Tension pneumocephalus (TP) refers to air accumulation within the cranial cavity. While trauma is the most common cause, it can also result from various other factors, including surgical interventions. Clinical manifestations might include symptoms like headaches, decreased consciousness, seizures, specific neurological deficits, and even cardiac arrest. However, because these symptoms are not exclusive to TP, its diagnosis primarily relies on brain imaging techniques. Immediate decompression is essential for treatment. Herein, we discuss a severe case of TP that arose following complications from the resection of a calvaria squamous cell carcinoma. It is an exceptional case because, as the authors established, pneumocephalus as a complication of skin carcinoma has been described only once. An 88-year-old male patient was diagnosed with squamous cell carcinoma of the calvaria and underwent extensive resection of the lesion. After resection he was managed by an oncology team with adjuvant radiotherapy. Wound infection developed during this treatment. The patient was treated conservatively, and after a month he completed the final session of radiotherapy. The patient was admitted to our hospital following an episode resembling a stroke, manifesting as reduced consciousness (Glasgow Coma Scale = 13) and muscle weakness on the right side. A CT scan showed extensive intraparenchymal TP surrounded by brain edema causing a midline shift. Treatment involved craniectomy with gravitational subdural drainage. Over the subsequent 48 hours, the patient showed marked improvement. He was extubated, began to verbally respond, and showed diminishing muscle weakness. In this case, a “one-way valve” mechanism led to deterioration of the patient’s condition, which was not recognized for several months. This example illustrates that TP can occur without obvious signs of a brain abscess or other direct disturbances in the brain tissue.

Glejaki drogi wzrokowej (OPGs, optic pathway gliomas ) to pierwotne nowotwory ośrodkowego układu nerwowego o niskim stopniu złośliwości, występujące najczęściej u dzieci oraz u młodych dorosłych. OPG może pojawiać się sporadycznie lub w przebiegu neurofibromatozy typu 1. Obraz kliniczny może różnić się w zależności od lokalizacji i wielkości guza. OPG może zarówno przebiegać bezobjawowo, jak i dawać objawy okulistyczne, takie jak jednostronny wytrzeszcz lub zaburzenia widzenia. Chociaż glejaki drogi wzrokowej są guzami o niskim stopniu złośliwości, mogą być agresywne, a ich leczenie często stanowi wyzwanie. Postępowanie w przypadku tych guzów jest wysoce zindywidualizowane. Zależy ono od charakteru i rozległości zmiany oraz funkcji wzrokowej. Może obejmować obserwację zachowawczą, chemioterapię, radioterapię lub interwencję chirurgiczną.

Rodzinna polipowatość gruczolakowata (FAP) jest chorobą rzadką, dziedziczoną autosomalnie dominująco, związaną z mutacją w genie supresorowym APC, kodującym białko odpowiedzialne za kontrolowanie proliferacji komórek błony śluzowej jelita. Ryzyko rozwoju nowotworu złośliwego jelita grubego u tych nosicieli tej mutacji, którzy nie przejdą całkowitej kolektomii, jest bliskie 100%. Większość pacjentów ze względu na późne występowanie pierwszych objawów zgłasza się w znacznym zaawansowaniu choroby, najczęściej z chorobą nowotworową. Diagnostyka FAP opiera się na ocenie klinicznej i genetycznej. Obciążenie rodzinne pacjenta jest wskazaniem do objęcia intensywnym nadzorem onkologicznym oraz do leczenia chirurgicznego. Leczeniem z wyboru jest całkowita kolektomia z wytworzeniem zespolenia krętniczo-odbytniczego (IRA) lub proktokolektomia z wytworzeniem ileostomii (IPAA). Przedstawiono przypadek 30-letniej chorej z rakiem odbytnicy w znacznym stopniu zaawansowania (pT4bN1cM1), która pomimo obciążenia rodzinnego oraz ustalenia rozpoznania FAP w 18. roku życia nie poddała się leczeniu chirurgicznemu. Na podstawie wykonanej diagnostyki i kwalifikacji wykonano całkowitą resekcją jelita grubego z brzuszno-kroczowym usunięciem odbytnicy wraz z macicą, częścią tylnej ściany pochwy wraz z lewymi przydatkami i przymaciczem, z wytworzeniem ileostomii definitywnej. Leczenie chirurgiczne u chorych z FAP jest jedyną szansą na uniknięcie choroby nowotworowej, przy zachowanym dobrym komforcie życia. Dostępność mniej radykalnych metod powinna zostać przedstawiona każdemu choremu na wczesnym etapie leczenia. Zintensyfikowanie edukacji tej grupy chorych pomogłoby zwiększyć ich świadomość na temat choroby, co bezpośrednio wpłynęłoby na odsetek zgonów z powodu nowotworów jelita grubego.

