original Paper ,medicine.diagnostic_test ,business.industry ,Urology ,General surgery ,Gastroenterology ,Obstetrics and Gynecology ,Pediatric Surgeon ,appendectomy ,Extracorporeal ,Appendix ,Standard procedure ,medicine.anatomical_structure ,clinical guidelines ,children ,Acute appendicitis ,Pediatric surgery ,Medicine ,Surgery ,Pediatric appendicitis ,survey ,business ,Laparoscopy - Abstract
Introduction: Despite the increase in use of laparoscopic appendectomy (LA) in recent years, until now no nationwide survey on this issue has been performed in Poland. Aim: To determine current surgical practice patterns among Polish pediatric surgeons in the treatment of appendi- citis in children. Material and methods: The nationwide survey was conducted in the form of an internet questionnaire asking for information concerning treatment of children suspected of having acute appendicitis in the years 2007-2011. Twen- ty-seven major pediatric surgical departments in Poland were invited to participate in the study. Results: The overall survey response rate was 70.37%. Laparoscopic appendectomy was offered in all departments except one. Laparoscopy was used in 33% of cases and was the standard procedure in 4 departments. In 1 center 100% of appendectomies were performed laparoscopically. The 3-port technique was used in all departments. Five centers offered transumbilical laparoscopic extracorporeal appendectomy and 2 centers single-port appendectomy. In LA the mesoappendix was mostly divided using bipolar or monopolar coagulation and the appendix was ligated using endoloops or was clipped. The mean hospitalization time was 3.31 days after laparoscopy and 5.47 days after open appendectomy. Conclusions: Despite an apparent consensus on some aspects of pediatric appendicitis among Polish pediatric sur- geons, significant inconsistency exists in the operative approach. The low rate of LA suggests that LA still remains far from being a standard. Personal experience and preference have a major influence on the choice of operative approach. It is recommended that national guidelines be set up, which could standardize the care for children and training of pediatric surgery residents.
- Published
- 2014
22. Editorial Comment to Laparoendoscopic single-site surgeries: A multicenter experience of 469 cases in Japan
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Andrzej Gołębiewski
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Japan ,business.industry ,Single site ,030220 oncology & carcinogenesis ,Urology ,030232 urology & nephrology ,Medicine ,Laparoscopy ,business ,Surgery - Published
- 2016
23. Single incision laparoscopic adrenalectomy – initial experience
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Andrzej Gołębiewski, Marcin Łosin, Piotr Czauderna, and Joanna Stefanowicz
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Laparoscopic surgery ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Less invasive ,laparoscopy ,lcsh:Medicine ,medicine ,Laparoscopy ,SILS ,Paediatric patients ,medicine.diagnostic_test ,business.industry ,General surgery ,Adrenalectomy ,lcsh:R ,Gastroenterology ,Obstetrics and Gynecology ,adrenalectomy ,Surgical procedures ,Single incision laparoscopic ,Surgery ,Small incision ,paediatric surgery ,business - Abstract
A laparoscopic approach to the adrenal gland was introduced in 1992. Since then many studies on adult populations evaluating the safety and results of laparoscopic surgery have been published. A laparoscopic approach to adrenal surgery in children still remains challenging. During the last 20 years we have observed a tendency to minimize surgical trauma that challenged many surgeons to seek new approaches in laparoscopic surgery. Single incision laparoscopic surgery (SILS), in which all instruments are placed through a single, small incision, might be a step towards less invasive surgical procedures. We present two cases of paediatric patients treated in our department with single incision laparoscopic adrenalectomy (SILA). According to our best knowledge this report includes the first such procedure performed in Poland.
- Published
- 2010
24. Rupture of the normal renal pelvis after blunt abdominal trauma
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Piotr Czauderna, Maciej Murawski, Andrzej Gołębiewski, and Leszek Komasara
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Male ,medicine.medical_specialty ,Adolescent ,Abdominal Injuries ,Wounds, Nonpenetrating ,Blunt ,Blood loss ,medicine ,Humans ,Kidney Pelvis ,Rupture ,Kidney ,Urinary symptoms ,business.industry ,General Medicine ,medicine.disease ,Insidious onset ,Surgery ,medicine.anatomical_structure ,Abdominal trauma ,Pediatrics, Perinatology and Child Health ,Abdomen ,Radiology ,business ,Renal pelvis - Abstract
Blunt abdominal trauma with isolated rupture of the normal renal pelvis is an extremely rare clinical entity. The correct preoperative diagnosis may be difficult and challenging because of the insidious onset, lack of blood loss, and frequently, lack of urinary symptoms. Intraoperative inspection of the collecting system is the most accurate method to fully define an extent of injury. The object of the case report is to present the case of a 15-year-old male with isolated pelvic rupture of a normal kidney because of strong punch in the abdomen during the handball match.
