PubMed Health⌕ Search

Biomedical subjects

D Mogoş

Publications and source records attributed to D Mogoş.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Thoracic esophageal neoplasm-therapeutical problems and post-surgery evolution].

The authors are presenting a few considerations on Thoracic Esophageal Neoplasm, as resulted from an 18-cases study performed on patients that were operated between 1994-1999. The esophageal resection rate was of 50%, as follows: 7 Esophageal Resections and 2 Superior Polar Esogastric Resections. The digestive transit was reestablished by means of intrathoracic transposition of the stomach (6 cases) or of the right ileo-colon (2 cases). In one of the cases an Esogastric Anastomosis was performed at the neck level (cervical-right). Immediate post-op mortality after Esophageal Resection (1 case) was due to an acute respiratory distress syndrome (ARDS). The post-op complications were as follow: one anastomotic fistula associated with a purulent pleurisy, 4 non-infectious pulmonary complications and 2 cardiac complications (paroxysmal supraventricular tachycardia). The Discussions and Conclusions of the present work are presenting samples of surgical techniques, post-op complications and prognosis.

Aged↗
PubMedDate not supplied

[Analysis of various gastric carcinoma classification systems, through the prism of a study performed at Craiova IV surgery clinic].

INTRODUCTION: The aim of this work is to analyze the various gastric carcinoma classification systems, trying, at the same time, to establish connections between the anatomopathologic evolutionary and prognostic aspects. CASE MATERIAL AND METHODS: The study was performed on a series of 66 patients who undergone excision surgery for gastric carcinoma. The study material are 31 cases of gastric cancer diagnosed in Clinical Hospital CFR Craiova, and another 35 cases diagnosed at the "I.V. Babeş" Pathology and Medical Genetics Institute in Bucharest. The excised pieces underwent anatomopathological investigation using histopathological, histochemical and immunohistochemical methods. RESULTS: From the macroscopic point of view, the most common tumor pattern was Bormann 2 ulcerovegetative, targeting patients over 60 years of age. In what the invasion level is concerned, most carcinomas were sanctioned at the time when the tumor was invading the serous fluid (pT3) or even the perigastric tissue (pT4). The microscopic criteria was approached by us using Goseky's method, the most common being Goseky stages 2 and 4, in equal rations. The distribution of cases depending on the OMS differentiation degree, shows a preeminence of low differentiated carcinomas (G3). CONCLUSIONS: The abundance of classification methods in gastric cancer shows the complexity of the matter but none of the classifications is perfect.

Carcinoma↗
PubMedDate not supplied

[The primitive gastric non- Hodgkin lymphoma].

THE PURPOSE: Of this work is to point out diagnostic problems together with the surgical indications in primitive gastric non-Hodgkin Lymphoma (LGNH). THE MATERIAL AND METHODS: Consist of 11 cases of LGNH (3.09% of 350 gastric cancers that underwent surgery between 1991-2000) of which 4 were women and 5 men, of an average 53 years of age. Three of the cases underwent surgery for various complications (HDS, perforation and pyloric stenosis) or for other clinical forms such as the pseudo-ulcerative one (4 cases) and the gastric carcinoma mimicking form (4 cases). Preoperative diagnosis was established by means of endobiopsy in 5 cases. SURGICAL TREATMENT: total gastrectomy (4 cases), inferior polar subtotal gastrectomy (5 cases) and 2/3 gastric resection (2 cases). RESULTS: Complications involving sub-phrenic abscess that triggered re-intervention in 2 cases; no immediately postoperative mortality. THE DISCUSSIONS AND CONCLUSIONS: Are enumerating the difficulties we encountered in diagnosing the cases and especially in the preoperative histologic diagnosis, the staging of the disease and setting the treatment with an emphasis on the surgical treatment. THE COMPLICATIONS: Induced by the disease, the diagnosis uncertainty and the early stages of the disease are as many eligible indications for the first linje surgical treatment in LGNH.

Adolescent↗
PubMedDate not supplied

[Microbiology of nosocomial infections in a general surgery department].

This paper aim is to outline the importance of nosocomial infections, characterized by great incidence, great mortality rate and specific bacteriology, in a surgery clinic. The study include 566 patients that developed 665 nosocomial infections (10.65% incidence), among the 5950 patients that underwent surgical operations in 5 years (1992-1996); 54 patients developed two or three nosocomial infections, which explain the incidence of nosocomial infection greater than number of patients. From bacteriological point of view predominance of Gram negative bacilli (especially E. coli) and pathogen staphylococcus characterized the nosocomial infections. The infection source was the patient himself, previously colonized with hospital specific microorganisms. Every clinical form of nosocomial infections was characterized by the present of specific pathogen microorganisms; the knowledge of these pathogen agents is very important for the antibiotic treatment applied before the bacteriological exam.

