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Introduction: Endoscopic sinus surgery is performed in chronic rhinosinusitis in case of unsatisfied effects of pharmacological treatment. Usually this procedure is done under general anesthesia, but it is also possible to do it in local anesthesia. Aim: To evaluate effectiveness and perioperative patient's comfort based on the developed local anesthesia protocol. Material and methods: Fifty patients were included in the survey. Local anesthesia protocol was developed, consisting of pterygopalatine ganglion blockade and lateral nasal wall infiltration. After the procedure, patients filled in a questionnaire marking pain level and comfort during and after the operation. Results: Based on the questionnaire, average pain level during the operation was at 4.2 in 10-point VAS scale. Average maximum pain during the operation was at 4.2, while average pain level during the anesthesia procedure was at 2.41. 41% and 50% of the patients felt safe and very safe during the operation, respectively. 68% of the patients were felling good level of comfort during the procedure, 26% very good. 58% of them were able to get back to normal activity in the same day. 85% of the patients would recommend the procedure in local anesthesia to the others. Conclusions: Based on the collected material, we believe that local anesthesia in endoscopic sinus surgery is a good alternative for selected group of patients. It is although essential to properly select right candidates for it. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to determine the frequency of Helicobacter pylori infections in obese patients qualified for bariatric surgery and in patients with normal body weight undergoing upper gastrointestinal endoscopy. All participants gave informed consent to be included in the study. Material and methods: The research was carried out among 124 patients (60 patients with obesity and 64 patients without obesity), who underwent gastroscopy in the Laboratory of Diagnostic and Surgical Endoscopy of the University Teaching Hospital in Białystok during the period 2018-2020. The obese patients underwent gastroscopy as part of qualification for bariatric surgery. The self-constructed questionnaire contained questions about demographic data, smoking, medications taken that affect the occurrence or elimination of gastrointestinal ailments, the presence of diseases coexisting with obesity, and the presence of ailments from the gastrointestinal tract. Moreover, the description of gastroscopy and the result of histopathology were analysed***** Results: The average body mass index (BMI) in the group of obese patients was 40.42 (the lowest 30.1 - the highest 64). In the group of patients with normal body weight, the mean BMI was 22.46 (the lowest 20.1 - the highest 24.9). The urease test and histopathological examinations confirmed the comparable frequency of infections. The correlation between the occurrence of Helicobacter pylori and patient age, gender, or place of residence has not been confirmed. Conclusions: Performing gastroscopy enables the diagnosis of abnormalities as part of qualification for a bariatric procedure. A high Helicobacter pylori detection rate tested in a group of patients may be an important predictor of postoperative complications. [ABSTRACT FROM AUTHOR]

Inverted papilloma (IP) is a benign neoplasm originating in the epithelium of the nasal cavities and paranasal sinuses, characterized by local aggressiveness manifested by bone infiltration, high recurrence rate and the risk of transformation into squamous cell carcinoma. Almost 25% of it is discovered accidentally during surgery due to chronic sinusitis. The risk factors for recurrence are still not fully understood and despite the development of diagnostic tools and surgical techniques, inverted papilloma poses a considerable clinical challenge and patients require lifelong observation. In order to systematize the current knowledge on IP, the authors reviewed the international literature on the basis of PubMed and ScienceDirect databases. [ABSTRACT FROM AUTHOR]

Aim of the study: Assessment of the quality of life of patients after endoscopic sinus surgery. Material and methods: The research period lasted from 15 February to 31 March 2019. The study group consisted of adults aged 18 to 75 years suffering from chronic sinusitis. The method of diagnostic survey was used in this research work. Results: Impaired nasal patency causes great difficulties in everyday functioning and contributes to sleep disorders, weakness in concentration, frequent headaches, irritability, and fatigue. Conclusions: The most common and troublesome symptom of chronic sinusitis was nasal congestion, which resulted in nasal breathing difficulties. Impaired nasal patency had a large impact on the daily functioning of patients. Ailments associated with chronic sinusitis have a decisive impact on comfort and poor quality of life. It was most noticeable in the area of everyday activities, while working, studying at school, and during activities of daily living. The use of regular pharmacotherapy using nasal glucocorticosteroids did not satisfactorily affect the quality of life of patients. The research showed that pharmacological treatment only slightly improved the quality of life. Early satisfactory results of functional endoscopic sinus surgery showed a highly satisfactory result. In almost all examined patients, nasal blockage resolved, which resulted in improved patency and nasal breathing. After the procedure, the patients' quality of life improved significantly. [ABSTRACT FROM AUTHOR]

