Piotr Spychalski, MD, PhD · colorectal surgeon, University Clinical Centre, Gdańsk · Assistant Professor, Medical University of Gdańsk · home · Polski
All 64 papers I have authored or co-authored, each with a short summary of design and main findings based on the published abstract. Full texts are linked by DOI; the maintained master list is on ORCID.
2026
Long-Term Functional Outcomes After Prehabilitation in Frail Older Adults Undergoing Colorectal Cancer Surgery: A One-Year Prospective Cohort Study.
Dobrzycka M, Wołoszyn P, Prud M, Bieniaszewski K, Spychalski P, Gierat-Haponiuk K, et al. Journal of Clinical Medicine 2026. Original study · DOI 10.3390/jcm15124731 · PubMed 42355899
Prospective observational cohort of frail patients aged over 70 years who completed structured prehabilitation before colorectal cancer surgery; 41 of 93 eligible patients completed 1-year follow-up. The 5-item Frailty Index increased slightly (mean difference 0.029, p = 0.012) with no change in the Clinical Frailty Scale, while postural function improved and functional performance remained stable (6-minute walk test 392.71 vs 384.36 m, p = 0.885; Timed Up and Go 12.36 vs 10.42 s, p = 0.051). The authors describe a dissociation between physiological vulnerability and functional status, to be interpreted descriptively given the absence of a control group.
Long-term effects of colonoscopy screening on colorectal cancer incidence and mortality: a multicountry, population-based randomised controlled trial.
Kaminski MF, Kalager M, Løberg M, Emilsson L, Macios A, Samy F, et al. (Spychalski P 18/22); NordICC Study Group. The Lancet 2026. Randomised trial · DOI 10.1016/S0140-6736(26)00508-8 · PubMed 42102826
Multicountry population-based randomised trial (NordICC) of 84,583 adults aged 55 to 64 years in Norway, Poland and Sweden, allocated 1:2 to invitation to a single screening colonoscopy or no screening, reporting 13-year follow-up. Colorectal cancer incidence was reduced (intention-to-screen RR 0.81, 95% CI 0.71 to 0.90; per-protocol RR 0.55, 95% CI 0.33 to 0.81), mainly for distal cancers, whereas colorectal cancer mortality was not significantly reduced (intention-to-screen RR 0.88, 95% CI 0.68 to 1.08). Observed mortality in the control group (0.47%) was substantially lower than the 0.82% assumed at trial design.
Minimum Case Volume Recommendations for Complex Surgery.
Correspondence in JAMA addressing minimum case volume recommendations for complex surgical procedures. No abstract is available; the letter contributes to the discussion on volume thresholds as a quality standard in complex surgery.
Study of Treatment with Intensified Omeprazole to Prevent High-Output Stoma - A Protocol for a Randomized, Parallel-Group, Open-Label, Superiority Trial in Adults Undergoing Ileostomy (STOP-HOS-1).
Sylwestrzak T, Ciosek M, Połomska K, Kobiela J, Spychalski P. Journal of Clinical Medicine 2026. Trial protocol · senior (last) author · DOI 10.3390/jcm15051841 · PubMed 41827257
Protocol of STOP-HOS-1, a two-centre randomised, parallel-group, open-label superiority trial in Poland planning to enrol 100 adults undergoing loop or end ileostomy. Participants are randomised 1:1 to intensified intravenous omeprazole (80 mg loading dose, then 40 mg twice daily) or standard dosing (40 mg once daily) through postoperative day 10; the primary outcome is mean ileostomy output across postoperative days 1 to 3, with a reduction of at least 250 mL/day prespecified as clinically meaningful. Secondary outcomes include high-output stoma incidence, time to output stabilisation, dehydration-related complications, length of stay and 30-day readmission, analysed by intention to treat.
Definitive surgery for Hirschsprung Disease between 3 and 12 months achieves best outcomes: A systematic review with meta-analysis.
Sowulewski O, Leszkowicz J, Sakowska M, Spychalski P, Szlagatys-Sidorkiewicz A. Journal of Pediatric Surgery 2026. Meta-analysis · corresponding author · DOI 10.1016/j.jpedsurg.2026.163039 · PubMed 41780589
Systematic review with meta-analysis (PRISMA) of 19 studies published 1998 to 2025 including 3980 children undergoing definitive pull-through for Hirschsprung disease, stratified by age at surgery. Neonatal surgery was associated with more Hirschsprung-associated enterocolitis (22.4% vs 15.5%), anastomotic leakage (7.1% vs 1.5%), long-term faecal incontinence (30.0% vs 17.8%) and constipation (25.2% vs 12.8%); surgery before 3 months showed a similar pattern. Procedures performed during infancy after 3 months showed more balanced outcomes, informing the timing debate not settled by current guidelines.
Reliability of Transcutaneous Laryngeal Ultrasonography Performed as Point-of-Care Ultrasound (POCUS) of the Larynx: A Preliminary Prospective Cohort Study.
Prospective cohort in which six ultrasound-naive medical students performed transcutaneous laryngeal ultrasonography (TLUSG) with a handheld point-of-care device (Butterfly iQ+) and a conventional system (Mindray ME8) in peri-thyroidectomy patients, using laryngoscopy as reference. Across 229 examinations per device in 96 patients, vocal fold visualisation (94.3% vs 96.1%, p = 0.29), sensitivity (58.3% vs 65.7%, p = 0.5) and specificity (97.8% vs 98.4%) did not differ significantly, and sensitivity improved with operator experience. Point-of-care devices may broaden implementation of TLUSG in perioperative and outpatient settings.
Does Transcutaneous Laryngeal Ultrasonography Improve Patient-Reported Outcome Measures (PROMs) Compared to Flexible Laryngoscopy? - A Cross-Sectional Survey Study.
