Endoscopy, 2009, issue 3

Editorial

Slovo úvodem

doc. MUDr. Ladislav Jarolím CSc

Endoskopie 2009; 18(3): 91

Main topic

Laparoscopic modificated retroperitoneal lymph node dissection

MUDr. Marek Schmidt FEBU

Endoskopie 2009; 18(3): 94-97

Retroperitoneal lymph node dissection is a therapeutic method for extraction of lymph nodes as a first localization of distant metastasis of most non-seminomatous testicular tumors. Before routine introduction of chemotherapy, retroperitoneal lymphadenectomy was only therapy after radical orchiectomy in patiens with positive retroperitoneal lymph nodes. Adjuvant chemotherapy is the first choice therapy in non-seminomatous testicular tumors at present, mostly for complexity and frequent complications of open retroperitoneal lymphadenectomy. Introduction of modificated and nerve-sparing lymphadenectomy reduced late complications rate but peroperative...

The cause and the results of treatment of ureteral injuries during open operation and laparoscopy

MUDr. Matúš Chocholatý, MUDr. Marek Schmidt FEBU, MUDr. Pavel Hanek, doc. MUDr. Ladislav Jarolím CSc

Endoskopie 2009; 18(3): 98-102

The aim of the study was to assess the cause and the results of treatment of ureteral injuries after open procedure or laparoscopy. Material & Methods: From 2002 to 2008, we treated 40 patients with 42 iatrogenic ureteral injuries, 15 of them were recognised immediately and 27 were detected 1 – 90 days (average 19 days) after initial procedure. Results: Intraoperative discovered injuries we treated with ureteroureterostomy or ureteroneocystostomy. Late recognised ureteral injuries were primarily treated using stent placement, percutaneous nephrostomy or both with the success rate 61 %. Conclusions: The immediately diagnosed and treated injuries...

Endoscopic and surgery treatment of vesicoureteral reflux

MUDr. Jan Kříž, MUDr. Jan Trachta, MUDr. Jiří Morávek CSc, MUDr. Vladimír Mixa

Endoskopie 2009; 18(3): 103-104

Method: Between 2006 and 2008 there were 33 pediatric patiens treated for vesicoureteral reflux (VUR) in our Department of Pediatric Surgery, Motol University Hospital, Prague. 25 children (39 ureteral units) were treated endoscopically by instillation of Urodex gel, 14 patients (19 ureters) reimplanted. In 6 patients reimplantation of ureter was indicated for failure of previous endoscopic treatment. Results: In the group of endoscopically treated patients VUR disappeared in 16 ureters and improved at least by one grade in 13 ureters which means a positive effect of the treatment in 74 % of our patients. In patients indicated for reimplantation...

Present and perspective of laser lithotripsy in urology

MUDr. Jan Pokorný, prof. MUDr. Tomáš Hanuš DrSc

Endoskopie 2009; 18(3): 105-107

Endoscopic stone removal including lithotripsy and the extracorporeal shock-wave lithotripsy are important parts of the stone disease treatment. As far as the devices for desintegration are concerned, the laser lithotripsy is superior to the common procedures such as ballistic, ultrasonic and electrohydraulic lithotripsy. In practice, the laser devices containing the solid lasing medium of the lanhtanoiddoped Yttrium-Aluminium-Garnet (YAG) crystal (especially Ho: YAG and Nd: YAG) are currently the only lasers used in this field. Among these, the Ho: YAG laser represents the most effective and universal solution. Both the Tm: YAG and Er: YAG lasers...

Review articles

Total mesorectal excision in rectal carcinoma: laparoscopic versus conventional open surgery

MUDr. Matej Škrovina

Endoskopie 2009; 18(3): 108-111

This study was designed on basis of literature review to compare laparoscopic versus open total mesorectal excision for rectal cancer on intraoperative and perioperative results, postoperative quality of life and oncological outcome.

Minimally invasive endoscopic surgery of thyroid and parathyroid glands

prof. MUDr. Jan Betka, DrSc, doc. MUDr. Jaromír Astl, CSc, MUDr. Martin Chovanec, Ph.D, MUDr. Petr Lukeš, MUDr. Michal Zábrodský, doc. MUDr. Jan Plzák, Ph.D

Endoskopie 2009; 18(3): 112-115

Endoscopic techniques were introduced to the field of thyroid and parathyroid surgery only recently. Literature describes large number of methods and approaches. Minimally Invasive Video-assisted Thyroidectomy (MIVAT) and Minimally Invasive Video-assisted Parathyroidectomy represent the most widely practiced techniques. Angled optics, magnification and illumination enable to perform thyroidectomy or parathyroidectomy from minimal skin incision (≤ 3 cm) with identification and preservation of laryngeal nerves and healthy parathyroids. Central approach is suitable for eventual bilateral surgery. These techniques can be used in only 10 % of...

Case report

Radiofrequency ablation in therapy of Barret’s esophagus - our first experience

MUDr. Přemysl Falt, MUDr. Ondřej Urban Ph.D, MUDr. Petr Fojtík, MUDr. Martin Kliment

Endoskopie 2009; 18(3): 118-123

Barrett´s esophagus is associated with an increased risk of developing neoplastic alterations. Early Barrett´s neoplasia with low risk of lymphatic dissemination can be treated by means of endoscopy in order to avoid surgery. Endoscopic mucosal resection is a method of choice in the case of a visible neoplastic lesion. Moreover, it serves as an optimal local staging procedure. The rest of Barrett´s epithelium can be removed by endoscopic ablation techniques and radiofrequency ablation seems to be the most promising one. Authors report their first experience in this field.

Video case reports

Endoscopic mucosal resection of Barrett‘s oesophagus with high-grade intraepithelial neoplasia

MUDr. Ondřej Urban Ph.D, MUDr. Petr Vítek, MUDr. Petr Fojtík, MUDr. Martin Kliment, MUDr. David Janík, MUDr. Přemysl Falt

Endoskopie 2009; 18(3): 117

Barrett‘s oesophagus (BO) is a precancerous condition with a risk of developing adenocarcinoma of approximately 0.5 % per year. Endoscopic surveillance of BO patients facilitates diagnosing early stages of malignancy. Therapeutic endoscopy allows the treatment of early neoplasia with endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or possibly with some of the ablation techniques such as radiofrequency ablation (RFA). A video case report of endoscopic resection of high-grade intraepithelial neoplasia using a transparent cap and a snare (EMR-C) is presented.

What is your diagnosis?

Jaká je vaše diagnóza ?

MUDr. Martin Bortlík

Endoskopie 2009; 18(3): 128

Technical news

Use of Green Light in clinical and experimental urology

MUDr. Viktor Eret, MUDr. Jiří Klečka Ph.D, doc. MUDr. Milan Hora Ph.D, MUDr. Petr Stránský, MUDr. Petr Běhounek

Endoskopie 2009; 18(3): 124-127

Introduction: This general article summarizes contemporary clinical opportunities of GreenLight (GL) laser in the treatment of benign prostatic hyperplasia (BPH) and evaluates possible experimental using of the laser in partial nephrectomy. Our article is based on literature data and paricularly on clinical and experimental work of authors. Technical data: Characteristics of GL are caused by its wavelenght (532 nm) and power. Previous laser beam emited by 80 Watts (W) device on potassuim-titanyl-phosphate (KTP) crystal base was recently replaced by 120 W device (HPS, high performance system) on lithium borate (LBO) crystal base. GL is nowadays...