搜索结果：Polski przeglad chirurgiczny

<b>Introduction:</b> Adolescent gynecomastia is a common benign enlargement of male breast tissue that may cause significant psychosocial distress. Persistent cases often necessitate surgical intervention. This study aimed to evaluate clinical features, surgical techniques, outcomes, complications, and patient satisfaction in adolescents undergoing gynecomastia surgery at a single center. <br><br><b>Aim:</b> The present study was undertaken to retrospectively analyze the clinical characteristics, surgical techniques utilized, treatment outcomes, complications, and patient satisfaction following surgical management of gynecomastia in adolescent boys treated at a single surgical center for the macro-region of western Poland between 2000 and 2025. The study also aimed to identify factors associated with treatment results to improve and individualize patient care in this population. <br><br><b>Methods:</b> A retrospective observational study analyzed data from 26 boys aged 10-17 years who underwent surgical treatment for unilateral or bilateral gynecomastia between 2000 and 2025 at the Clinic of Pediatric Surgery, Traumatology, and Urology, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences. Surgical management primarily involved periareolar excision of glandular tissue, with selective liposuction or skin resection based on severity. Collected data included demographics, gynecomastia laterality, operative times, histopathology, complications, and patient satisfaction (5-point Likert scale). Statistical analyses included descriptive statistics, t-tests, Mann-Whitney U tests, chi-square tests, and Spearman correlation. <br><br><b>Results:</b> Bilateral gynecomastia was predominant (77%), with a median age at surgery of 16 years. Mean operative time was longer for bilateral procedures (58.5 min) than for unilateral ones (38.3 min). Histopathology confirmed benign glandular tissue in most cases. Postoperative complications were rare (11.5% hematomas; one transfusion), and no reoperations were required. Overall satisfaction was high (median 4/5), though older adolescents reported slightly lower satisfaction (Rs = -0.395, p = 0.046). <br><br><b>Conclusions:</b> Surgical management of adolescent gynecomastia is safe, effective, and associated with high patient satisfaction. Bilateral cases require longer operative times, but complication rates remain low. Individualized preoperative planning, including weight optimization and age-appropriate counseling, enhances cosmetic and psychosocial outcomes. These results support timely surgical intervention in adolescents with persistent gynecomastia causing aesthetic or psychological concerns.

Ovarian lesions in the paediatric population are rare and may be either non-neoplastic or neoplastic in nature. Among the neoplastic lesions, the vast majority are benign, with mature teratomas being the most common subtype. This review outlines the current surgical management of ovarian lesions in paediatric patients, with particular focus on recent research findings and advances in the field. Ovary-sparing, minimally invasive surgical techniques, including robot-assisted approaches, are recommended for benign lesions. In cases where malignancy is suspected, laparotomy with complete tumour excision, oophorectomy, and staging is performed. Accurate evaluation of the lesion's nature and early diagnosis are critical to preventing complications and preserving future fertility.

<p><strong>Introduction:</strong> Artificial intelligence, particularly large language models like ChatGPT-5.0, is increasingly applied in medical education and decision support. At the same time, there is a lack of research assessing the effectiveness of the latest language models in high-stakes specialized examinations in Poland, which justifies the need for such an analysis.</p><p><strong>Aim: </strong>This study evaluates ChatGPT-5.0's performance on the Polish Specialization Examination (PES) in general surgery.</p><p><strong>Methods:</strong> A total of 701 single-choice questions from six PES sessions (2023-2025) were analyzed. The questions were divided into various categories. Each question was independently posed to ChatGPT-5.0 three times, and responses were compared with official answer keys. AI performance was compared with that of residents.</p><p><strong>Results:</strong> ChatGPT-5.0 achieved scores ranging from 75.6% to 82.8%, with an overall accuracy of 81-84%, consistently exceeding both the 60% pass threshold and the average score of residents. While ChatGPT-5.0 occasionally outperformed the top-performing residents, the highest human scores were superior in most sessions. Confidence scores were positively correlated with answer accuracy.</p><p><strong>Conclusions:</strong> ChatGPT-5.0 demonstrates strong written exam performance in general surgery. These findings highlight the potential of AI in medical education and exam preparation, while underscoring the limitations of single-choice assessments for clinical competence.</p><p><strong>The significance of the study:</strong> This study provides the first systematic evaluation of ChatGPT-5.0 on the National Specialty Examination in General Surgery in Poland, offering new insights into how advanced AI models perform across clinical domains and cognitive task types, and highlighting their potential role in future surgical training frameworks.</p&gt.