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- 2008
25. One, two or three port appendectomy - a rational approach
- Author
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Dominika Lubacka, Marcin Łosin, Andrzej Gołębiewski, Agnieszka Wiejek, Maciej Murawski, and Piotr Czauderna
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medicine.medical_specialty ,Original Paper ,medicine.diagnostic_test ,business.industry ,Urology ,transumbilical ,Gold standard ,Group ii ,Gastroenterology ,Abdominal Abscess ,laparoscopy ,Obstetrics and Gynecology ,Abdominal cavity ,appendectomy ,Appendix ,Extracorporeal ,Surgery ,medicine.anatomical_structure ,one port ,medicine ,Operative time ,business ,Laparoscopy - Abstract
Introduction: Laparoscopic appendectomy is a safe and feasible technique accepted by many surgeons as the gold standard approach for the treatment of acute appendicitis in children. Traditionally laparoscopic appendectomy requires the use of three ports. However, surgical techniques with fewer ports have been reported. Aim: To evaluate the efficacy of laparoscopic appendectomy in children according to the proposed 3-step protocol using one, two or three ports. Material and methods: A total of 100 children with the diagnosis of acute appendicitis underwent laparoscopic appen dectomy. Patients were treated according to the following protocol: transumbilical access with one 10 mm port using the laparoscope with working channel. The appendix was mobilized and delivered through the umbilical port and tied extracorporeally and removed. If the appendix was placed retrocecally or had adhesions, a second port was intro duced. The appendix was mobilized and finally retrieved from the abdominal cavity through the camera port, and resected extracorporeally. In the cases of very short and gangrenous appendix and immobile colon, a third port was introduced and totally intra-abdominal appendectomy was performed. Patients were evaluated regarding the dura tion of the operation, and operative and postoperative complications. Results: During the study period 100 children (58 males, 42 females) had laparoscopic appendectomy: 48 children by one-port technique (group I), 27 children by two-port technique (group II) and 25 children by three-port technique (group III). The mean operative time was 33 min (20-55 min) in group I, 39 min in group II (23-60 min), and 49 min (30-75 min) in group III. There were no intraoperative complications. Wound infections were recorded in 4 (8.3%) patients in group I, three (11.1%) in group II and four (16.0%) in group III. One patient in group III developed an abdominal abscess managed conservatively. Conclusions: One-port laparoscopic appendectomy is a feasible technique in children. It allows 48% of children to have the operation. The addition of a second port allows one to mobilize the appendix and perform extracorporeal resection in an additional 27% of cases. These approaches have shorter operative time compared to 3-port technique. Laparoscopic extracorporeal appendectomy, especially one-port, is found to be cost effective and have excellent cosmetic results.
- Published
- 2012
26. Laparoscopic management of giant ovarian cysts in adolescents
- Author
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Mariusz Sroka, Maciej Murawski, Piotr Czauderna, and Andrzej Gołębiewski
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medicine.medical_specialty ,Percutaneous ,Urology ,Umbilicus (mollusc) ,laparoscopy ,Case Report ,Abdominal cavity ,Malignancy ,children ,medicine ,Cyst ,Laparoscopy ,minimally invasive surgery ,Mucinous cystadenoma ,cyst ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Obstetrics and Gynecology ,medicine.disease ,Surgery ,Serous fluid ,medicine.anatomical_structure ,ovary ,business - Abstract
A laparoscopic approach to giant ovarian cysts in girls, when the cyst's size exceeds the umbilicus, may be difficult regarding the risk of cyst rupture and limited working space. We present a series of three 12-year-old girls with giant ovarian cysts treated by percutaneous drainage under ultrasonographic guidance followed by laparoscopic resection. Clinical, laboratory and radiological diagnosis showed no signs of malignancy. After induction of general endotracheal anaesthesia, under ultrasonographic guidance, a 10 F vesicostomy catheter was placed into the cyst. Two to 4 l of serous (in one case mucinous) fluid were drained from the cyst. During laparoscopy, the abdominal cavity was inspected by the scope and no signs of malignancy were found. The laparoscopic procedure was completed with excision of the cyst and keeping some ovarian tissue in all cases. No intraoperative complications were observed. The mean operation time was 73 min. Pathological examination revealed a mature cystic teratoma in two cases and mucinous cystadenoma in one. The postoperative recovery was uneventful in all girls and they were discharged home on postoperative day 2-4 with minimal pain. The ultrasound scans and tumour markers were normal on follow-up after 3 and 6 months. Laparoscopic excision of giant ovarian cysts after ultrasound-guided drainage seems to be a safe and applicable treatment modality in pre-menarchal girls with a normal tumour marker profile and benign features of the cyst, excluding the possibility of malignancy.
