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INTRODUCTION: Nowadays the vast majority of inguinal hernia repairs are laparoscopically assisted. Single incision laparoscopy aims to accelerate recovery and provide a better cosmetic outcome after the operation. AIM: To present our own modification of the totally extraperitoneal (TEP) procedure with a single incision and without a multiport, and compare the results with those obtained in the classic three-trocar TEP method. MATERIAL AND METHODS: The study group comprised 61 males. The first group consisted of 35 males who underwent single incision videoscopic alloplasty TEP. The second group comprised 26 males who underwent videoscopic alloplasty using the classic approach. The study assessed the time of operation, complications and postoperative pain based on the VAPS scale. RESULTS: The operation time in the first group was statistically longer compared with the time in the second group. The assessment of differences in postoperative pain in both the examined groups on the first and seventh day after the operation was considered statistically insignificant. In both the studied groups there was no recurrence of hernia established on the first and seventh day after the operation. CONCLUSIONS: The reduced number of incisions in the TEP method with a single incision approach without a multiport involves a decrease in the number of postoperative scars, and thus offers a better cosmetic outcome compared with the classic TEP procedure. The time of TEP operation performed with a single incision approach without a multiport is statistically longer than the duration of the classic laparoscopic TEP procedure.

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THE AIM OF THE STUDY: was to evaluate the safety of one-day thyroid surgery based on the assessment of the incidence of early postoperative complications. MATERIAL AND METHODS: The study comprised 726 patients who underwent total thyroidectomy during the period between January, 2012 and February, 2013. The study considered the three most common thyroidectomy complications. RESULTS: In the group of 726 patients, recurrent laryngeal nerve paralysis was observed in 22 cases, accounting for 3.07% of all patients. Postoperative bleeding was observed in 12 cases (1.65%). In 8 cases, bleeding occurred during the first 8 hours after surgery, while in the remaining four cases- 9, 12, 18, and 26 hours after surgery. The study group was divided into three subgroups, in which the concentrations of calcium and parathyroid hormone, 6 hours and 20 hours after surgery, were determined. In the first group (223 patients), only the parathyroid hormone level was determined. The decreased PTH level was associated with the appearance of tetany symptoms in 15% of cases. Amongst patients in whom the parathyroid hormone level was normal, tetany symptoms were observed in 0.5% of cases. In the second group (256 patients), only the serum calcium level was determined. Amongst patients with normal serum calcium levels, 1% of cases presented with tetany symptoms. In patients where the serum calcium level was reduced, tetany symptoms appeared in 35% of cases. In the third group (247 patients), both serum calcium and parathyroid hormone levels were determined. In the group of patients with normal, both serum calcium and parathyroid hormone levels, tetany symptoms were not observed. Amongst patients with normal serum calcium levels and decreased PTH levels on the day of surgery, tetany symptoms were observed in 25% of cases, while during the first postoperative day-37% of cases. CONCLUSION: One-day thyroid surgery, due to the appearance of complications cannot be regarded as a completely safe procedure.

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Spontaneous, idiopathic urinary bladder rupture is a very rare disease entity, which may face the problem of proper preoperative diagnosis. In many cases the medical history, physical examination, and additional tests raise false suspicion of gastrointestinal perforation. The study presented a case of a female patient with spontaneous urinary bladder perforation, paying particular attention to the diagnostic difficulties associated with the above-mentioned pathology. The aim of the study was to analyse the presence of symptoms and imaging and laboratory results observed in case of spontaneous urinary bladder rupture, as well as differentiate the above-mentioned pathology with gastrointestinal perforation. Whenever diagnosing a patient with acute peritonitis symptoms, in whom the predominating symptoms include sudden abdominal pain, peritoneal cavity fluid presence, hematuria, oliguria, and coexisting increased urea, creatinine, and potassium levels, one should consider the possibility of urinary bladder rupture.