Cross Infection↗
PubMedDate not supplied

[Causes of failure in the treatment of postoperative peritonitis].

The authors analyze a group of 49 postoperative peritonitis, which represent 0.57% of a total of 8550 surgical interventions performed over the last 7 years and 1.19% of 4100 laparotomies carried out in an elective operation orientated general surgery department. The mortality rate was 28.57% (14 patients) among the 49 studied cases, which represents 25% of all deaths recorded in our department over the same time interval. A full account on postoperative peritonitis vital prognostic factors is given, insisting on: specific bacteriology (nosocomial infections), peculiar etiologies (10 out of 14 fatalities were originally operated on for digestive cancers), different associations of postoperative peritonitis with other infectious and noninfectious postsurgical complications (as encountered in all 14 deaths), type of postoperative peritonitis (13 death out of 14 were due to generalized peritonitis), postoperative peritonitis secondary to ignored lesions at the original operation (3 cases--3 deaths), surgical treatment limitation (late operative timing which was responsible of 9 deaths); treatment inadequacies of peritonitis and its cause--5 fatalities.

Adult↗
PubMedDate not supplied

[Tuberculous perforation of the small bowel].

The authors present their experience with two cases of acute peritonitis scattered characteristic lesions were secondary to the tuberculous of the bowel. It is noteworthy, as far as these two cases are concerned, the rarity of intestinal tuberculous fistulation occurrence in addition to the peculiarity of both their preoperative course with its related diagnostic and operative timing difficulties and their postsurgical recurrent perforation complicated evolution. This article also pin-points the special management problems due to the gravity of these cases.

Adult↗
PubMedDate not supplied

[Esophagoplasty with right ileocolon, technical problems].

The authors present their experience with 14 cases of esophagoplasty by right ileocolon interposition which were performed to re-establish the digestive continuity in 12 patients operated on for caustic burns induced esophageal strictures and 2 patients with esophageal neoplasm managed by esophagectomy. The current study aims to pin/point both the anastomotic risk and the technical difficulties related to the colon interposition graft anatomic trajectory and vascular supply. Given the utmost importance of both the preoperative correction of the nutritional deficit and the improvement of pulmonary function the authors suggest that esophagoplasty should bu preceded by a "preoperative intervention", consisting of ileocolic artery ligation, gastrostomy and pleural drainage. The acute respiratory failure was the immediate main threat following esophagoplasty, whereas cervical anastomotic breakdown was the complication which dominated the early postoperative period in terms of frequency and gravity, but the death rate was nil. When esophagoplasty by right ileocolon interposition simplicity and efficacy are taken into account it appears as the surgical therapy of choice whenever the local and general status of the patients allows it.

Adolescent↗
PubMedDate not supplied

[Breast conserving surgery --7 years of experience].

The breast cancer treatment is based nowadays on a new surgical option: breast-conserving surgery, which is reliable at least for the first and second stage of cancer, with radical intention, obviously. We have started to practice the breast-conserving surgery in our surgical clinic (at CFR Hospital, from Craiova) for 7 years; until now we have performed 159 breast-conserving operation and, as results, we have recorded 3 local recurrences (2.12%) and 1 death due to cancer evolution. Our protocol includes removal of the primary tumor with enough surrounding tissue to ensure negative margins of resectable specimen, associated with total axillary lymph-node dissection and postoperative breast irradiation. Our oncologist on different postoperative conditions indicated the chemotherapy: tumor size, axillary lymph node involvement, patient age, etc. The purpose of this paper is to emphasize our unassuming experience but especially to draw attention on important results, obtained by long-term monitoring the patient who underwent breast-conserving surgery, in a two prospective protocols, which demonstrate the importance and applicability of breast-conserving therapy. The conclusion of this study is that breast-conserving surgery followed by breast irradiation is reliable, as the results are similar with the radical mastectomies; the main objective is to obtain a good cosmetic result, which depends on tumor size/size of the breast ratio.

Adult↗
PubMedDate not supplied

[Tumour-host interaction and prognosis in patients with gastric cancer].