Prospective cross-sectional survey nested in a learning-curve study, in which patients undergoing elective thyroidectomy (n = 96; 116 responses) rated transcutaneous laryngeal ultrasonography (TLUSG) and laryngoscopy using a purpose-designed 12-item questionnaire. TLUSG had lower composite burden scores (median 7 vs 20.5, p < 0.001), was preferred by 84.4% of patients, and all patients were willing to repeat it compared with 82.3% for laryngoscopy (p < 0.001); comfort was lower in men and in patients with vocal fold palsy. The findings support considering TLUSG in patient-centred perioperative vocal fold screening.
Learning Curve Analysis of Conventional and Point-of-Care Transcutaneous Laryngeal Ultrasonography.
Prospective cohort (Gdańsk, January to August 2022) in which six ultrasound-naive medical students performed transcutaneous laryngeal ultrasonography with point-of-care and conventional devices in thyroidectomy patients, with laryngoscopy as reference; learning curves were analysed with CUSUM, segmented regression and LC-CUSUM. Across 120 examinations the visualisation rate was 94.9%; the learning phase for time to visualisation and to complete examination ended at the 7th and 5th examination for point-of-care and the 24th and 16th for conventional ultrasound, and diagnostic proficiency was reached between the 7th and 15th examination. Proficiency was acquired around the 25th examination, supporting feasibility of bedside implementation.
2025
Single Nucleotide Polymorphisms as Biomarkers of Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer: A Systematic Review.
Połomska K, Rybicka M, Jażdżewska A, Prud M, Jackowska S, Kobiela J, Spychalski P. Cancers 2025. Systematic review · senior (last) author · DOI 10.3390/cancers17243995 · PubMed 41463244
Systematic review (PRISMA; PubMed and Web of Science) of 32 studies including 4116 patients, evaluating 304 single nucleotide polymorphisms (SNPs) across 126 genes as predictors of response to neoadjuvant chemoradiotherapy in rectal cancer. DNA repair (XRCC1, XRCC3, ERCC1, ERCC2) and folate metabolism genes (MTHFR, TYMS) were most studied; only rs25487 (XRCC1) and rs1801133 (MTHFR) showed predictive value in more than one study, with inconsistent associations, and no SNP was validated across independent cohorts. Current evidence does not support clinical use of individual SNPs; large prospective studies and polygenic or multi-omic models are proposed.
Bioimpedance Measurement for Monitoring Chronic Wounds: A Systematic Review.
Antoszewska M, Połomska K, Spychalski P, Kekonen A, Viik J, Barańska-Rybak W. International Wound Journal 2025. Systematic review · DOI 10.1111/iwj.70707 · PubMed 40505690
Systematic review (PRISMA; PubMed, Scopus and Web of Science, searched August 2024) of 16 studies on bioimpedance measurement for monitoring chronic lower leg wounds. Included studies consistently showed significant bioimpedance differences between wound and healthy skin and changes over the healing process, with wide heterogeneity in electrode types and configurations. Bioimpedance appears potentially useful for quantitative wound monitoring, but methodological challenges remain before clinical implementation.
Adenoma Detection Rates and Risk of Colorectal Cancer-Reply.
Authors' reply to correspondence on their JAMA study of physician adenoma detection rate (ADR) improvement and subsequent colorectal cancer risk in the Polish Colonoscopy Screening Program. No abstract is available; the reply addresses readers' comments on that analysis.
Effectiveness of Open Incision Negative Pressure Wound Therapy for Surgical Site Infection Prevention for Abdominal Surgery-A Systematic Review and Meta-Analysis.
Połomska K, Kowalik J, Kobiela J, Spychalski P. International Wound Journal 2025. Meta-analysis · senior (last) author · DOI 10.1111/iwj.70199 · PubMed 40234096
Systematic review and random-effects meta-analysis (PROSPERO CRD42024401669) of 8 studies (3 randomised trials, 5 cohort studies; 1655 patients) on open incision negative pressure wound therapy (NPWT) in abdominal surgery, 5 of which were pooled. NPWT was associated with lower surgical site infection risk than primary closure (OR 0.15, 95% CI 0.02 to 0.87), with no significant difference compared with delayed primary closure (OR 0.28, 95% CI 0.06 to 1.27). Standardised treatment and reporting protocols are needed to evaluate NPWT effectiveness.
Comparison of Staging and Treatment of Rectal Cancer between Patients Younger and Older than 70 years - An International Multicenter Study.
Krzeszowiak J, Duta C, Pach RA, Richter P, Lorenc Z, Rutkowski A, et al. (Spychalski P 22/25). Chirurgia (Bucharest) 2025. Original study · DOI 10.21614/chirurgia.3108 · PubMed 40367306
Retrospective analysis of prospectively collected data from nine centres in Poland, Romania and Germany including 2443 patients operated on for rectal cancer between 2013 and 2019, compared by age (under vs at least 70 years). Staging, sex and tumour location did not differ, but older patients more often had stoma formation, had lower lymph node yield and less frequent preoperative radiotherapy, with no difference in R0 resection or complete response rates. Overall survival was significantly lower in older patients in stages I to IV, indicating age-related differences in treatment intensity.
Technical Aspects of Transcutaneous Laryngeal Ultrasonography: A Review.
Technical review of transcutaneous laryngeal ultrasonography (TLUSG) for peri-thyroidectomy vocal fold assessment. It describes identification of the false vocal folds, true vocal folds and arytenoid cartilages via the anterior (transverse) or lateral (sagittal) approach, with passive breathing, phonation and the Valsalva manoeuvre to elicit movement. The paper provides a step-by-step algorithm, common pitfalls and modifications to support adoption by surgeons, anaesthesiologists and endocrinologists.
Adenoma Detection Rates by Physicians and Subsequent Colorectal Cancer Risk.