<p><strong>Introduction:</strong> Diabetic foot infection (DFI) is a major complication of diabetes associated with high rates of amputation, recurrence, and healthcare utilization. The prognostic interaction between clinical and microbiological markers remains unclear.</p><p><strong>Aim:</strong> The present analysis aimed to characterize clinical, inflammatory, and microbiological predictors of course and resource use in surgically managed DFI.</p><p><strong>Material and methods:</strong> We retrospectively analyzed 121 hospitalizations of 86 patients treated surgically for DFI (2021-2025). Clinical, laboratory, and microbiological variables were assessed in relation to amputation, reamputation, rehospitalization, length of stay (LOS), and mortality.</p><p><strong>Results:</strong> Amputation was performed in 72/121 episodes (59.5%), including 57 minor and 15 major procedures. Reamputation occurred in 13/72 cases (18.1%). Rehospitalization was recorded in 42/86 patients (48.8%). Median LOS was 13 days (IQR 8-21). A total of 227 isolates were obtained, with <em>Enterococcus faecalis</em> (38 isolates, 16.7%) and <em>Staphylococcus aureus</em> (28 isolates, 12.3%) being the most frequent. Polymicrobial infections were present in 75/121 episodes (63%). Neuro-ischemic ulcer phenotype independently predicted reamputation (aOR 3.72; p = 0.036). <em>Staphylococcaceae</em> increased the likelihood of rehospitalization (aOR 3.32; p = 0.014). NLR &amp;gt;5 prolonged LOS by 42%, and <em>Enterococcus</em> spp. by 51%. Repeat hospitalizations showed enrichment of ESBL <em>Klebsiella pneumoniae</em> (5 cases) and HLAR E. faecalis (9 cases).</p><p><strong>Conclusions: </strong>Ulcer phenotype and systemic inflammatory response were the strongest predictors of adverse outcomes. Microbiology contributed selective yet clinically meaningful prognostic information, particularly regarding <em>Staphylococcaceae</em> and <em>Enterococcus</em> spp.</p&gt.

<b>Introduction:</b> Hand injuries are common, accounting for between 7 and 28% of all injuries. These are both closed injuries (joint dislocations and bone fractures) and open injuries (wounds and amputations). They occur in workplaces, in agriculture, during housework, sports, and during traffic accidents. <br><br><b>Aim:</b> The aim of the paper was to review the literature and present own experiences on the mechanisms of occurrence and methods of preventing severe hand injuries. <br><br><b>Material and methods:</b> Data from the literature were obtained from the Medline and PubMed databases, using keywords such as those in this paper. In addition, data from the author's institution experience are presented. <br><br><b>Results:</b> Various mechanisms of hand injuries when operating various devices, e.g., circular saws, angle grinders, mechanical presses, agricultural machinery, and fireworks, are presented. The most common causes of injury at operating these devices are discussed. Methods to prevent injuries that are specific to each device were discussed. The number of serious accidents in factories and workplaces has decreased noticeably over the last 10 years, while their incidence in households remains unchanged. <br><br><b>Conclusions:</b> Most injuries occur when operating devices with a rotating blade: circular saw, angle saw, and manual circular grinder. The cause of these injuries is most often careless handling of tools and failure to follow the operating instructions when tinkering at home. <br><br><b>Relevance of the study to the development of the field:</b> The results of this work may contribute to increasing public attention to the observance of safety when operating mechanical equipment.