Inguinal herniorrhaphy is one of the most common operations in general surgery wards worldwide. Tension free techniques with mesh implantation (among Lichtenstein most common) reduced recurrence rate to less than 1 %. Chronic pain comprising up to 40% of operated patients still remains a clinical problem. Laparoscopic (endoscopic) techniques avoid extensive preparation in the groin, what is more hernia mesh is placed in avascular space of Borgios which contribute to reduction in chronic pain level. Apart from mentioned advantages laparoscopy (endoscopy) have drawbacks as well, among which high cost and long learning curve has to be taken into account. Currently many authors are keen on preperitoneal non laparoscopic minimal incision hernioplasty which result in few recently published operation techniques. In the article we present new hernioplasty methods and discuss them. [ABSTRACT FROM AUTHOR]

A case of effective and save treatment of stones in patient with solitary kidney using a minimally invasive surgical techniques was presented. Treatment consisted of complete removal of stagehorn calculi in solitary kidney using percutaneous nephrolithotrypsy ( PCNL). [ABSTRACT FROM AUTHOR]

Aim of the study is to estimate the influence of PEG placement on exponents of gastroesophageal reflux with the use of Multiple Intraluminal Impedance (MII/pH) in neurologically impaired children qualified for home enteral nutrition (HEN). Material and methods: The study comprised 14 children aged 4-16.7 years with chronic diseases of the central nervous system. All children underwent 24-hour multiple intraluminal impedance (MII/pH; SLEUTH Sandhill Scientific) monitoring - basic one before PEG placement and second one between 6-8 months of HEN duration. Minimal MII/pH monitoring time was 22 hours. All impedance recordings were visually inspected for the typical MII pattern of gastroesophageal reflux (GER). Acid, weakly-acid and non-acid reflux episodes, number and median duration of refluxes and symptom index (SI) comprising choking, coughing, emesis and regurgitation were calculated. Results: Based on MII-pH results pathological GER was detected at pre-PEG monitoring in 6/15 subjects (40.0%). The median number of refluxes was 26.93. The positive SI was observed in I child presenting with non-acid reflux. The second MII/pH revealed positive results in 2/14 children (13.3%): in 2 weakly-acid reflux were detected. Positive SI was reported in one subject (the same as in pre-PEG monitoring). The median number of reflux events was 24.73. Differences between indices of GER obtained by MII/pH before gastrostomy placement and on PEG feeding were not statistically significant. Enteral feeding improved clinical status (weight gain, frequency of regurgitation) of all patients with PEG regardless of MII-pH results. However, one subject demonstrated severe esophagitis and was placed on PEG/PEJ. Conclusions: The primary results of our MII/pH - PEG study suggest that the presence of GER does not exclude good clinical response to enteral feeding via gastrostomy in neurologically impaired children. The choice of route of enteral feeding supply should rely on clinical tolerance and MII/pH results with symptom index. [ABSTRACT FROM AUTHOR]

Introduction. Colonoscopy is now widely accepted as a gold standard for detection of pre-malignant lesions, mainly adenomatous polyps. Their removal reduces the risk for colorectal cancer in patients with adenomatous polyps. Aim. This study aimed at evaluating the efficiency and safety of colonoscopic polypectomies which were performed between 2001 and 2007. Materials and methods. A retrospective analysis of the course and results of polypectomies which were performed during 2970 colonoscopies on patients admitted to hospital with symptoms of colorectal pathology. Results and discussion. Total colonoscopy, i.e. with caecal intubation, was performed in 2602 (91%) cases. Colonoscopic polypectomies were performed during 628 (21.5%) examinations. Single polyps were found in 346 (55.1%) cases and multiple polyps in 282 (44.9%). The total number of removed polyps amounted to 901. Out of that number 690 (76.5%) were adenomas and 173 (23.5%) presented features of the so-called advanced pathology. In 26 (2.8%) cases, the detected adenomas coexisted with colorectal cancer and were removed preoperatively. Post-polypectomy bleeding occurred in 15 (2.3%) cases but only 2 patients required surgical treatment because of the inability to stop the bleeding by an endoscopic procedure. Moreover, out of 268 rectal polyps, 19 (7%) unpedunculated polyps were removed surgically (18 of them by trans-anal excision). Conclusions. The effectiveness of this method was high. Polyps were detected and removed in the course of more than 20% of colonoscopic examinations. Polypectomies were relatively complications-free, although in 2 (0.28%) cases surgical treatment was necessary to stop post-polypectomy bleeding due to the inability to stop the bleeding from the polyp stalk endoscopically. Some rectal polyps (7%) had to be removed surgically. Preoperative endoscopic clearance of large bowel po lyps, coexisting with neoplastic tumours, facilitated the adjustment of the resection margin in the subsequent colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Foreign bodies of upper gastrointestinal tract are observed in children from various social classes and age groups. Depending on the age of patient, kind of foreign body and its localization proper type of procedures are implemented. The majority of foreign body ingestions concern children between 2 and 3 years of age, which is due to high level of activity in this age group. Foreign bodies are divided according to shape, form and shape into "sharp", "oval" and bezoars. The highest risk of gastrointestinal tract damage is associated with sharp bodies and swallowed batteries. Modern medical standards propose fast removal of foreign body by endoscopic instruments or, when foreign body cannot be removed, pushed to a "safe" area. This article reviews diagnostic and therapeutic options in patients with foreign body of gastrointestinal tract. [ABSTRACT FROM AUTHOR]