Observational study of 789 physicians and 485,615 patients in the Polish Colonoscopy Screening Program (2000 to 2017, median follow-up 10.2 years; 1873 colorectal cancers), using joinpoint regression to relate change in adenoma detection rate (ADR) to postcolonoscopy colorectal cancer incidence. A change in trend occurred at an ADR of 26%; among physicians with baseline ADR below 26%, improvement was associated with lower incidence (31.8 vs 40.7 per 100,000 person-years; difference 8.9, 95% CI 5.06 to 12.74), whereas above 26% no difference was observed (23.4 vs 22.5; difference 0.9, 95% CI -6.46 to 8.26). ADR improvement appears relevant mainly for endoscopists below this threshold.
2024
Preoperative stoma site marking: nurses' perspective
Leyk-Kolańczak M, Spychalski P, Kruk A, Terech-Skóra S, Książek J, Dobosz M, et al. Pielęgniarstwo Chirurgiczne i Angiologiczne / Surgical and Vascular Nursing 2024. Original study · DOI 10.5114/.2024.141477
Survey of 164 Polish nurses recruited at three nursing conferences on perceived practice of preoperative stoma site marking. Forty percent reported that marking is always performed before elective surgery on their ward and 30% that it is performed only sometimes; marking before emergency surgery was confirmed by 14.6%, and the main barrier was absence of a ward protocol (82.3%), followed by lack of trained staff, surgeon restrictions and time. Implementation in Poland remains unsatisfactory, supporting training of ostomy nurses and a uniform national procedure.
Mortality and rate of hospitalization stratified by patients' BMI in a colonoscopy screening - a cross sectional analysis of data from Polish Colonoscopy Screening Platform.
Spychalski P, Wieszczy P, Połomska K, Kobiela J, Regula J, Kaminski MF, et al. Scandinavian Journal of Gastroenterology 2024. Original study · first author · DOI 10.1080/00365521.2024.2410795 · PubMed 39363857
Retrospective cohort of 55,390 individuals screened in the Polish Colonoscopy Screening Program (2012 to 2015), comparing mortality and unplanned hospitalisation from 42 days before to 30 days after colonoscopy across BMI categories, with adjustment and subanalyses by sex and procedure type. Obese individuals had more hospitalisations than non-obese individuals (1.94% vs 0%, p = 0.038), particularly obese men, while unadjusted and adjusted mortality did not differ by BMI. Overweight and obesity were not clinically relevant risk factors for mortality or hospitalisation around screening colonoscopy.
Bioimpedance sensor array for monitoring chronic wounds: Validation of method feasibility.
Antoszewska M, Spychalski P, Kekonen A, Viik J, Barańska-Rybak W. International Wound Journal 2024. Original study · DOI 10.1111/iwj.14899 · PubMed 39099180
Single-centre observational feasibility study of a multielectrode sensor array for bioimpedance measurement in chronic lower leg wounds of venous, mixed venous-arterial and diabetic aetiology. In 104 measurements of 18 ulcers (7 patients analysed), bioimpedance increased as wound area decreased, with a strong negative correlation (r = -0.86, p < 0.001). The method is feasible for quantitative wound monitoring; long-term studies are needed to establish usability of the electrode dressing.
The impact of oncological package implementation on the treatment of rectal cancer in years 2013-2019 in Poland - multicenter study.
Krzeszowiak J, Pach R, Richter P, Lorenc Z, Rutkowski A, Ochwat K, et al. (Spychalski P 24/25). Polish Journal of Surgery (Polski Przegląd Chirurgiczny) 2024. Original study · DOI 10.5604/01.3001.0054.2680 · PubMed 38940243
Multicentre retrospective analysis of 1418 patients operated on for rectal cancer in five Polish centres (2013 to 2019), comparing periods before, early after and later after introduction of the 2015 oncological package (fast-track pathway with mandatory multidisciplinary team meetings). Across periods, local T stage decreased, median lymph node yield increased in the latest period, and use of preoperative (especially short-course) radiotherapy rose, including among patients with T3/4 or N+ M0 disease. The association with the oncological package is indirect and requires further data.
2023
Recommendations on the use of prehabilitation, i.e. comprehensive preparation of the patient for surgery.
Banasiewicz T, Kobiela J, Cwaliński J, Spychalski P, Przybylska P, Kornacka K, et al. Polish Journal of Surgery (Polski Przegląd Chirurgiczny) 2023. Guideline · DOI 10.5604/01.3001.0053.8854 · PubMed 38348849
Multidisciplinary Polish expert recommendations on prehabilitation before surgery, covering indications, scope, duration and methods of delivery. Core components include nutritional optimisation, exercise, psychological support and addiction cessation, together with correction of anaemia, glycaemic control, stabilisation of comorbidities and procedure-specific preparation (for example, ostomy). Prehabilitation is recommended whenever possible, particularly for patients with comorbidities scheduled for major procedures, delivered by interdisciplinary teams and requiring systemic and reimbursement solutions.
Letter (comment) in Colorectal Disease on the relationship between obesity and colorectal cancer. No abstract is available; the letter comments on the role of obesity, including body mass index (BMI), as a factor in colorectal cancer.
Assessment of Calcium Score Cutoff Point for Clinically Significant Aortic Stenosis on Lung Cancer Screening Program Low-Dose Computed Tomography: A Cross-Sectional Analysis
Cross-sectional analysis of 6631 heavy smokers in the MOLTEST BIS lung cancer screening programme, with Agatston aortic valve calcium scoring on LDCT; participants with a calcium score of 900 or more (n = 54) underwent echocardiography. ROC analysis identified a cutoff of 1758 for at least moderate aortic stenosis (sensitivity 85.71%, specificity 75.76%) and 2665 for severe stenosis (sensitivity 87.5%, specificity 76.92%). Calcium scoring on screening LDCT may allow opportunistic detection of clinically significant aortic stenosis.