<b>Introduction:</b> Pancreatic ductal adenocarcinoma (PDAC) is one of the most common causes of cancer mortality worldwide, and most patients develop local and/or distant recurrence at some point during follow-up. <br><br><b>Aim:</b> This review aims to present the follow-up protocols used in Poland and worldwide for patients undergoing surgical treatment for PDAC. <br><br><b>Material and methods:</b> The analysis included studies on oncological follow-up following surgical treatment for pancreatic adenocarcinoma. After searching PubMed, Scopus, and Google Scholar databases using the terms "pancreatic adenocarcinoma recurrence", "surveillance after pancreatic adenocarcinoma resection", "postopererative follow-up for pancreatic adenocarcinoma", 50 articles were ultimately qualified for analysis. <br><br><b>Results:</b> Currently, there are no unified international standards for postoperative follow-up for PDAC. Furthermore, standardized national guidelines do not exist in Poland; thus, the optimal modality and duration of surveillance remain undefined. Furthermore, the impact of early detection and treatment of recurrence on survival and quality of life is unknown. Early detection of recurrence potentially offers greater treatment options due to systematic improvements in the treatment of local recurrence and distant metastases (DM), but it may also be associated with increased economic burden on "the payer" (healthcare system), without clearly translating into benefits resulting from longer survival. Currently, there are no clear recommendations on this issue - it seems necessary to conduct prospective studies to assess whether increased postoperative surveillance can translate into improved survival of patients with PDAC. <br><br><b>Conclusions:</b> Multidisciplinary collaboration in developing uniform, nationwide oncological surveillance principles can enable effective supervision of patients with PDAC and bring health benefits. <br><br><b>The importance of this work for the development of the field:</b> This summary of the applicable guidelines and the proposed corrective actions proposed by the authors can translate into progress and improved treatment outcomes in this challenging therapeutic area.

<b>Introduction:</b> Necrosis of the round ligament of THE liver is an extremely rare cause of peritonitis, its nonspecific clinical signs frequently causing diagnostic difficulties. For this reason, contrast-enhanced multiphasic CT scan of the abdomen and pelvis is crucial in the diagnostic management.<b>Case report:</b> A 77-year-old male patient with epigastric pain and suspicion of acute cholecystitis was diagnosed with suspected necrosis of the round ligament of the liver on diagnostic imaging. The patient was qualified for surgical treatment. During the laparoscopic procedure, the necrosis of the round ligament of the liver was confirmed, and the necrotic ligament was subjected to laparoscopic resection. The patient was discharged home in good general condition on postoperative day 3.<b>Conclusions:</b> Necrosis of the round ligament of the liver is a rare but clinically significant entity that should be taken into consideration in the differential diagnosis of acute abdomen, particularly presenting with nonspecific symptoms. In most cases, the treatment of choice involves minimally invasive surgical treatment in the form of laparoscopic resection.

<b>Introduction:</b> Achalasia is a primary esophageal motility disorder of unclear etiology. The development of third-space endoscopy has enabled the advancement of peroral endoscopic myotomy (POEM) as a promising therapeutic alternative. <br><br><b>Aim:</b> To assess the safety profile of the POEM procedure in patients with diverse clinical characteristics. <br><br><b>Material and methods:</b> A retrospective analysis of 484 consecutive POEM procedures performed between 2015 and 2024 at PCZ in Brzeziny (Brzeziny specialized medical center) was conducted. The analysis included demographic data, procedure duration, type of achalasia, as well as intraoperative and early postoperative complications. <br><br><b>Results:</b> Significant complications during or post hospitalization occurred in 26 patients (5.4%), including bleeding, mucosal perforation, pain requiring prolonged treatment, and asymptomatic elevation of inflammatory markers. Two cases of mediastinitis and 7 readmissions were recorded. All complications were successfully managed conservatively. <br><br><b>Conclusions:</b> POEM is characterized by a high safety profile in the treatment of achalasia.

