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Microscopic Structure of Intestinal Anastomoses and the Use of Animal Models in Experimental Intestinal Surgery
Kural, Tomáš ; Tonar, Zbyněk (advisor) ; Kachlík, David (referee) ; Kocián, Petr (referee)
Despite extensive research and the implementation of modern surgical methods, the incidence of anastomotic leaks remains high. The exact pathophysiological mechanisms responsible for these leaks are still unknown, making prevention a challenge. The use of animal models is extensive in the research of intestinal anastomotic leakage. The literature review of this thesis, therefore, presents a brief history of the usage of experimental animals as well as major differences in terms of anatomy and histology between humans and the experimental mammals utilized in intestinal healing studies. The thesis is based on four studies describing the possibilities of using quantitative histological methods in different applications, animal models, and experimental surgical techniques in the research of intestinal anastomotic healing. The conclusions of these four studies can be summarized as follows: Conclusion 1: TeIGen software is readily accessible to scientists researching fibrous and porous materials using micro-CT analysis. This software aids in producing virtual image sets with defined morphometric attributes, and it can also help with fine-tuning of quantification tools required to examine micro-CT scans. The software also enables the identification of material morphological properties and image...
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The Importance of Measuring Intraabdominal Pressure in Cases of Severe Acute Pancreatitis
Kural, Tomáš ; Třeška, Vladislav (advisor) ; Chytra, Ivan (referee) ; Kala, Zdeněk (referee) ; Leffler, Jan (referee)
Treatment of severe acute pancreatitis is considered to be conservative. The only generally accepted indication for surgery in severe acute pancreatitis patients is an established infection of the necrotic tissue and persisting or progressing symptoms of multiorgan failure despite the maximal intensive treatment. For surgical treatment are also indicated patients with complications of severe acute pancreatitis (erosive hemorrhage, perforation of GIT etc.). In the proposed work, attention is drawn to those cases, where the general condition of the patient deteriorates combined with a progression of ACS and where a decompressive laparotomy can improve the prognosis of the disease. In our group of 214 patients with severe acute pancreatitis, who were treated over the last six years, 70 patients were indicated for surgery. Out of this count, in 17 cases the indication for decompressive laparotomy was a raise of intraabdominal pressure up to the values of ACS together with the symptoms of organ dysfunction, 6 patients died and 11 younger patients survived.
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The Importance of Measuring Intraabdominal Pressure in Cases of Severe Acute Pancreatitis
Kural, Tomáš ; Třeška, Vladislav (advisor) ; Chytra, Ivan (referee) ; Kala, Zdeněk (referee) ; Leffler, Jan (referee)
Treatment of severe acute pancreatitis is considered to be conservative. The only generally accepted indication for surgery in severe acute pancreatitis patients is an established infection of the necrotic tissue and persisting or progressing symptoms of multiorgan failure despite the maximal intensive treatment. For surgical treatment are also indicated patients with complications of severe acute pancreatitis (erosive hemorrhage, perforation of GIT etc.). In the proposed work, attention is drawn to those cases, where the general condition of the patient deteriorates combined with a progression of ACS and where a decompressive laparotomy can improve the prognosis of the disease. In our group of 214 patients with severe acute pancreatitis, who were treated over the last six years, 70 patients were indicated for surgery. Out of this count, in 17 cases the indication for decompressive laparotomy was a raise of intraabdominal pressure up to the values of ACS together with the symptoms of organ dysfunction, 6 patients died and 11 younger patients survived.
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