Triiodothyronine lowers the potential of colorectal cancer stem cells in vitro
In vitro study of colonospheres derived from two colorectal cancer cell lines incubated with triiodothyronine (T3). T3 reduced viability, proliferation and spherogenic potential (P<0.05), increased apoptosis, shifted cells towards G0/G1 arrest and reduced sphere size, with effects on THR alpha 1, THR beta 1, DIO2 and DIO3 expression depending on cell line and clinical stage of origin. The findings suggest a role for thyroid hormone signalling in regulating colorectal cancer stem cells and a possible therapeutic target.
2022
Comparison of the Long-term Outcomes of RYGB and OAGB as Conversion Procedures After Failed LSG: a Case-Control Study
Wilczyński M, Spychalski P, Proczko-Stepaniak M, Bigda J, Szymański M, Dobrzycka M, et al. Journal of Gastrointestinal Surgery 2022. Original study · DOI 10.1007/s11605-022-05395-w · PubMed 35790676
Case-control study from a prospectively maintained database of 80 patients converted after failed laparoscopic sleeve gastrectomy (33 RYGB, 47 OAGB). At 5 years mean %EBWL was 84.04% after RYGB vs 72.95% after OAGB (p = 0.2176); complete type 2 diabetes remission was more frequent after OAGB (97.3% vs 33%; p = 0.035), with no significant differences in other comorbidity remission or Comprehensive Complication Index; 7 patients developed de novo GERD after OAGB and none after RYGB. Both procedures appear acceptable as conversion options, with OAGB favoured for diabetes remission.
For and Against Routine Removal of Peripheral Intravenous Catheters
Letter (comment) in JAMA Internal Medicine discussing arguments for and against routine versus clinically indicated removal of peripheral intravenous catheters. No abstract is available; the content is summarised from the title and indexing terms (catheter-related infections, device removal). It contributes to the debate on catheter replacement policies.
Short-course radiotherapy and consolidation chemotherapy: in search of a balanced protocol
Letter (comment) on neoadjuvant short-course radiotherapy followed by consolidation chemotherapy for rectal cancer. No abstract is available; based on the title, it argues for defining a protocol that balances oncological efficacy and toxicity. It links to the authors' meta-analytic work on this regimen.
Adenoma to Colorectal Cancer Estimated Transition Rates Stratified by BMI Categories: A Cross-Sectional Analysis of Asymptomatic Individuals from Screening Colonoscopy Program
Spychalski P, Kobiela J, Wieszczy P, Bugajski M, Reguła J, Kaminski MF. Cancers 2022. Original study · first author, corresponding author · DOI 10.3390/cancers14010062 · PubMed 35008224
Cross-sectional analysis of 147,385 participants of the Polish Colonoscopy Screening Program, with prevalence adjusted for sex, age, family history, smoking, diabetes and medication use, and estimated transition rates (eTR) calculated as ratios of adjusted prevalences across BMI strata (normal, overweight, obese). Prevalence of non-advanced adenomas (12.19%, 13.81%, 14.70%) and advanced adenomas (5.20%, 5.77%, 6.61%) rose with BMI (p < 0.001), while eTR from early to advanced cancer was lowest in obese individuals (73.73%, 69.90%, 50.54%). The data suggest an obesity paradox in the adenoma to carcinoma sequence.
2021
Proton pump inhibitors and colorectal cancer: A systematic review
PRISMA-based systematic review of MEDLINE, EMBASE, Scopus and Web of Science to May 2021, including 28 studies (12 basic research, 11 epidemiological, 5 treatment studies). Basic research suggests PPIs do not promote and may inhibit colorectal carcinogenesis, epidemiological data do not support a causal association with increased cancer risk, and treatment studies suggest concomitant PPI use may reduce capecitabine efficacy, while pantoprazole may act as a chemosensitiser with FOLFOX. Agent-specific effects warrant prospective evaluation.
Transcutaneous Laryngeal Ultrasound for Vocal Cord Paralysis Assessment in Patients Undergoing Thyroid and Parathyroid Surgery: A Systematic Review and Meta-Analysis
Patel A, Spychalski P, Aszkiełowicz A, Mikaszewski B, Kobiela J. Journal of Clinical Medicine 2021. Meta-analysis · DOI 10.3390/jcm10225393 · PubMed 34830675
Systematic review and meta-analysis (PRISMA) of 16 studies assessing transcutaneous laryngeal ultrasound against laryngoscopy for vocal cord assessment around thyroid and parathyroid surgery. Pooled visualisation rates were 86.28% preoperatively and 94.13% postoperatively; postoperative pooled sensitivity was 83.96% (95% CI 77.24 to 88.50%) and specificity 96.15% (95% CI 95.24 to 96.88%), with male sex and older age as main risk factors for non-visualisation. The method may serve as a screening tool, potentially avoiding laryngoscopy in about 80% of patients.
Neoadjuvant short-course radiotherapy with consolidation chemotherapy for locally advanced rectal cancer: a systematic review and meta-analysis
Spychalski P, Patel A, Corrao G, Jereczek-Fossa BA, Glynne-Jones R, Garcia-Aguilar J, et al. Acta Oncologica 2021. Meta-analysis · co-first author · DOI 10.1080/0284186X.2021.1953137 · PubMed 34308767
Systematic review and meta-analysis of 11 studies (6 randomised, 5 non-randomised; seven cohorts) comparing short-course radiotherapy with consolidation chemotherapy (SCRT-CCT) and long-course chemoradiotherapy (LCRT). SCRT-CCT increased pathological complete response (RR 1.75, 95% CI 1.41 to 2.19) without a significant difference in 3-year overall survival (RR 1.06, 95% CI 0.98 to 1.14), with comparable R0 resection, downstaging, compliance and late toxicity but higher acute toxicity. Protocol heterogeneity limits firm conclusions pending ongoing trials.