The study analyzed the prognostic significance of a group of three histologic markers belonging to intra- and peritumorous stroma as derived from a series of 66 patients with gastric adenocarcinoma operated upon in Craiova CFR General Surgery Clinic. To this end we attempted to uncover any possible correlation between the three stromal parameters represented by type of angiogenesis, peritumorous inflammatory infiltrate and desmoplastic reaction and both the depth of malignant invasion through the gastric wall and the histologic type of gastric cancer. The results of our investigation highlighted that type A2 angiogenesis is displayed mostly by gastric carcinomas with well-differentiated tubular and secretory structure (class 2 Goseky) whereas type A3, angiogenesis is mainly a feature of gastric cancer with a poorly-differentiated tubular morphology (classes 3 and 4 Goseky). Moreover there was no statistically significant correlation between the intensity of inflammatory infiltrate and both the Goseky classes and the depth of neoplastic spread. Finally a clearly desmoplastic reaction was encountered in less than 50% of our patient series and represented almost a characteristic of both poorly-differentiated tubular structured malignancies and serosa invading tumors.

Adenocarcinoma↗
PubMedDate not supplied

[Functional secondary megaduodenum].

This paper aim is to present the case of a 72 year old male, diagnosed with functional secondary megaduodenum. We intend to discuss the pathogenic and positive diagnostic difficulties (the presence or absence of a mechanical obstructive factor or the participated of the megaduodenum in an intestinal pseudo-obstruction syndrome). Also we outline the rare frequency of this disease and especially the therapeutic difficulties: inefficiency of conservatory treatment, delicate problems of surgical tactics and technique.

Aged↗
PubMedDate not supplied

[Clinical course of an ileal carcinoid with mesenteric metastasis].

This paper aim is to present the case of a male patient, age 63 admitted in hospital for non-specific gastroenterologic symptoms easily attributed to colecyst calculosis; the anamnesis and careful clinical examination have avoided a useless cholecystectomy and permitted to establish indication for laparotomy; during that was found an ileal tumor with massive metastasis in the base of mesentery. The surgical attitude was dictated by histological diagnostic difficulties (prostate adenocarcinoma metastasis), so it has given up the idea of tumor excision (unjustified intraoperative risk for a metastasis), performing a bypass of the ileal tumor by an enteroenterostomy, then the patient was sent to the Oncological Department. Postoperative evaluation of the patient finally permitted to establish the neuroendocrine origin of the tumor; after oncological treatment (chemotherapy), about 10 months after operation the patient didn't present any sign of tumor (tumor markers and CT scan within normal). The paper emphasizes the problem of practicing an aggressive surgical treatment for carcinoid intestinal tumors with mesenteric metastasis but also brings attention to nonsymptomatic forms of cholecyst calculosis that may hide associated malignant tumors undetected by laparoscopic cholecystectomy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Locoregionally advanced rectosigmoid cancer: diagnosis, surgical approach, late results].

The colorectal cancer continues to be diagnosed in advanced stages in our country, mainly due to unapplying of a programmer of active diagnosis through screening on the population with risk for colorectal cancer, and inefficiency of primary care system. In the department of General Surgery CFR Craiova Hospital between 1991-2001 were operated a number of 231 patients with colon cancer and 104 patients with rectal cancer. The results, showing an increased number of recurrences in cases of resection performed for advanced loco-regional tumors of rectosigmoid, made us to reconsider the attitude of avoiding the abdominoperineal resection even when the distance between the inferior limits of the tumors and the anal edge exceeded the distance considered being standard for a low anastomosis performing. The follow-up of the patients with paraclinic technique that didn't prove efficient led in the most cases to a delaying in diagnosis of local recurrences until the moment of resectability was exceeded. The applying of efficient methods in early diagnosis of colorectal cancer and follow-up could provide in the future better results for anterior resections with low anastomosis.

Adolescent↗
PubMedDate not supplied

[Ovarian cancer--diagnostic dilemmas and unusual therapeutic response].

The aims of this paper are both to highlight some dilemmas concerning the diagnosis of primary epithelial ovarian carcinoma mainly in its early stages and to underline the capricious responses of this type of malignancy to an otherwise well coded modern management. This study is based on the analysis of the records of 78 patients with ovarian carcinoma admitted for diagnosis and surgical treatment to the Department of General Surgery of Craiova C.F.R. Clinic from 1993 through 2003. The results of this analysis are difficult to interpret due to loss to follow up (in terms of response rates) of some of our 78 operated on ovarian carcinoma patients who went on with their platinum-based chemotherapy (following surgical cytoreduction) under the supervision of different Oncology Departments nationwide. Nevertheless, it is worth mentioning that most of this study patients (71.9%) presented with advanced-stage (III and IV) ovarian carcinoma which sometimes seemed quite confusing by its clinical polymorphism but its prognosis was very much related to both the degree of surgical cytoreduction accomplished and tumor sensitivity to chemotherapy. Finally, although this study does not allow us to draw firm conclusions it is an attempt to share out our current perception on the primary epithelial ovarian cancer management.

