PubMed Health⌕ Search

Biomedical subjects

I Stratan

Publications and source records attributed to I Stratan.

At least 19 recordsLinked to original sources

[Laparoscopic cholecystectomy in acute cholecystitis].

Contrary to earlier opinions, the laparoscopic cholecystectomy (LC) is not a contraindication in the acute cholecystitis. The most important parameter in determining the feasibility of attempting laparoscopic cholecystectomy in the setting of acute inflammation appears to be the experience of the surgeon. 59 cases with LC are analyzed: 50 LC and 9 conversion. The operations were more difficult and lasted longer. The patients appeared to be at a greater intraoperative risk and the conversion rate was also higher. Neither lesions of the common bile duct nor deaths were recorded. The advantages of the method (the hospital stay was reduced, less postoperative pain, and early return to normal activities) should not make the surgeon disregard the risks and stubbornly employ LC in acute cholecystitis.

Acute Disease↗

[Minimally invasive treatment of pulmonary and pleural hydatid cyst].

The incidence of hydatid disease is increased in Balkan region and Eastern Europe. The global incidence in Romania is 5-6 cases of 100,000 populations. The etiological agent is Taenia echinococcus. The pulmonary localization is about 30% from all cases with hydatic disease. The only efficient treatment is represented by surgical intervention with minimal visceral and parietal destruction. We will present 4 cases with pulmonary and pleural hydatic cysts that were treated with minimally invasive techniques. New minimally invasive approaches are developed to reduce physical discomfort, to offer a better intraoperative visibility, for the esthetic aspect of incisions, shorten hospitalization and quick socio-professional reintegration. The mean duration of hospitalization in these 4 cases was 8.5 days (limits between 7-12 days). The rate of complication and the necessary of analgesics were reduced. The medical treatment with Albendazole 10 mg/kg/day, 14 days in preoperative and 3 months postoperative period was followed in all patients. After discharge, imaging evaluation in the first 24 months is very important. The obtained results were excellent and we conclude that minimally invasive surgery in pulmonary hydatid disease represent a better method of surgical treatment.

Adult↗

[Surgical treatment of hepatocellular carcinoma--indications, limitations, realities].

The present study analyzes the importance of the factors in improving the resectability, obtaining morbidity and mortality rates in accordance to the actual exigencies. In The III-rd Surgical Clinic, "Sf.Spiridon" Hospital, Iaşi, during 1998-2003, 24 cases of CHC (19 men, 5 women with a median age of 58.5 years), usually developed on a cirrhotic liver, benefited by surgical approach. The tumoral mass (median size 7.8 cm) was situated in the left liver (15 cases--62.5%), right liver--13 cases and for 1 case with multiple localization (the segments VI-VII and III). For 12 cases (50%) various extensions of liver resections have been undergone: left lobectomies II-III--4 cases, left hepatectomy--1 case, segmentectomies VI--3 cases, segmentectomy III + bisegmentectomy VI-III--1 case, atypical hepatectomy--3 cases. Only 2 cases benefited by right portal vein ligation prior to resection. In 12 cases intraoperative exploration and US examination (4 cases) contraindicated the resection. One patient deceased on the entire lot (4.16%); post-resection mortality--8.33%. In conclusion, the early diagnostic of CHC developed on cirrhotic liver, the patients selection, the use of laparoscopy and intraoperative US, the available devices (CUSA dissector), selective ligation of portal branch prior to resection represents imperative elements in improving the resectability in safe conditions for the patient.

Adult↗

Effects of ceruletide on post-operative intestinal atony: a manometric study.

The effects of ceruletide on jejunal motor activity were studied in seven patients with postoperative intestinal atony. Jejunal pressures were recorded by three perfused catheters with orifices spaced 5 cm apart, the proximal one being positioned 10 cm beyond the ligament of Treitz. Ceruletide (0.05 microgram/Kg i.v.) significantly (p less than 0.0001) increased the number and amplitude of jejunal contractions. The action of ceruletide was most obvious the first 15-minutes after administration, then its effect diminished progressively and ceased after 65-75 minutes. The adverse reactions of ceruletide were minimal and self-limiting.

Adult↗