Letter: mind the gap - search and publication date of systematic reviews and meta-analysis
Letter (comment) addressing the time gap between the literature search date and the publication date of systematic reviews and meta-analyses. No abstract is available; based on the title, it highlights that such delays may render syntheses outdated at publication. Relevant to reporting standards and the currency of evidence syntheses.
Treatment of intractable pruritus in patients with cholestasis with molecular adsorbents recirculating system dialysis: a case series
Case series on molecular adsorbents recirculating system (MARS) albumin dialysis for intractable cholestatic pruritus, from Aarhus University Hospital collaborators. No abstract is indexed; the summary is based on the title only, and outcome data are not reported here. It adds to limited clinical experience with extracorporeal albumin dialysis for refractory pruritus.
Mortality Rates of Colorectal Cancer Screening Programs: Differing Methodologies, Complimentary Results
Spychalski P, Błażyńska-Spychalska A, Kobiela J. Clinical Gastroenterology and Hepatology 2021. Letter · first author, corresponding author · DOI 10.1016/j.cgh.2020.11.018 · PubMed 33220522
Letter (comment) on mortality estimates in colorectal cancer screening programmes. No abstract is available; based on the title, it argues that studies using different methodologies yield complementary rather than conflicting results. It relates to the authors' randomised health services study of screening colonoscopy safety.
Postcolonoscopy colorectal cancer - in search of quality
Letter (comment) on postcolonoscopy colorectal cancer. No abstract is available; based on the title, it frames postcolonoscopy cancer as a colonoscopy quality issue. Relevant to quality indicators in screening endoscopy.
2020
Obesity in work-up of kidney transplant candidates: review of clinical practice guidelines
Dobrzycka M, Spychalski P, Łącka M, Proczko-Stepaniak M, Dębska-Ślizień A, Kaska Ł, et al. European Journal of Translational and Clinical Medicine 2020. Review · DOI 10.31373/ejtcm/128771
Review of eight current national and international clinical practice guidelines on pre-transplant evaluation of patients with end-stage kidney disease, focusing on obesity. All guidelines emphasise early detection of obesity and related comorbidities, but only two address bariatric surgery and none issues a formal recommendation owing to insufficient evidence; most omit pharmacological and surgical treatment. High-quality evidence on weight loss, including surgery, is needed to inform future guidelines.
Costs of elective vs emergency cholecystectomy in diabetic patients
Łącka M, Spychalski P, Obłój P, Łaski D, Rostkowska O, Wieszczy P, et al. European Journal of Translational and Clinical Medicine 2020. Original study · DOI 10.31373/ejtcm/128963
Single-centre retrospective analysis of age and sex-matched diabetic and non-diabetic patients undergoing elective or emergency cholecystectomy in Poland (2016 to 2019). Elective cholecystectomy costs were similar (739.31 vs 797.14 USD, p = 0.51), whereas emergency cholecystectomy cost more in diabetic patients (3950.72 vs 2464.31 USD, p = 0.04); emergency surgery was significantly costlier than elective in both groups. Early elective referral of diabetic patients with gallstone disease may reduce costs.
Assessment of nutritional status of patients with cancer who are qualified for home enteral nutrition: a retrospective analysis
Kaźmierczak-Siedlecka K, Folwarski M, Jankowska B, Spychalski P, et al. European Journal of Translational and Clinical Medicine 2020. Original study · DOI 10.31373/ejtcm/120583
Retrospective analysis of 84 patients with cancer qualified for home enteral nutrition at a nutritional counselling centre in Gdańsk (2009 to 2015), assessed by body mass index, serum total protein and albumin, total lymphocyte count and Nutritional Risk Score 2002. Hypoalbuminaemia was more frequent in gastric than oesophageal cancer (p = 0.02), low lymphocyte count was present in 47.6%, and all patients scored at least 3 points on NRS 2002 (most often 5 points, 40.4%). All patients required nutritional treatment, although nutritional status varied.
Circulating Tumor DNA in KRAS positive colorectal cancer patients as a prognostic factor - a systematic review and meta-analysis
PRISMA systematic review of PubMed, Web of Science and Scopus including 18 studies (1779 patients) on KRAS-mutant circulating tumour DNA in serum or plasma of colorectal cancer patients. Six of 8 studies linked ctDNA presence, and all 6 studies linked high ctDNA concentration, with inferior overall survival. KRAS ctDNA appears to be a negative prognostic factor; concentration cut-offs are needed before clinical implementation.
Clinical presentation and outcomes of cholecystectomy for acute cholecystitis in patients with diabetes - A matched pair analysis. A pilot study
Retrospective pilot matched-pair analysis of 267 patients undergoing emergency cholecystectomy for acute cholecystitis (2007 to 2017), with 197 age- and sex-matched controls without diabetes (3:1). Symptoms at admission did not differ, but patients with diabetes had significantly higher operative and postoperative complication rates, longer operative time and hospital stay, and more frequent open surgery, without a higher conversion rate. The authors suggest early cholecystectomy in diabetic patients.
Letter (comment) on methods of estimating the case fatality rate of COVID-19 early in the pandemic. No abstract is available; the summary is based on the title and indexing only. It contributes to the methodological discussion on case fatality estimation during an ongoing epidemic.