Adult↗
PubMedDate not supplied

[False surgical acute abdomen with intermittent acute porphyria].

This article presents a case of acute intermittent porphyria admitted to the Surgery Department of C.F. Craiova Hospital between 18.08.2003-26.08.2003 then transferred to the Colentina Hospital in Bucharest for diagnosis confirmation and adequate treatment. The purpose of this paper is to bring attention on a rare metabolic inherited disease that, due to its non-specific and often noisy symptoms and limited possibilities of biochemical, enzymatic and genetic diagnosis, could generate potential serious confusions. The presentes case illustrates the fact that sometimes the acute attack may be mistaken for an acute surgical affection which requires an emergency operation with all the aggravating consequences and delay in the real diagnosis. About 1% of acute attacks of porphyria may be fatal. Only the drugs known as safe should be prescribed. Basic treatment consists in oral and intravenous glucose and hematin administration.

Abdomen, Acute↗
PubMedDate not supplied

[Primary retroperitoneal tumors--diagnostic and therapeutic difficulties].

This paper emphasizes the diagnosis and therapeutic difficulties in primary retroperitoneal tumors. There were analyzed 68 primary retroperitoneal tumors (1992-2002): 16 (23.5%) benign tumors, 39 (57.35%) malignant tumors and 13 tumors with unknown histological structure. The preoperative diagnosis was clinically suggested and confirmed by ultrasound and CT examination; the operability was always established by laparotomy. All cases were operated on: complete resection of tumor was possible in 39 cases (57.35%); partial resection in 11 cases (16.17%) and 18 (26.47%) cases were inoperable. There were 5 major intraoperative vascular lesions: 1 inferior vena cava lesion, 1 superior mesenteric vein lesion, 1 left common iliac vein lesion and 2 lumbar artery lesions. Postoperative mortality was represented by 2 cases. Postoperative complication was represented by 3 postoperative hemorrhages, 2 severe pulmonary infections, 1 postoperative evisceration, 1 postoperative acute pancreatitis and 1 acute myocardial infarction. In conclusion the primary retroperitoneal tumors represent a challenge for all surgeons, especially due to surgical approach difficulties, because of problems in tumors intraoperative exploration and resection and because of difficulties in hemostasis.

Adolescent↗
PubMedDate not supplied

[The mirage of the first lesion (gallstones) and laparoscopic cholecystectomy are able to defer the diagnosis of colon cancer].

The study's aim was to analyze a series of colon cancer cases in which the mirage of the first (clinically most obvious) lesion (gallstones) along with its minimally invasive approach - that explored only the biliary disease - had contributed to the delay of large bowel malignancy' diagnosis and treatment. 1327 patients aged between 17 and 83 years and diagnosed with cholecystolithiasis were operated upon laparoscopically in the Department of General Surgery of Craiova CFR University Hospital from 2000 through 2004. Four out of these 1327 patients (0,3%) were readmitted with the diagnosis of colon carcinoma between 1 and 16 months after the laparoscopic cholecystectomy. Our retrospective study gives a full report on these 4 cases insisting upon the links between their clinical - laboratory evaluations and final diagnosis. Despite the low laparoscopic cholecystectomy overlooked colon cancer' incidence it seems reasonable to both improve the technique of peritoneal cavity exploration during this type of surgery and extend the preoperative evaluation whenever the slightest suspicion of associated pathology is raised especially in patients over 50 years of age.

Adolescent↗
PubMedDate not supplied

[Indications for temporary diversions and for primary resections in emergency colon surgery].

The authors make a critical analysis of indications for temporary derivations, and for "d'emblée" resection in the emergency surgery of the colon. This study is based on a series of 267 cases where emergency surgery was necessary for various conditions of the colon. All were operated in the I-st Clinic of Surgery from Craiova. The authors stress the inefficiency of cecostomy for the solution of occlusions due to neoplasms of the colon, and list the present indications of this type of temporary derivation, which include: protection of a colo-colonic anastomosis, and the solution of perforations (diastatic, traumatic) of the caecum. Supratumoral anus is considered as the choice solution for cancers of the left colon complicated by occlusion. Latero-lateral ileo-transverse anastomosis is considered as a temporary derivation, and is indicated in tumours of the right colon also complicated by occlusion. In cases of emergency the authors practice colonic resections by necessity, but they also perform colonic exeresis with relative indications. In cases of colonic resections by necessity the problem is mainly the opportunity of recovery of the digestive transit. Emergency colectomies with relative indications concern colonic cancer, or volvulus of the colon, and particular conditions are necessary for their performance. The authors consider the protection of colo-colonic, or recto-colic anastomoses as useful.

Anastomosis, Surgical↗