<b>Introduction:</b> Trauma remains the leading cause of death in the pediatric population under 18 years of age. Non-operative management (NOM) has become the standard of care for hemodynamically stable pediatric patients with nonpenetrating abdominal injuries. <br><br><b>Aim:</b> This study evaluates the application of the American Pediatric Surgery Association (APSA) guidelines in a pediatric trauma center in Krakow, Poland, between 2017 and 2024. <br><br><b>Methods:</b> A retrospective analysis was conducted on 295 pediatric patients hospitalized with multi-organ injuries, including the intra-abdominal ones. The data were analyzed with respect to injury severity, hospitalization duration, and outcomes. Statistical methods included Shapiro-Wilk tests, Mann-Whitney U tests, Spearman&apos;s rho correlation, and chi-square tests. P-value of less than 0.5 was considered significant. <br><br><b>Results:</b> Conservative treatment was effective in all implemented cases, with no complications or rehospitalizations. Hospitalization duration correlated with age and presence of central nervous system (CNS) or thoracic injuries in multi-organ injuries, but not with sex or radiological American Association for the Surgery of Trauma (AAST) organ injury scales. Within abdominal organs, liver injury had the greatest impact on hospital stay length. Surgical intervention was required only in hemodynamically unstable patients or selected high-grade pancreatic injuries. Conservative management following APSA guidelines proved to be safe and effective, though concurrent injuries often prolonged hospitalization. Hospital stay length appeared to better reflect overall trauma severity than organ-specific injury grading. Imaging included eFAST (Extended Focused Assessment with Sonography in Trauma) and contrast-enhanced computed tomography (CEST); follow-up was typically conducted with standard ultrasound. No long-term complications were reported on. <br><br><b>Conclusions:</b> The application of APSA guidelines in diagnostic and therapeutic management in pediatric patients with blunt abdominal trauma is safe and effective. Nonoperative management remains the gold standard for stable pediatric abdominal trauma patients. <br><br><b>Significance for the field:</b> Conservative treatment of blunt abdominal injuries in children is a safe way of patient management and needs a raised awareness, especially among non-pediatric surgeons.

<b>Introduction:</b> Full-thickness rectal prolapse (FTRP) is a multifactorial disease that can be treated with different surgicaltechniques. There is still no standard surgical procedure, and the selection of the surgical technique is based on the individualassessment and the experience of the surgeon. The benefits to patients should focus on repair of bowel prolapse, reduction ofconstipation, and an improvement in pelvic floor muscle insufficiency.<b>Aim:</b> Aim of this study was to evaluate clinical and functional outcomes after abdominal surgery for FTRP in a prospective single- -center observational study.<b>Materials and methods:</b> Between 2016 and 2022, a total of 94 consecutive patients (46.2 18.2 years) underwent abdominal surgery due to FTRP using an abdominal approach. They were operated on with ventral mesh rectopexy (VMR) (55 pts.) or resection and suture rectopexy - Frykman-Goldberg procedure (FG) (39 pts.). Before and after the surgery, clinical and functional outcomes were measured. The follow-up period ranged from 1 to 6 years (mean: 26 months).<b>Results:</b> At last follow-up, constipation occurred in 27.6% of VMR and 31.3% of FG patients (p = 0.754; calculated among patients with available postoperative constipation status). The Wexner incontinence score was significantly better in the VMR group (1.0 2.1 <i>vs.</i> 3.6 5.0, p = 0.009). There were no differences in the EQ5D indices between the groups (1.7 2.0 <i>vs.</i> 2.4 2.8, p = 0.257).<b>Conclusions:</b> Both surgical procedures revealed comparable rates of recurrence and complications. While QoL was similarbetween groups, VMR yielded a significantly greater improvement in the Wexner incontinence score.

Introduction: Colorectal cancer (CRC) is the second most common cancer worldwide. Much attention has recently been paid to the epigenetic features of CRC. Homologous recombination repair (HRR) is a biochemical pathway that plays a crucial role in maintaining genome integrity through the repair of double-strand breaks (DBS). RAD51 recombinase is widely considered a key enzyme in HRR. Genome-wide single nucleotide polymorphisms (SNPs) are a significant type of genetic variation. Aim: The aim of this study was to assess the association between the occurrence of individual genotypes/alleles of the RAD51 172G/T polymorphism (rs1801321) and the risk of CRC.Materials and methods: The material used for DNA isolation was peripheral blood from patients at the Department of General and Colorectal Surgery, Medical University of Lodz. The study recruited patients (n = 188) with histologically confirmed colorectal cancer. The control group consisted of undiagnosed individuals (n = 200), matched for age and gender, without a family history of cancer among first-degree relatives.Results: No statistically significant association was found between the frequency of the assessed alleles/genotypes and the presence of CRC. The analysis also showed that the 127G/T variant of the RAD51 gene was not statistically significantly associated with the development of colorectal cancer.Discussion: The 127G/T polymorphism of the RAD51 gene appears to be an unpromising marker for colorectal cancer. However, new observations regarding the variant in the distal promoter may open up prospects for future research on molecular markers.Conclusions: The study results indicate no association between the RAD51 172G/T polymorphism and the risk of CRC. Therefore, there is a need for further research in the area of selected polymorphisms in CRC.

