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Primary malignant tumors of the duodenum are infrequent. In this study we are dealing with two case-reviews of young patients with adenocarcinomas of the distal part of the duodenum. In both cases, we performed segmental duodenal resections as radical resection procedures.

During the period between January and August 1999 the authors performed in 26 patients with breast cancer stage T1 to T3, N0 to N1b preoperative identification and histological examination of the sentinel node as compared with examination of samples of the axillary lymph nodes. In the examined group the sentinel node and all other nodes were oncologically negative in 57.6% of cases, both were oncologically positive in 23% cases In 3.8% the sentinel node was oncologically positive and the other nodes were oncologically negative. In 15.4% it did not prove possible to identify the sentinel node. The authors did not record any case of false negativity of the sentinel node. In the authors opinion the use of the sentinel node for staging of breast cancer in early stages is a perspective method which makes it possible to eliminate standard dissection of the axilla and thus permanent sequelae for the patient. The authors are aware that the group of their patients is small but the results do not differ from those reported recently in the literature abroad.

In 1997 and 1998 the authors implemented and evaluated endosonographic examinations of the rectum in 34 patients, incl. 22 on account of carcinoma and 12 for adenoma. Carcinomas classification T1 were recorded in 9%, T2 in 27.3%, T3 in 54.5% and T4 in 9%. Agreement with histopathological staging was recorded in 63.6%. In adenomas in 17% a suspect malignant appearance and spread into the muscularis propria was found and this was confirmed by histological examination. The results confirmed the contribution of routine endosonographic examinations to accurate staging and subsequent indication of different therapeutic modalities. From the surgical aspect it is important for assessment of the stage T4 and thus also primary inoperability. The examination is valuable also when it is impossible to visualize highly located tumours, as it rules out infiltration of adjacent organs.

The authors describe the case of a successfully cured severe multiple injury in a seven-year-old boy, who after falling from his bicycle under a lorry suffered a brain injury, injury of the small intestine and of the neurovascular bundle in the retroperitoneal and inguinal area. The author emphasizes that in multiple injuries the life can be saved and best possible function recovered only by a correct algorithm of different surgical procedures in therapeutic care focused first on saving the patient's life and subsequently on restoration of all important functions and application of the maximum of contemporary therapeutic possibilities. The authors describe the life saving revision of the abdominal cavity and arrest of massive haemorrhage, the urgent reconstruction of blood vessels of the left inguinal area made within six hours after the accident and the delayed reconstruction of the femoral nerve made within four months after the injury. The resultant condition is evaluated after a six-year period. The general condition of the injured boy is normal, the functional condition of the left lower extremity can be evaluated clinically and on the basis of EMG as excellent.

The authors present their initial experience with transanal endoscopic microsurgery which they introduced as the first department in the Republic. So far they used the method in 10 patients. The purpose of the present paper is to provide information on the surgical approach to adenomas and carcinomas in the area of the rectum by a new surgical technique.

The authors present their first experiences with laparoscopic cholecystectomy. They introduced this new operative method in Czechoslovakia. They operated upon 58 patients. The authors discuss about indication, complications and results.