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The current treatment of GI tract tumours is based to a large degree on the combined use of varied types of therapy: surgery, chemotherapy, irradiation. Severe post-operative complications may significantly affect the possibilities of application of non-surgical methods of treatment. Therefore, monitoring the early results of surgical treatment is extremely crucial to ensuring the appropriate necessary follow up and keep the risk of post-operative complications to a minimum. This paper describes the methodology of prospective collection of clinical data, which allows monitoring the quality of the surgical treatment of GI tumours on a current basis. On the basis of the data collected in the period from 2010 to 2015, the results of the analysis of three types of surgeries were presented (anterior resection of the anus, right hemicolectomy and a total gastric resection) and the actions taken on the basis of the annual report concerning the post-operative complication risks were described. Moreover, the examples of the application of prospectively collected clinical information for academic purposes were presented. [ABSTRACT FROM AUTHOR]

Gastric cancer is one of the most commonly diagnosed cancers found in the world (980,000 new cases in 2008), but its treatment outcomes are poor, particularly in the European Union (EU); only a 25% survival after 5 years. Despite advances made in combination therapy, the only effective treatment that remains is surgery. The extent of gastric resection and lymphadenectomy, along with reconstruction methods, have systematically evolved over the last 100 years. This paper discusses both present day recommendations and the pathways that were taken enabling modern gastric surgery to develop. [ABSTRACT FROM AUTHOR]

Surgical interventions in patients with peritoneal metastases combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and systemic treatment are becoming more common and, when applied to selected patient groups, they reach 5-year survival rates of 32-52%. Good clinical outcomes require experienced and well-equipped healthcare centers, experienced surgical team and adequate patient qualification process. As a result of the discussion on the need for evaluation of quality of care and treatment outcomes and at the request of the Peritoneal Cancer Section of the Polish Society of Surgical Oncology, accreditation standards have been developed and the Accreditation Committee has been established for healthcare centers providing cytoreductive surgery and HIPEC for the management of primary and secondary peritoneal cancers.

Background: The aim of this study was to verify if positive results yielded with conventional cytology and immunocytochemical analysis of peritoneal washes correlate with established prognostic factors and overall survival (OS) in gastric cancer patients., Methods: The study included the data of 271 gastrectomized patients. Peritoneal washes of 131 (48.3%) patients were examined by means of conventional cytology, and material from 140 (51.7%) subjects treated surgically after this date was subjected to immunocytochemical analysis., Results: Free cancer cells (FCCs) were detected significantly less often in patients from conventional cytology group than in those from immunocytochemistry group (4.6% vs. 12.1%). Positive result of immunocytochemical analysis was significantly more often associated with presence of pT3/4 tumor (94.1% vs. 60.2%), lymph node ratio ≥0.2 (82.4% vs. 43.1%) and involvement of blood vessels (64.7% vs. 28.5%). Median OS in patients with immunocytochemical evidence of FCCs in peritoneal washes was significantly shorter than in those without (11 vs. 45 months). Moreover, the two groups differed significantly in terms of 5- (0% vs. 43.1%) and 10-year OS rates (0.0% vs. 29.3%)., Conclusions: In contrast to conventional cytology, immunocytochemically documented presence of FCCs in peritoneal washes correlates with established prognostic factors and OS in gastric cancer patients.

Background: The aim of this study was to verify the accuracy of the existing scoring system for the assessment of anastomotic leakage risk after anterior resection and to identify additional risk factors that were not included in this classification., Methods: The study included 501 consecutive rectal cancer patients who underwent anterior resection without formation of protective stoma. The risk for anastomotic leakage was determined using a previously proposed scoring system based on three factors: male sex, intraoperative blood loss and level of anastomosis., Results: Symptomatic leakage occurred in 12.2% (61/501) of our patients. Lower level of anastomosis (P<0.001) and longer duration of surgery (P=0.018) were identified as independent risk factors for the leakage. Anastomotic dehiscence occurred in 7.3% (24/327), 20.1% (29/144) and 26.7% (8/30) of patients at low, intermediate and high risk of leakage according to the previously proposed scoring system. No differences were found in the leakage rates of patients from the intermediate and high risk groups (20.1% vs. 26.7%, P=0.427, RR=0.755 (95% CI: 0.384-1.486)., Conclusions: The new scoring system is necessary for the identification of patients at increased risk of anastomotic leakage after anterior resection.