Patients seeking information about colonoscopy - lessons learned from Google
Łaski D, Perdyan A, Spychalski P, Łachiński AJ, Śledziński Z, Tybińkowska A, et al. Przegląd Gastroenterologiczny 2020. Original study · DOI 10.5114/pg.2020.95557 · PubMed 32550947
Infodemiological analysis using Google Trends of searches for 'colonoscopy', related queries, and weekly and annual search patterns. First-page results were generally of good quality (with Wikipedia ranked first), search volume dipped at weekends and during holiday periods, and bowel preparation was the most common topic of interest. Healthcare providers should account for online information sources when educating patients.
Intensity-modulated radiotherapy (IMRT) in the treatment of squamous cell anal canal cancer: acute and early-late toxicity, outcome, and efficacy
Dell'Acqua V, Surgo A, Arculeo S, Zerella MA, Bagnardi V, Frassoni S, et al. (Spychalski P 12/21). International Journal of Colorectal Disease 2020. Original study · DOI 10.1007/s00384-020-03517-x · PubMed 32036405
Retrospective review of 84 patients with squamous cell anal canal cancer treated with IMRT-based chemoradiotherapy, with toxicity graded by CTCAE v4.03 and RTOG criteria and response by RECIST v1.1. Severe (grade 3 or higher) acute gastrointestinal and skin toxicity occurred in 5% and 23%, treatment interruption in 77%, colostomy-free survival was 96% (95% CI 89 to 99) at 6 months and 92% (95% CI 83 to 96) at 12 months, and complete response at 12 months was 81%. The data support IMRT as standard of care for curative anal cancer treatment.
Mortality and Rate of Hospitalization in a Colonoscopy Screening Program From a Randomized Health Services Study
Spychalski P, Kobiela J, Wieszczy P, Pisera M, Pilonis N, Rupinski M, et al. Clinical Gastroenterology and Hepatology 2020. Randomised trial · co-first author, corresponding author · DOI 10.1016/j.cgh.2019.09.010 · PubMed 31525515
Randomised health services study within the Polish Colonoscopy Screening Program: 338,477 individuals aged 55 to 64 invited to screening colonoscopy (16.4% attended) vs 338,557 matched controls, with mortality and hospitalisation from national registries around actual or virtual colonoscopy dates. In intention-to-treat analysis mortality did not differ (0.22% vs 0.22%; P = .913), whereas unplanned hospitalisation was higher in the screening group (2.39% vs 2.31%; risk difference 0.08%, 95% CI 0.01 to 0.15%), driven by post-screening admissions, including colonoscopy-related ones (0.24% vs 0.22%; P = .046). Screening colonoscopy does not increase mortality but carries a small excess of unplanned hospitalisations.
Jejunal ectopic pancreas mimicking a gastrointestinal stromal tumor
Patel A, Hellmann A, Spychalski P, Szymański M, Śledziński M. Polish Archives of Internal Medicine 2020. Case report · DOI 10.20452/pamw.14992 · PubMed 31556403
Case report of jejunal ectopic pancreas mimicking a gastrointestinal stromal tumour. No abstract is available; the summary is based on the title and indexing terms only. It adds ectopic pancreas to the differential diagnosis of submucosal small bowel lesions.
Statins and Colorectal Cancer: A Systematic Review
Dobrzycka M, Spychalski P, Łachiński AJ, Kobiela P, Jędrusik P, Kobiela J. Experimental and Clinical Endocrinology & Diabetes 2020. Systematic review · corresponding author · DOI 10.1055/a-0668-5692 · PubMed 30149418
Systematic review of PubMed and Cochrane records (April 2010 to April 2018) on statin use and colorectal cancer incidence, mortality and treatment; of 126 records identified, 69 were excluded. Preclinical data supported chemopreventive and adjuvant effects, whereas human data on cancer risk were heterogeneous, with some studies reporting better overall and cancer-specific survival among statin users and a possible chemopreventive role in inflammatory bowel disease. Further studies are needed to define the effects of individual statins and doses.
2019
Sources of medical information of patients referred to colorectal surgery outpatient clinic for hemorrhoidal disease
Spychalski P, Perdyan A, Łaski D, Kobiela J, Błażyńska-Spychalska A, Łachiński AJ, et al. European Journal of Translational and Clinical Medicine 2019. Original study · first author · DOI 10.31373/ejtcm/105778
Survey of 78 outpatients with haemorrhoids at a university colorectal surgery clinic, combined with Google Trends analysis of search queries and content assessment of the top 10 Google results. Over 80% of respondents searched online, of whom 50% were satisfied with the information; the term 'hemorrhoids' dominated search trends, and 7 of 10 organic results led to professional sources. Patients rely on the internet for information on haemorrhoids, and the top-ranked content was largely reliable.
Interdisciplinary treatment of large adrenocortical carcinoma infiltrating inferior vena cava
Dobrzycka M, Spychalski P, Rusek U, Brzeziński M, Kobiela J, Kłosowski P, et al. European Journal of Translational and Clinical Medicine 2019. Case report · DOI 10.31373/ejtcm/111365
Case report from a single-centre series of 245 adrenal tumour operations (2014 to 2018) describing a 57-year-old woman with a large left adrenocortical carcinoma invading the vena cava, diagnosed by computed tomography and core biopsy. An interdisciplinary team performed open adrenalectomy with thoracotomy, achieving R0 resection. The case supports a multispecialty approach for locally advanced adrenal cancer with vascular infiltration.
Acute cholecystitis in patients with diabetes mellitus: systematic review
Łącka M, Spychalski P, Dobrzycka M, Rostkowska O, et al. European Journal of Translational and Clinical Medicine 2019. Systematic review · DOI 10.31373/ejtcm/115402
PRISMA-based systematic review of 40 studies (from 1632 records) comparing the hospital course of patients with and without diabetes undergoing cholecystectomy for acute cholecystitis. Operative and postoperative complication rates were significantly higher in diabetic patients, and diabetes was a risk factor for conversion from laparoscopic to open surgery, while opinions on prophylactic elective cholecystectomy were divided. Low data quality precluded meta-analysis and strong conclusions.