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THE AIM OF THE STUDY was comparison of inflammatory response intensity through estimation of CRP, IL-6 and WBC concentration in blood serum in patients before and after inguinal hernia operations with Stoppa and TEP method. MATERIAL AND METHODS. The study involoved 117 patients operated on inguinal hernia between 2006-2008. The patients were divided into two groups. In the first group (group I - 56) Stopp'a method was used, in the second (group II - 61) TEP method. The patients selection was coincidental. All examined patients were men between 25-75 years old (mean age 54.3). Moreover, the operation's time, state of postoperative wound, the average hospitalization time and intensity of pain were estimated. The observations were directed over two weeks after operation. RESULTS. The inflammatory response estimated with CRP, IL-6 concentration in blood serum was considerably higher in patients operated with Stoppa method. There wasn't observed a relevant difference in increase of white blood cells' concentration in both groups. Moreover, the patients operated on with TEP method experienced lower pain. In group, operated on with Stoppa method, 3 cases of wound healing complications were observed. The operation's time was considerably shorter in the first group. The hospitalization time, was considerably shorter in patients operated on with videoscopic method. CONCLUSIONS. The operation of inguinal hernia with TEP technique in comparison with Stopp'a method is connected with considerably lower inflammatory response of organism, what directly involve with postoperative pain abridgment and reduction of hospitalization time. Moreover it may have influence on frequency of postoperative complications related with wound healing.

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UNLABELLED: Angiogenesis is a process of new blood vessels creating based on existing already vascularisation. This composed and multistage mechanism, which is responsible for growth of the tissues and organs, plays a crucial role in neoplasia. The exact role of particular cells, cytokines and extracellular matrix in cancerogenesis is still discussing. An identification of it is the key to searching the antiangiogenic substances breaking simultaneously neoplastic proliferation. THE AIM OF THE STUDY was to compare the angiopoietin-1(Ang-1), angiopoietin-2 (Ang-2) and Tie-2 receptor (rec. Tie-2) concentrations in the serum of colorectal cancer patients with concentrations of these factors in the serum of healthy people. Moreover the aim of the study was to assess the correlation between the concentrations of these factors and stage of clinical neoplasm progression. MATERIAL AND METHODS: The study included 35 patients hospitalized in the Department of General Surgery due to confirmed by histopatological examination colorectal cancer, between 2006 to 2007. The group of examined patients consisted of 9 women and 26 men with ages between 39 to 81 (average 67.20+/-8.85). The control group consisted of 11 healthy people. The examinations relied on the 10 ml of blood sampling from all the patients, in fasting state, one day before the operation. 10 ml of blood, in the healthy group was also sampled in fasting state. Afterwards all blood samples, 30 minutes after collecting, were centrifuged with velocity 6000 rotation per minute. The gaining serum was freezed in temperature -80 degrees C. The concentrations of Ang-1, Ang-2 and rec.Tie-2 were measured with ELISA method. RESULTS: Among examined patients with colorectal cancer, the statistically significant, higher concentration of Ang-2 in comparison with control group was revealed (6239.7+/-3482.3 pg/ml vs. 2954.9+/-9624.2 pg/ml). The concentration of Ang-2 among the patients from III and IV group according to the clinical and pathomorfological progression classification was statistically significant, higher than in I and II group of the patients (III: 8668,8+/-4938.57 pg/ml; IV: 9002.1+/-5380.92 pg/ml vs. I: 4672.3+/-1808.7 pg/ml; II: 5284.8+/-3204.2 pg/ml). The concentration of Ang-1 and rec. Tie-2 in blood of all the patients with colorectal cancer didn't statistically differ from the control group (Ang-1: 42339.9+/-20197.2 pg/ml vs. 48976.4+/-2284.5 pg/ml; rec.Tie-2; 14.4+/-5.1 vs. 16.8+/-6.2 ng/ml). CONCLUSIONS: The concentration of Ang-2 in the colorectal patients was statistically higher than in the control group. The increase concentration of Ang-2 correlated with the stage of colorectal cancer's clinical progression. The higher concentration of Ang-2 may eventually become a helpful marker in diagnostic and assessment of colorectal cancer's clinical progression stage.

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