In March 2020, the WHO declared a state of a pandemic, which encompassed the whole world. During the pandemic, numerous new solutions have been introduced and some of the already existing ones have been improved to increase the safety, both of patients and healthcare professionals. The publication aims to present the achievements in the field of innovations with the effects of the Covid-19 pandemic, considering the activities of Polish scientists. The literature and current data were reviewed and useful in the topic of research were selected. The pandemic period showed the interdisciplinary nature of medical robots, both for surgical and diagnostic purposes. Robots are widely used in cleaning and disinfecting rooms. Patient psychological care systems also deserve attention - during the pandemic, the number of those in need suffering from mental diseases increased. Medical robotics should be developed and used more and more commonly.

Chronic venous disease (CVD) is a progressive condition that affects a significant percentage of thepopulation. Clinical manifestation of CVD differs between the patients: from asymptomatic patients withesthetic problems only to the very severe stages (including venous leg ulcer) that significantly decreasethe quality of life (Qol). Although the varicose vein patients can be asymptomatic and they decide fortreatment only for cosmetic reasons, many of them present the symptoms and/or signs of CVD, includingpain, heaviness, itching, cramps, swelling, trophic changes or ulcerations. Therapeutic management ofvaricose veins includes surgery, minimally invasive procedures (involving saphenous ablation or sclerotherapy), compression therapy and pharmacological treatment. Traditional surgical treatment has been a leading method in invasive VV management for many years. Nonetheless, minimally invasive treatment thrived in the 21st century and overtook open surgery regarding VVS and more advanced stages of CVD. Another commonly used minimally invasive method in the treatment of VV is foam sclerotherapy. The efficacy of EVLA in the treatment of VV can be improved by performing adjunctive foam sclerotherapy(FS) of the tributaries. The combination of EVLA and FS is an effective method of reducing the rate ofreinterventions in VV patients with saphenous vein incompetence. In the patients undergoing saphenousablation, VV treatment (FS or mini phlebectomy) can be performed within the same procedure or as thedelayed treatment. The argument for delayed treatment is the potential possibility of the VV regression(partial or complete) after saphenous vein ablation. On the other hand, saphenous ablation and varicosevein treatment within the same session result in fast and complete varicose vein removal without the needfor additional procedures. Nevertheless, there is no consensus regarding the optimal timing of performingFS after EVLA of the GSV trunk and because of many diversified scientific reports there are still differentapproaches to this problem in phlebological centres around the world. Since the timing of adjunctiveFS after EVLA procedure in the treatment of VV associated with GSV incompetence is a topic of opendebate among surgeons, this study is a review that compares concomitant and staged treatments of VV.

Ortner’s syndrome is a non-specific symptom of thoracic aortic aneurysm, therefore, it constitutes a challenge — both, diagnostic and therapeutical — for contemporary physicians. This paper presents the case of a 70-year-old patient reporting a hoarse voice for several months. Due to the suspicion of neoplastic disease, the diagnostics were deepened and during this diagnostic, an aneurysm of the descending thoracic aorta with the concurrent infrarenal abdominal aortic aneurysm and critical stenosis of the left internal carotid artery was diagnosed. Based on the clinical condition and the imaging examinations, the patient was qualified for endovascular surgical treatment — the implantation of stent grafts into the thoracic aorta and the abdominal aorta, preceded by the endarterectomy of the left internal carotid artery and one of the variants of debranching of the aortic arch.

Introduction: This retrospective study aimed to compare short- and long-term outcomes between laparoscopic sleeve gastrectomy (SG) and laparoscopic adjustable gastric banding (LAGB). Material and methods: This retrospective one-centre study included patients who underwent bariatric surgery in the form of LAGB and SG. Results: %BMIL was significantly higher in the SG group than in the LAGB group during postoperative follow-up months (p < 0.001). LAGB patients had a lower %EWL compared to SG at each postoperative follow-up month (p < 0.05). After LAGB, 25.0% patients had %EW ≥ 50%; in the LSG group, 44.8% patients achieved %EWL ≥ 50% (p < 0.0001). The LAGB group’s %EWL ≥ 50 was dependent on BMI before operation (p = 0.049). There are no postoperative complications after LAGB. A total of 221 patients in the SG group 6 (2.7%) had postoperative surgical complications within 30 days after surgery. Postoperative complications in the long term were significantly higher for LAGB than for LSG (p = 0.0062). Reoperation was performed in 16 (7%) patients after LAGB compared to 2 (0.9%) patients after LSG. Conclusions: LSG is a more effective procedure than LAGB, contributing to greater improvement of weight loss. LAGB is associated with lower surgery-related complications in the early postoperative period, but long-term outcomes contributing to a higher late complication rate led to a higher reoperation rate than SG procedure.