<b>Introduction:</b> Robotic platforms are increasingly used in colorectal surgery. Versius is a modular robotic system whose safety and feasibility are currently being evaluated in routine clinical practice.<b>Aim:</b> To assess the safety, feasibility, and short-term oncologic outcomes of Versius-assisted colorectal cancer surgery in a single center during a two-year implementation period.<b>Material and methods:</b> A retrospective observational study was conducted, including patients undergoing elective robotic colorectal cancer resection using the Versius system between December 5, 2022, and August 27, 2025. Demographic characteristics, operative parameters (skin-to-skin time, docking time, console time, blood loss, conversions), intra- and postoperative complications (Clavien-Dindo classification), reoperations, 30-day readmissions and mortality, length of stay, and oncologic outcomes (resection margins, lymph node yield, mesorectal quality) were analyzed.<b>Results:</b> A total of 191 patients were included (51.8% male, mean age 69.7 9.8 years). The most common procedures were anterior resection (41.4%) and right hemicolectomy (26.7%). The median skin-to-skin operative time was 225 minutes (IQR 185-269). Median length of stay was 6 days (IQR 5-7). Conversion to laparotomy occurred in 8 patients (4.2%). Postoperative complications occurred in 40 patients (20.9%), including minor complications (Clavien-Dindo I-II) in 26 (13.6%) and major complications (&#x2265;III) in 14 (7.3%). Reoperation was required in 13 patients (6.8%), and 30-day readmission occurred in 6 (3.1%). One perioperative death was recorded (0.5%). Median lymph node yield was 22 (IQR 14-25), and &#x2265;12 nodes were retrieved in 87.9% of patients. Complete mesorectal excision was achieved in 75.3%, with a combined rate of complete and nearly complete excision of 95.7%.<b>Conclusions:</b> Versius-assisted colorectal cancer surgery is feasible and safe in a center with established laparoscopic expertise. Acceptable complication rates and adequate oncologic parameters support its implementation in routine colorectal practice.

Patients with chronic intestinal failure (CIF) require long-term parenteral administration of nutrients, minerals, vitamins, and water. CIF is associated with a high risk of malnutrition and sarcopenia, resulting from factors such as malabsorption, chronic inflammation, and sometimes, some case, delayed initiation of parenteral nutrition. The main goal of nutritional therapy in patients with CIF is to maintain adequate nutritional and hydration status, prevent complications arising from nutrient deficiencies, optimize quality of life, minimize the risk of complications related to parenteral nutrition (especially in patients after intestinal resections, e.g., short bowel syndrome), and aim to achieve partial or complete independence from parenteral nutrition, if the intestine retains adaptive potential. This study aims to systematise the current scientific knowledge on nutritional management in CIF patients and to determine the impact of nutritional therapy on intestinal adaptation. One of the significant challenges for the therapeutic team treating CIF patients is the assessment of gastrointestinal function. There is a lack of high-quality data from randomised clinical trials and carefully conducted clinical observations on therapeutic decision-making regarding the introduction of enteral nutrition in CIF patients.

<b>Introduction:</b> Visceral artery compression syndromes are rare diseases with ambiguous symptoms, varying between patients.<b>Aim:</b> The aim of the paper was to review the disease&apos;s pathology, diagnosis and treatment.<b>Methods:</b> Review based on a MEDLINE database search.<b>Results:</b> Medial arcuate ligament syndrome (MALS) is caused by celiac trunk compression by the diaphragm&apos;s medial arcuate ligament. MALS is a diagnosis of exclusion because its symptoms are not clear-cut. Diagnostic imaging is based on Doppler ultrasound and computed tomography. Invasive treatment is aimed to decompress the celiac trunk with open, laparoscopic, or robotic methods, whereas endovascular procedures do not eliminate the disease cause. Superior mesenteric artery syndrome (SMAS) is a rare disease with symptoms resulting from compression of the duodenum between the superior mesenteric artery and the abdominal aorta. Symptoms may result from other pathologies within the abdominal cavity, therefore the diagnosis is based on exclusion of other gastrointestinal causes and on tomographic criteria. Conservative treatment is usually ineffective, while the choice of surgical methods requires individual assessment. Nutcracker syndrome (NCS) is characterized by symptoms caused by compression of the left renal vein by the superior mesenteric artery. Diagnosis is made after excluding other causes, as there are no established NCS diagnostic criteria. Doppler ultrasound and computed tomography are used in syndrome diagnosis, and its treatment should be individualized.<b>Conclusions:</b> The compression syndromes are rare diseases that occur significantly more frequently in women. Their diagnosis and treatment are a clinical challenge. A better pathophysiology understanding and the use of minimally invasive treatment techniques can improve the patient&apos;s quality of life.