Background: The aim of this prospective study was to compare subjective and objective quality of life (QoL) of gastric cancer patients after total gastrectomy with and without preservation of the duodenal passage during short- and long-term follow-up., Methods: The study included 68 patients, among them 37 (54%) persons subjected to total gastrectomy with Roux-Y reconstruction (R-Y group) and 31 (46%) individuals in whom gastrectomy was followed by formation of Henley-Longmire loop (H-L group). Subjective and objective QoL was determined 1 and 10 years postsurgery. During each visit, subjective QoL was determined with EORTC QLQ-C30 questionnaire, along with markers of nutritional status and self-reported incidence of symptoms specific to postgastrectomy syndrome., Results: The two groups did not differ significantly in terms of their subjective QoL and markers of nutritional status at 1 and 10 years postsurgery, and none of these parameters underwent significant changes between the first and second evaluation. Patients from R-Y group reported subjective weight loss significantly more often during both visits, and individuals from H-L group significantly more often complained on postprandial diarrhea during long-term follow-up. Moreover, both groups showed an increase in the incidence of postprandial vomiting between the first and second evaluation., Conclusions: QoL of gastric cancer patients subjected to total gastrectomy stabilizes at relatively high level within a year from the surgery. Preservation of the duodenal passage does not exert a beneficial effect on both objective and subjective QoL after total gastrectomy.

The paper contains a description of the case--63 year old patient with surgery due locally advanced cancer of the gastric cardia. In 28 postoperative day symptoms of GI bleeding occurred. Despite the endoscopic attempts undertaken to stop bleeding, the patient died in the course of hemorrhagic shock. Posed by the post-mortem consider: aorto-esophageal fistula, is a rare complication in surgery of the esophagus. The rapidly increasing symptoms and deterioration of the patient, in most cases, despite the measures taken, ending in death of the patient. In the literature, there are few reports of this complication. There is also no clear guidelines on how to proceed. Reminder of the possibility of bad promising complications and the analysis carried out on the basis of this case and the available literature can be helpful for specializing in surgery of the digestive tract.

Searching for the methods, which may improve the visualisation of the membranous labyrinth, authors decided to evaluate autofluorescence of the membranous structures of the inner ear. The analysis of the inner ear autofluorescence parameters was performed. We assessed, whether the detected differences in autofluorescence between the bony elements and the membranous structures, allows the practical apply, owning to increased contrast in the operating microscope. The optimal wave length inducing autofluorescence of membranous labyrinth amounts to 465 nm. Obtained in these circumstances contrast of the membranous structures don't cause a significant improvement in their visualisation, comparing with the picture received in the traditional optical microscope.

Tympanic sinus is located at the medial wall of the tympanic cavity. It's visualisation is difficult from most of approaches. Tympanic sinus is often filled with cholesteatoma in course of chronic otitis. Intraoperative assessment of tympanic sinus was performed in 29 patients with facial recess cholesteatoma, and in 20 patients with acoustic neuroma operated with translabyrinthine approach. In the group of patients with cholesteatoma four patients underwent canal wall up tympanoplasty with posterior tympanotomy, 25 underwent canal wall down tympanoplasty. Tympanic sinus was assessed during surgery with 30 degrees endoscope. In all cases depth of the sinus was measured with the use of calibrated hook. In 11 patients depth of the sinus exceeded 4 mm. In 6 among these features of bone destruction was found.

The authors described a technique and presented the results of the modified labyrinthectomy in 9 cases. A labyrinthectomy was performed during the removal of neuromas by translabirynthine approach, in advanced unilateral Meniere disease, in a huge perylimphatic fistula and in a case of labyrinthitis latens. In 3 cases of the neuromas removal the residual hearing was preserved. In remained cases of labyrinthectomy hearing was preserved partially.