Methods of imaging flap perfusion in autologous breast reconstructions
Błażyńska-Spychalska A, Brzezicka A, Spychalski P, Kondej K, Jankau J. Chirurgia Plastyczna i Oparzenia 2019. Review · DOI 10.15374/ChPiO2019020
Narrative review of imaging methods for assessing flap perfusion in autologous breast reconstruction, where partial or complete flap necrosis is a key complication. Preoperative computed tomography angiography is reported to offer the best sensitivity and specificity, approaching 100%, whereas intraoperative indocyanine green angiography (ICGA) and dynamic infrared thermography (DIRT) are promising but require further evaluation.
Selection of endovascular equipment according to the type of procedure
Wilczyński M, Kaska Ł, Spychalski P, Baścik B. Ogólnopolski Przegląd Medyczny 2019. Review
Narrative article on selecting endovascular equipment according to the type of procedure; no abstract was available, and the summary is based on the title only.
Stereotactic body radiation therapy for early-stage hepatocellular carcinoma: a systematic review on outcome
PRISMA-based systematic review of 16 studies (973 patients, 1034 lesions; 14 retrospective) of SBRT for small hepatocellular carcinoma (mean diameter 23 mm; median BED10 100 Gy). Mean weighted local control was 94%, 92% and 93% and overall survival 90.9%, 67.5% and 73.4% at 1, 2 and 3 years; grade 1 to 2 toxicity occurred in 17.5% and grade 3 or higher in 5.3%, with no treatment-related deaths. Outcomes appear comparable with radiofrequency ablation and surgery, but incomplete reporting and retrospective designs call for prospective studies before guideline recommendation.
Double indocyanine green technique of robotic right colectomy: introduction of a new technique
Kobiela J, Bertani E, Petz W, Crosta C, De Roberto G, Borin S, et al. (Spychalski P 9/10). Journal of Minimal Access Surgery 2019. Original study · corresponding author · DOI 10.4103/jmas.JMAS_127_18 · PubMed 29974874
Technical report describing robotic modified complete mesocolic excision with central vascular ligation for right-sided colon cancer using dual indocyanine green fluorescence: preoperative endoscopic submucosal peritumoural injection for lymph node mapping and intraoperative intravenous injection for near-infrared assessment of bowel perfusion before anastomosis. Nodal visualisation facilitated standard and selective extended lymphadenectomy, and perfusion assessment guided the extent of resection. No comparative outcome data are reported; the authors propose the technique as a candidate standard for robotic right colectomy.
Stereotactic radiation therapy in oligometastatic colorectal cancer: outcome of 102 patients and 150 lesions
Dell'Acqua V, Surgo A, Kraja F, Kobiela J, Zerella MA, Spychalski P, et al. Clinical & Experimental Metastasis 2019. Original study · DOI 10.1007/s10585-019-09976-z · PubMed 31165360
Retrospective series of 102 consecutive patients with oligometastatic colorectal cancer (150 lesions) treated with stereotactic radiotherapy in 2012 to 2015 (median 45 Gy in 3 fractions, BED 112.5 Gy; median follow-up 11.4 months). No grade 3 or 4 toxicity occurred; local control was 70% and 55%, overall survival 90% and 90%, and progression-free survival 37% and 27% at 1 and 2 years. Local control was better with BED of 75 Gy or more and PTV below 42 cm3, and Karnofsky performance status below 90 predicted out-field progression.
Clinical stages of colorectal cancer diagnosed in obese and overweight individuals in the Polish Colonoscopy Screening Program
Spychalski P, Kobiela J, Wieszczy P, Kamiński MF, Reguła J. United European Gastroenterology Journal 2019. Original study · first author, corresponding author · DOI 10.1177/2050640619840451 · PubMed 31316783
Cross-sectional analysis of 163,129 screenees from the prospectively maintained database of the Polish Colonoscopy Screening Program comparing colorectal cancer stage by body mass index category. Overweight and obese individuals had less advanced cancer at screening (p = 0.014), most markedly in men, and obesity was a negative predictor of advanced cancer detection (odds ratio 0.72, 95% CI 0.52 to 1.00); overweight and obesity did not predict death risk. A higher proportion of early-stage cancers may translate into a survival benefit in obese screenees.
Patient specific outcomes of charged particle therapy for hepatocellular carcinoma: a systematic review and quantitative analysis
Spychalski P, Kobiela J, Antoszewska M, Błażyńska-Spychalska A, Jereczek-Fossa BA, Høyer M. Radiotherapy and Oncology 2019. Systematic review · first author, corresponding author · DOI 10.1016/j.radonc.2018.12.012 · PubMed 30825961
PRISMA-based systematic review and quantitative analysis of 17 cohorts (16 studies, 1516 patients; 11 retrospective) of proton or carbon ion therapy for hepatocellular carcinoma (median BED10 68.75 to 122.5 GyE). Mean weighted overall survival was 86%, 62%, 59% and 35% and local control 86%, 89%, 87% and 89% at 1, 2, 3 and 5 years; acute grade 3 or higher toxicity was 6% and late grade 3 or higher below 4%, with no treatment-related deaths. Incomplete reporting and retrospective designs limit the evidence and support the need for prospective studies.
Effects of thyroid hormone imbalance on colorectal cancer carcinogenesis and risk: a systematic review
Rostkowska O, Spychalski P, Dobrzycka M, Wilczyński M, Łachiński AJ, Obołończyk Ł, et al. Endokrynologia Polska 2019. Systematic review · DOI 10.5603/EP.a2019.0007 · PubMed 31039272
Systematic review (PICO and PRISMA) of MEDLINE, trial registries and Cochrane; of 3054 records, 11 studies (4 cell line, 7 human) were included. Hypothyroidism was associated with increased colorectal cancer risk (adjusted odds ratios 1.16, 95% CI 1.08 to 1.24, to 1.69, 95% CI 1.21 to 2.36), whereas thyroid hormone replacement was associated with lower risk (adjusted odds ratios 0.60, 95% CI 0.44 to 0.81, to 0.92, 95% CI 0.86 to 0.98). Thyroid hormones appear to contribute to colorectal carcinogenesis, warranting further study.