<b>Introduction:</b> Anxiety before surgery, which may affect up to 80% of patients, contributes to postoperative complications and prolongs both hospital stay and recovery time. Thus, identifying patients with excessive anxiety and implementing appropriate interventions is essential.<b>Aim:</b> This study aimed to evaluate the effectiveness of a video-based educational intervention in reducing perioperative anxiety in patients scheduled for elective surgery in the general surgery department.<b>Materials and methods:</b> The study comprised 294 patients referred to the hospital for elective surgical procedures. Anxietylevels were evaluated using a translated version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) andState-Trait Anxiety Inventory Trait-5 (STAI-T5).<b>Results:</b> The Amsterdam Preoperative Anxiety and Information scale scores were found to be significantly lower in the videogroup compared to the control group. A significant correlation was found between the trait anxiety measured by the STAI-T5and the anxiety and information scores of the APAIS. The most frequently reported subjective concern was related to theinfluence of the possible failure of surgery on the fate of their families.<b>Conclusions:</b> Video-based educational intervention helps patients become familiar with the detailed description of the hospital stay and the course of surgery. Educational videos are effective in reducing preoperative anxiety and patient&apos;s need forinformation. Therefore, they should be increasingly implemented into everyday medical practice.

<b>Introduction:</b> Refeeding syndrome (RS) is a serious complication of nutritional therapy in critically ill patients, to which patients on surgical wards are particularly vulnerable. It is a potentially life-threatening, complex metabolic disorder that occurs in response to the implementation of overly aggressive, inadequate adaptive patient nutritional therapy, often exacerbated by malnutrition. Moreover, if an appropriate diagnostic and therapeutic process is not undertaken, RS itself becomes the cause of subsequent systemic complications such as respiratory failure, neurological disorders, circulatory failure or seizures. Identified risk factors for RS are mostly modifiable.<b>Aim:</b> The article reviews the literature on the current knowledge and recommendations regarding RS and provides practical recommendations to assist surgeons in effectively diagnosing and managing the syndrome during the perioperative period.<b>Methods:</b> A database query was conducted to identify the most recent information related to the topic of this study.<b>Results:</b> Treatment of RS in critically ill patients undergoing surgery is challenging due to overlapping symptoms of the underlying disease and coexisting severe metabolic disorders. Current guidelines recommend a gradual increase in energy intake and regular monitoring of a patient&apos;s metabolic status (especially phosphorus, potassium, and magnesium levels) during nutritional treatment.<b>Conclusions:</b> It is necessary to regularly follow the recommendations of scientific societies, which will take into account the specificity of the treatment of patients in the perioperative period with Refeeding Syndrome in the context of coexisting diseases to improve the quality and safety of care of these patients.

<b>Introduction:</b> Tension faecopneumothorax (TFP) is a rare but potentially lethal complication of missed diaphragmatic injuries, wherein the herniated intestine perforates, releasing gas and faeces-contaminated fluids in the pleural cavity. This leads to an increase in the intrapleural pressure to levels that exceed the atmospheric pressure and results in adverse effects, which include mediastinal shift, kinking of the great vessels, reduced venous return, and cardiovascular collapse. <br><br><b>Aim:</b> This article was composed to review the profile of the cases of tension faecopneumothorax arising as a complication of missed diaphragmatic injuries, as reported in the recent literature. <br><br><b>Materials and methods:</b> A systematic literature search was conducted through electronic databases, including PubMed, Scopus, and Google Scholar, using the keywords and terms 'tension faecopneumothorax ', 'delayed diaphragmatic rupture', 'missed diaphragmatic injury', 'delayed tension faecopneumothorax', and 'traumatic diaphragmatic herniation'. Only literature in English was considered for inclusion in this study, and the time frame of 20 years was fixed between 2004 and 2024. <br><br><b>Results:</b> A total of 12 cases with a mean age of 45.2 years were included in the review. Abdominal pain, respiratory distress, and hemodynamic instability were the major presenting clinical features, manifesting acutely or gradually with sudden deterioration. All the hernias were left-sided and herniation of transverse colon was found in 11 (91.7%) cases. All the cases were managed by laparotomy with or without thoracotomy. There was one mortality and intensive care for variable periods was required in 4 (33.3%) cases. <br><br><b>Conclusions:</b> Tension faecopneumothorax is a rare and potentially lethal complication of missed diaphragmatic injuries that may appear even after years of trauma. This condition needs to be considered as a possible differential diagnosis, when a patient of sudden onset respiratory distress is being evaluated, particularly if there is a past history of blunt or penetrating abdominothoracic trauma.