- Published
- 2010
27. Dye-assisted lymph vessels sparing laparoscopic varicocelectomy
- Author
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Andrzej Gołębiewski, Piotr Czauderna, Marek Królak, and Leszek Komasara
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Male ,endocrine system ,medicine.medical_specialty ,Adolescent ,Postoperative Complications ,Hydrocele ,Testis ,Varicocele ,Rosaniline Dyes ,Medicine ,Humans ,Child ,Coloring Agents ,Lymphatic Vessels ,urogenital system ,business.industry ,Ultrasonography, Doppler ,medicine.disease ,Surgery ,Testicular Hydrocele ,Lymphatic system ,Ambulatory Surgical Procedures ,Feasibility Studies ,Laparoscopy ,Lymph ,business ,Complication ,Follow-Up Studies - Abstract
Hydrocele, the main complication of laparoscopic varicocelectomy, is thought to result from a disruption of gonadal lymphatics. The aim of this study was to evaluate the effectiveness of patent blue V dyeing to identify and preserve lymphatic vessels and to assess whether the lymphatic sparing technique avoids postoperative hydrocele in adolescent boys undergoing a laparoscopic procedure.Fifty-two (52) boys affected by varicocele Grade III (range, 12-16 years) underwent a left-sided laparoscopic varicocelectomy. Twenty-six (26) boys were randomly assigned to a lymphatic nonsparing (LNS) group, and the others to a lymphatic sparing (LS) group. Before surgery in the LS group, 2 mL of patent blue V was injected under the tunica dartos on the left side.All varicocelectomies were performed laparoscopically. Lymphatic vessels were identified in 23 (88.5%) boys of the LS group. In the remaining three (11.5%), the lymphatics could not be identified clearly. No adverse local or generalized reactions were noted. At a mean follow-up of 14 months, no recurrent varicocele or testicular volume reduction were detected. Hydrocele developed in 4 LNS patients and 1 was operated on. No patient from the LS group developed a hydrocele.Staining gonadal lymph vessels with patent blue V is an effective and simple method of visualization of the lymphatic drainage from the testis. Blue-stained lymph vessels could be readily distinguished and preserved during a laparoscopic varicocelectomy, which results in a decrease of hydrocele development. To validate an efficacy of vital staining of lymphatic vessels in avoiding hydrocele formation, a larger series and longer follow-up are necessary.
- Published
- 2007
28. Podejrzenie wady wrodzonej układu moczowego – postępowanie u noworodka i niemowlęcia – część II: Wady miąższu nerek
- Author
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Piotr Gastoł, Lidia Hyla-Klekot, Marcin Tkaczyk, Anna Wasilewska, Emeryk Samolewicz, Iwona Ogarek, Michał Brzewski, Paweł Kroll, Maria Roszkowska-Blaim, Tomasz Koszutski, Anna Cieślak-Puchalska, Katarzyna Kiliś-Pstrusińska, Piotr Adamczyk, Przemysław Sikora, Stanisław Warchoł, Piotr Kaczmarek, Aleksandra Żurowska, Piotr Czarniak, and Andrzej Gołębiewski
- Subjects
business.industry ,zalecenia ,dzieci ,niemowlęta ,diagnostyka ,infant ,Pediatrics, Perinatology and Child Health ,wady wrodzone układu moczowego ,urinary tract malformation ,Medicine ,Pediatrics, Perinatology, and Child Health ,guidelines ,Theology ,neonate ,business - Abstract
StreszczenieZmiany w ilości i strukturze miąższu nerek u płodu są wykrywane ze znacznie mniejszą częstością niż poszerzenie układu kielichowo-miedniczkowego. Jeśli jednak znajdują swoje potwierdzenie w badaniach postnatalnych, mogą być sygnałem poważnych zaburzeń w czynności nerek w okresie niemowlęcym, a także sugerować postęp choroby nerek w wieku późniejszym. W celu spójnej i szybkiej weryfi kacji grupy dzieci zagrożonych rozwojem niewydolności nerek Polskie Towarzystwo Nefrologii Dziecięcej przygotowało zalecenia dotyczące diagnostyki pourodzeniowej w przypadku wad miąższu nerek podejrzewanych prenatalnie.AbstractCongenital malformations of kidney structure are detected less frequently than dilatation of the urinary tract in the prenatal evaluation of fetus. However, when confi rmed after birth may refl ect serious impairment of kidney function in infancy or put the child at risk of deterioration of glromerular fi ltration later in the life. In order to support adequate selection of high risk patients Polish Society for Paediatric Nephrology presented specifi c guidelines for postnatal evaluation of malformation of kidney structure in fetus and newborn.
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