[Clinical and therapeutic aspects in surgery-related septic shock].
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Biomedical subjects
Publications and source records attributed to C Dolinescu.
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Out of a group of 361 patients with various anatomo-clinical forms of hyperthyroidia--of which 328 had underwent surgery--hospitalized in the Surgical Clinic from Jassy between 1965 and 1974, a total of 17 observations are analised, from the clinical and the therapeutical viewpoint, that showed postoperative thyreotoxicosis crisis. The fact is stressed that the prophylaxis of the crisis is dominated by the principle that no case of hyperthyroidia should be operated on before it has been perfectly balanced from the endocrinological viewpoint. The complex treatment of the cases that are presented included a symptomatic component to which were associated oxygen therapy, tonics, vitamins, hepatotrop preparations, eventually antibiotics. The results obtained--complete recovery in all the cases--can be compared with the best from the literature.
In a total of 448 hydatic cysts that have been treated in the I-st Surgery Clinic of Jassy between 1947 and 1977 rare localizations were noted in 61 cases. Of these 47 were primary echinococcoses and 14 were secondary. The clinical and therapeutic aspects are discussed for each particular localization: the splenic localization was encountered in 16 cases, the peritoneal one in 10 cases, the diaphragmatic in 6 cases. There were also 2 renal localizations, 3 retro-peritoneal ones, 3 ovarian and salpyngean localizations, 3 thyroid, 7 endo-thoracic but extra-pulmonary, 5 muscular and 6 subcutaneous localizations. Radical surgery had immediate and late results that were quite satisfactory. No deaths or recidives were noted.
One hundred twenty-two benign tumors of subdiaphragmatic digestive tract admitted in the interval 1975-1988 at the III-rd Surgical Clinic of Iaşi are reported. Out of these patients 120 required surgical treatment, the remainder of 2 being treated conservatively (diffuse intestinal angiomatosis, Peutz-Jeghers' syndrome). The clinical evolution being atypical, the surgical intervention was required, in most of the cases, due to hemorrhagic and occlusive complications. Histologically, the polyps and schwannomas were prevalent. The diagnostic difficulties, especially in the cases with jejuno-ileal localization, are mentioned.
This paper is part of a comprehensive study on subphrenic digestive cancer carried out between 1984 and 1988, representing the experience of the III-rd, I-st, IV-th and emergency surgical clinics of Iaşi (1530 cases). The peculiarities of gastric cancer with antral site in 231 out of a total of 612 cases, representing the experience of the III-rd Surgical Clinic, are presented. Clinically, the relative early occurrence of the symptoms, the need for an endoscopic examination and biopsy for all gastric ulcer lesions, for the antral ones particularly, are mentioned. The treatment is surgical, but it has to be associated with adjuvant therapy. For the antral site, the oncological subtotal gastrectomy was the surgery of choice (157 cases), the need of restoring the transit in a gastrojejunal manner being underlined. Total gastrectomy was performed in 12 cases.
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This paper deals with the outcome of the various "antireflux" surgical procedures performed in 21 patients having esophagitis. Immediate and long-lasting results are better for those methods which restore the gastroesophageal competence: Hill's operation (4) and Nissen's fundoplication (3). The participation of the stomach in producing reflux is stressed and is emphasized the necessity to treat the gastric lesions simultaneously. The duodenal diversion following Harrington procedure offers good results with minimal surgical risk in some particular cases.
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