<b>Introduction:</b> Oesophageal cancer is one of the leading causes of malignant death worldwide, and its incidence has increased sixfold in recent decades. Although it ranks sixth in mortality and eighth in incidence worldwide, it is one of the least understood and described cancers, which is probably related to its highly aggressive course and poor treatment outcomes.<b>Aim:</b> The aim of this study was to review the current literature regarding the treatment of oesophageal cancer.<b>Results:</b> Surgical treatment is the most important stage of therapy, and advances in this field and the development of new surgical techniques have significantly improved the five-year survival and reduced the incidence of postoperative complications. However, surgical treatment of oesophageal cancer is considered one of the most extensive and invasive procedures in cancer surgery, resulting in a steep learning curve for oesophageal resection procedures, especially minimally invasive (MI) techniques. Nevertheless, in the early stages of disease, oesophageal resection is the only currently accepted and used procedure that can potentially lead to a cure. The results of several studies comparing conventional and MI approaches have demonstrated the superiority of MI oesophagectomy, which is associated with fewer perioperative complications and inhospital deaths, shorter operation times, shorter intensive care unit stays, and higher quality of life rates. The learning curve for hybrid surgery, which bridges the gap between classic and MI procedures, is much shorter than for fully MI procedures, which is particularly appealing for surgeons who lack extensive experience in laparoscopy and thoracoscopy.<b>Conclusions:</b> In conclusion, given the clear advantages of MI techniques over classic techniques, we believe that despite a longer learning curve and more difficult surgical procedures, MI techniques should be the target techniques for treating oesophageal cancer.

<b>Introduction:</b> Laparoscopic sleeve gastrectomy (LSG) is one of the most popular bariatric surgeries, which contributes to a significant reduction in body weight and improvement of metabolic parameters. At the same time, gastroesophageal reflux disease (GERD) remains one of the key complications after this intervention.<b>Aim:</b> The aim of this study was to determine the main factors contributing to the development of GERD after LSG.<b>Materials and methods:</b> The study included 328 patients (mean age 42.3 9.6 years, mean BMI [body mass index] 41.7 6.1 kg/m) who underwent LSG in 2016-2022. Patients were divided into two groups: the study group (n = 72, 21.95%) - patients with occult GERD, the control group (n = 256, 78.05%) - patients without signs of the study disease. Before the operation, a comprehensive assessment of the patients&apos; condition was performed, including the GERD-HRQL questionnaire and 24-hour pH monitoring (DeMeester index [IDM]). Latent GERD was defined as IDM>14.72 in the absence of symptoms. Postoperative disease was diagnosed on the basis of changes in GERD-HRQL and repeated pH metering 12 months after LSG. The Review Manager program was used for statistical analysis.<b>Results:</b> One year after surgery, 33.23% (n = 109) of patients developed clinically significant GERD. Among those who had latent disease before LSG, 76.38% (n = 55) developed symptoms of the disease. In the control group, the disease appeared in 21.19% (n = 54) of patients, and another 5.08% (n = 13) had a latent form of the disease. Statistical analysis revealed a strong association between the presence of latent disease before surgery and an increased risk of developing clinical disease after LSG (RR: 0.55, OR: 12.10, p<0.001). There was also a tendency to an increased risk of developing this disease in patients over 55 years of age, but this relationship was not statistically significant (p = 0.34), as well as female gender (p = 0.75).<b>Conclusions:</b> LSG is an effective method of treating obesity, but it can contribute to the development of GERD, especially in patients with occult disease. Considering that 76.38% of such patients developed symptoms of the disease after surgery, it is advisable to include preoperative 24-hour pH-metry in the standard examination for the timely detection of occult reflux.