Introduction. Pelvic exenteration (PE) is a curative or palliative radical surgical procedure applied for advanced or recurrent pelvic or perineal cancers. From 1948 to date, improvements in surgical techniques, including urinary conduits and pelvic reconstruction, have improved its morbidity and mortality. Aim. The present study reviews the evolution of PE, indications, complications and current results. Material and methods. Large case series and studies on PE were searched in PubMed, covering all years available, and recent applications of PE were reviewed. Results. Indications of PE are primary or locally advanced tumors (cervix. rectum. vulva. bladder), recurrence after radiotherapy (cervix), recurrence after primary resection (vulva, vagina, cervix, rectum) and palliative treatment for advanced tumors or pubic fistulas. Contraindication are distant metastases, involvement of iliac vessels, pelvic side-wall or para-aortic lymph nodes and invasion of sacrum proximal to S1/S2 or sciatic foramen. However, recent studies have reported more radical resections, including side-wall and vessels. Patient’s health condition and fitness are also important in decision-making. Conclusion. PE can be the last chance of cure or improving quality of life for advanced or locally recurrent pelvic cancers. 5-year survival rates with PE are better, but complications of such a radical surgery are still high, and should be improved.
Opisano historię zabiegów kleszczowych od pionierskich Petera i Hugona Chamberlana oraz Jeana Palfyna w XVII i XVIII wieku, ewolucję wskazań do tych zabiegów w Europie, w szczególności w Anglii, Francji, Austrii i Niemczech. Podkreślono rolę Polaka Maurycego Madurowicza w konstrukcji kleszczy. Przedstawiono budowę kleszczy, technikę zabiegów kleszczowych oraz aktualne wskazania do tych zabiegów.
EN
The article contains the history of forceps delivery since the pioneers Peter and Hugon Chamberlen and Jean Palfyn in the 17th and 18th century as well as the evolution of indications for such procedures in Europe, particularly in England, France, Austria and Germany. The role of a Polish man called Maurycy Madurowicz in the forceps construction has been underlined. The article comprises detailed forceps construction, the technique of forceps delivery and current indications for such procedures.
W artykule przedstawiono historię cięcia cesarskiego od czasów starożytnych do XXI w. Zwrócono uwagę na ewolucję technik operacyjnych i postępowania okołoporodowego na przestrzeni dziejów, co spowodowało obniżenie śmiertelności z 100 % do minimum. Omówiono pierwsze udokumentowane cięcie cesarskie wykonane w Polsce. Na zakończenie zestawiono aktualne wskazania do cięcia cesarskiego rekomendowane przez Polskie Towarzystwo Ginekologiczne. Rozszerzenie tych wskazań spowodowało, że cięcie cesarskie jest najczęściej wykonywanym zabiegiem położniczym w Europie i na świecie (około 30 % wszystkim porodów).
EN
This study contains the cesarean section history since the ancient times until the 21 st century. The consideration was taken into the evolution of the surgical techniques and the perinatal procedures within the centuries, which led to the mortality reduction from 100 per cent to a minimum. The presentation discusses the first evidence of the cesarean section performed and documented in Poland. Finally, the article presents current indications for the cesarean section recommended by the Polish Gynecological Society. Expanding the indications has resulted in the fact that the procedure is now the most commonly used among other obstetrical ones performed in Europe and the rest of the world (approximately 30% of all child-births).
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.