Metformin and Colorectal Cancer: A Systematic Review
Kobiela J, Dobrzycka M, Jędrusik P, Kobiela P, Spychalski P, Śledziński Z, et al. Experimental and Clinical Endocrinology & Diabetes 2019. Systematic review · DOI 10.1055/a-0621-8830 · PubMed 29954001
Systematic review of PubMed and Cochrane (January 2005 to December 2017); of 189 studies identified, 66 were reviewed, including cell line, animal, diabetic and healthy-population studies. Preclinical data showed reduced colorectal cancer incidence and enhanced chemotherapy effects, and studies of metformin-treated patients with type 2 diabetes (146,496 patients in total) suggested risk reduction, although some findings conflicted. Further studies are needed to define the role of metformin in prevention and treatment.
2018
Medical applications of adipose-derived stem cells
Brzezicka A, Kondej K, Błażyńska-Spychalska A, Spychalski P, et al. Chirurgia Plastyczna i Oparzenia 2018. Review · DOI 10.15374/ChPiO2018016
Narrative review of adipose-derived stem cell applications in regenerative medicine, with emphasis on plastic, reconstructive and aesthetic surgery. Reported outcomes are encouraging, but interventions remain investigational, and longer follow-up with rigorous randomised controlled trials is needed to enable meta-analyses.
Pneumomediastinum and pneumoretroperitoneum as a result of mephedrone intoxication: a case report
Perdyan A, Piątkowska A, Spychalski P, Łaski D, Łachiński A, Kobiela J. Disaster and Emergency Medicine Journal 2018. Case report · DOI 10.5603/DEMJ.2018.0022
Case report of a 27-year-old man with non-traumatic pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema after four days of mephedrone inhalation. Imaging and endoscopy excluded airway and gastrointestinal perforation, and he recovered with conservative treatment (fluids and antibiotics) within six days of hospitalisation. Such presentations may resolve spontaneously, supporting observation rather than surgical intervention once perforation is excluded.
Application of minimally invasive techniques in surgery
Narrative article on the use of minimally invasive techniques in surgery; no abstract was available, and the summary is based on the title only.
Ablative stereotactic radiotherapy for oligometastatic colorectal cancer: systematic review
Kobiela J, Spychalski P, Marvaso G, Ciardo D, Dell'Acqua V, Kraja F, et al. Critical Reviews in Oncology/Hematology 2018. Systematic review · corresponding author · DOI 10.1016/j.critrevonc.2018.06.005 · PubMed 30097241
PRISMA and PICO-based systematic review of stereotactic body radiotherapy for colorectal liver and lung oligometastases; 15 of 457 records were included (colorectal histology with reported local control). One and 2-year local control ranged from 50% to 100% and 32% to 91% for liver (BED 40.5 to 262.5 Gy) and from 62% to 92% and 53% to 92% for lung (BED 51.3 to 262.5 Gy). Data suggest high local control with low toxicity but remain immature, requiring observational studies and randomised trials.
Structured box training improves stability of retraction while multitasking in colorectal surgery simulation
Kobiela J, Spychalski P, Łaski D, Błażyńska-Spychalska A, Łachiński AJ, Śledziński Z, et al. Journal of Surgical Research 2018. Original study · corresponding author · DOI 10.1016/j.jss.2018.03.043 · PubMed 29937020
Pre and post study of 58 medical students completing a basic laparoscopic box-training curriculum, measuring force parameters of retraction as a single task and while multitasking with camera navigation. Before training, multitasking degraded retraction stability (greater maximal force, range and standard deviation); after training, maximal force and range for traction while multitasking decreased significantly, and single-task versus multitask performance no longer differed. Structured box training improves retraction stability specifically under multitasking conditions.
Genital marginal failures after intensity-modulated radiation therapy (IMRT) in squamous cell anal cancer: no higher risk with IMRT when compared to 3DCRT
Dell'Acqua V, Kobiela J, Kraja F, Leonardi MC, Surgo A, Zerella MA, et al. (Spychalski P 17/20). Medical Oncology 2018. Original study · DOI 10.1007/s12032-018-1118-3 · PubMed 29594584
Retrospective cohort of 117 patients with non-metastatic squamous cell anal cancer treated with IMRT (n = 64) or 3DCRT (n = 53), mostly with concurrent chemotherapy. Marginal failures occurred in 3.1% after IMRT (median follow-up 25 months) and 3.8% after 3DCRT (median 71.3 months), with no significant difference (p = 0.85). IMRT did not increase marginal failure, but dose constraints should be applied cautiously in women with vaginal or rectovaginal septum involvement.
2017
Therapeutic strategies against cancer stem cells in human colorectal cancer
Narrative review of colorectal cancer stem cell markers and experimental therapies targeting these cells, including agents inducing proliferation, differentiation or apoptotic sensitisation (Dickkopf-1, BMP4, Kindlin-1, tankyrases, PAK1), inhibitors of Wnt, TGF-beta and Notch signalling (pyrvinium pamoate, silibinin, PRI-724, P17 and P144 peptides) and metabolic targets (sirtuin 1 via miR-34a, AMPK via metformin). These approaches define novel therapeutic targets but require further investigation before application in human colorectal cancer.
Last updated: 2026-09-27. Summaries are based on the published abstracts; letters without an abstract are described in general terms.