In the paper the problem of hypertrophy of adenoids is presented. Indications and contraindications for surgical procedure are discussed, and compared with those described 100 years ago. The role of endoscopic procedure in the diagnostics and surgery is stressed. [ABSTRACT FROM AUTHOR]

Frontal sinus surgery evolved from external, highly invasive approaches to minimally invasive, endoscopic procedures. With the development of advanced endoscopic instrumentation, endoscopic frontal sinus surgery becomes very popular. The purpose of this work was the review of the literature of frontal sinus osteoma surgical technics. The ability to remove a frontal sinus osteoma endoscopically is determined by the location and size of the lesion. The most important are selection criteria for endoscopic or external excisions of frontal sinus osteoma. There are still some important indications for the external approach — supraciliar or bicoronal to frontal sinus osteoma. [ABSTRACT FROM AUTHOR]

Aim. Evaluation of the effectiveness of endoscopic subfascial division of perforating veins in treating chronic venous insufficiency (CVI) in lower extremities on the basis of 370 performed surgical procedures. Materials and methods. Between August 1999 and 31 July 2006 we performed 370 procedures of endoscopic subfascial division of perforating veins using lap aroscopic surgical optics. The patients qualified for ESDP had previously undergone 2-D Doppler sonography of the venous system of the lower extremities. The surgery was per- formed on 111 patients (30%) with 6th degree CVI, 81 patients (22%) with 5th degree CVI, 92 patients (25%) with 4th degree CVI and 86 patients (23%) with 3rd degree CVI. ESDP simultaneously with the excision of the thigh section of the great saphenous vein and varicectomy was performed in 57 cases, ESDP simultaneously with autogenic skin graft in 24 cases. Results. Total healing of the ulceration in the patients with 6th degree CVI was achieved in the period lasting from 2 to 8 weeks. 1.5% of the patients developed complications in healing trocar wounds, 1.7% local haematoma, 12% paraesthesia, and 8% ulceration recurrence. No serious early or remote complications were observed. Results. ESDP is a safe and effective method for treating chronic venous insufficiency of the lower extremities. Using laparoscopic optics and subfascial emphysema carrying CO2 allow medical staff to accurately identify perforating veins and repair them safely. Perioperative complications are minimised along with gained experience. ESDP supported with other methods is worth recommending for treating ulceration in the course of chronic venous insufficiency. [ABSTRACT FROM AUTHOR]

Aim. Evaluation of the safety and effectiveness of endoscopic diagnostics and treatment of cholelithiasis. Materials and methods. The analysis of 2329 cases of retrograde cholangiopancreatography performed in the Division of Endoscopy of the Department of General Surgery in the Municipal Hospital in Olsztyn between 2000 and 2007. Results and discussion. 1176 cases of retrograde cholangiopancreatography and endoscopic sphyncterotomy in treating choledocholithiasis were analysed. Indications for the procedures, their course and results were evaluated. The major group (626 patients = 54%) consisted of patients with retained gallbladders, generally before scheduled laparoscopic cholecystectomies. The number of patients who underwent cholecystectomy and procedures on bile ducts amounted to 413 (35%). Additionally, 83 (7%) emergency procedures in acute biliary pancreatitis were performed, which were beneficial for the course of the disease, and 54 (4%) re-sphyncterotomies with the evacuation of concrements in recurring residual calculosis. The failure in the application of the method was revealed in 91 cases (7.7%). In 43 patients (3.7%) it was not possible to canalise bile ducts, and in 48 (4%) to evacuate gall stones. In such cases, an emergency or delayed surgical removal of the concrements was performed, following the insertion of prosthesis for decompressing cholestasis. Due to the complications following the endoscopic procedure (bleeding from the papilla of Vater, blocking of a Dormia basket, haemorrhagic necrotic pancreatitis), surgery was performed in 6 cases. Conclusions. The obtained results point to a high effectiveness of treating choledocholithiasis by this method before performing cholecystectomy and treating residual calculosis after the performed cholecystectomy and surgery on bile ducts. An improvement in the course of the disease was observed almost in all cases of acute biliary pancreatitis. The number of complications in the analysed period was not higher than that provided by reference centres. [ABSTRACT FROM AUTHOR]