Myeloid sarcoma (extramedullary myeloblastoma, granulocytic sarcoma, chloroma) is an extramedullary isolated malignant tumor of myeloblasts and immature myelocytes. It can occur anywhere in the body as a solitary tumor or can be accompanied with acute myeloid leukemia. We are presenting a case of a young male patient that presented with sings of a small bowel obstruction and a palpable tumor mass in the abdomen. After uneventful postoperative period, the immunohistochemistry analysis reported an extramedullary myeloid sarcoma since a normal bone marrow biopsy was revealed.
Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.
Stenosis of stoma is late complication after colostomy in about 1-13% of the patients. The severe colostomy stenosis needs surgical treatment because resulting bowel obstruction with possibility of emergency operation and serious complications. In four year period we treated 7 patients with severe colostomy stenosis with Zplasty according Lyons and Symon technique. All the treated stenoses were endcolostomies resulted from abdominalperineal resection of the rectum for adenocarci noma. There were no intra and postoperative complications, with good functional results and without recurrences of the stenosis within followup period of the 636 months. Zplasty is easy and safe procedure for stenosis of the stoma after end colostomy. This extraabdominal procedure used on daysurgery basis, eliminate possibility for intraperitoneal complications. Key words: colostomy, stenosis, ZplastyStomos susiaurėjimas, arba stenozė, yra vėlyva kolostomos komplikacija ir ji pasitaiko 1-13 % atvejų. Ženklią stomos stenozę reikia koreguoti chirurginiu būdu, nes ji sukelia žarnų nepraeinamumą ir net gali baigtis skubia operacija ir sunkiomis kom plikacijomis. Per 4 metų laikotarpį mes operavome 7 pacientus, turinčius didelę stomos stenozę, atlikdami Zplastiką pagal Lyonso ir Symono techniką. Visos stomos buvo galinės ir po tiesiosios žarnos ekstirpacijos dėl vėžio. Komplikacijų nebuvo nei operacijos metu, nei pooperaciniu laikotarpiu, o stebint ligonius nuo 6 iki 38 mėnesių po operacijos stenozės recidyvų nekonstatuota. Zplastika buvo paprasta ir saugi metodika galinės stomos stenozei koreguoti. Šiai operacijai nereikia atverti pilvo ertmės ir ji atliekama dienos stacionare, kartu padeda išvengti intraperitoninių komplikacijų.
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