Biomedical subjects
S Georgescu
Publications and source records attributed to S Georgescu.
[Computed tomography in exploring hepatopancreatic lesions].
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[Retroperitoneal hemangiopericytoma].
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[Incidence of chronic suppurative otomastoid complications at the Colţea ENT Clinic in 1976-1980].
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[The place and value of computerized tomography in the study of tumor masses in children].
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[Cervicomediastinal and thoracic goiters].
Between 1950 and 1979 approximately 2400 patients with thyropathies have been operated in the I-st Surgical Clinic of Jassy. Of these 100 had cervico-mediastinal goiters, of which 79 were of the plunging cervico-mediastinal type, 18 were of the mediastino-cervical type and 3 were mediastinal goiters. The surgical treatment was applied in 98 patients, cervicotomy being sufficient to relieve the symptoms in 92 of the cases. The mixed approach (cervicosternotomy, or cervico-thoracic approach) were necessary in 5 cases, and the thoracic approach was selected in one case with an independent posterior mediastinal goiter. The immediate postoperative evolution, as well as the late evolution was good in most of the cases. Postoperative mortality was of 2 percent.
[Postoperative peptic ulcer. The experience of the 1st Surgical Clinic of Iaşi].
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[Lipomas of the small intestine and colon].
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[Splenic artery aneurysms. Considerations on 2 cases].
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[The cardiac manifestations in hyperthyroidism. The surgical implications].
In a statistics including 954 patients with hyperthyroidism [correction of Huprotoncoses] treated between 1966-1989, the authors found 522 cases (54) with various associated cardiac disorders. Of these cases, 199 presented rhythm disturbances: extrasystolic arrhythmia, auricular fibrillation and flutter to which 34 postoperative arrhythmias are added. Cardiac insufficiency present in 46 cases was the main complication and end point of the various myocardial conditions. Ischemic cardiopathy (181 cases), arterial hypertension (98 cases) and rheumatic valvulopathies (9 cases), either isolated or dominating the clinical picture, complete the nosological spectrum of these disturbances. The frequency of associated conditions and the absence of some specific morphologic lesions suggest that thyrotoxicosis is rather an aggravating factor although in many cases the presence of a previous cardiac disease is excluded. The two objectives in the management of thyrocardiac diseases are the amelioration of cardiac condition and an endocrine balance. In the conditions of a careful selection and preoperative preparation, surgery gave good results consisting, in this series, in over 70% cures and ameliorations.
[Mechanical anastomoses in esophagogastric surgery for malignant tumors].
The authors present their experience in employing for the first time the mechanical circular suture with I.L.S. stapler in the surgery of 10 malignant esophagogastric tumors sited in C (4 cases) and M areas (6 cases). The disease was in stage II in 2 patients and in stage III in the remainder of 4. Three upper polar esophagogastrectomies (Akiyama technique) and 7 total gastrectomies were performed in old patients (mean age 63 years) at high surgical risk. Neither death nor fistulas were recorded. The average hospital stay was 14 days. A series of 17 patients (mean age 59 years), at medium surgical risk, with total gastrectomy for gastric carcinoma and classical suture served as controls. Five fistulas, two deaths and a two times longer hospital stay were recorded. Although the high cost of staplers prohibits the routine use of this technique, the authors demonstrate the great advantages resulting from mechanical suture in esophagogastric surgery.
[Laparoscopic esophagomyotomy in cardial achalasia].
Two patients underwent a transabdominal laparoscopic Heller myotomy for achalasia. All patients had barium esophagograms. preoperative endoscopy, esophageal manometry. There were no surgical morbidity and the average hospital stay was 5 days. Excellent result was reported by one patients and good result by one. Laparoscopic Heller myotomy is a safe and effective treatment for achalasia.
[The value of laparoscopic cholecystectomy in the treatment of gallbladder pathologies].
We have prospectively studied all cholecystectomies performed in one year in our clinic in two groups: 190 cases performed laparoscopically and 98 open. We used standardized records and the EPI 5 program on an IBM compatible computer. There were no significant differences between groups regarding weight, sex and proportion of cases with acute cholecystitis. There were however major differences regarding age, type of habitat, ASA score and association with acute pancreatitis, obstructive jaundice and angiocholitis. Conversion of laparoscopic cholecystectomy to open procedure was imposed in 17 cases (not included in statistical analysis) due to technical difficulties (12 cases), haemorrhagic accidents (6 cases), injury of the common bile duct (1 case), stones lost in the abdominal cavity (3 cases), local peritonitis (5 cases). Laparoscopic cholecystectomy lasted a mean of 74 minutes. We encountered 3 specific complications: one CBD injury recognized intraoperatively and managed by Kehr's procedure (one CBD injury in the open cholecystectomy group), one small bowel perforation and one of biloma. Mortality averaged 0.5% in the LC group (one case of late postoperative stroke considered not related to the procedure) and 1% in the open cholecystectomy group. The hospital admission period was significantly reduced in the LC group (5 days vs. 12 days). LC appears as a safe procedure with a low complication rate. Conversion to open procedure is not a complication. Our study recommend LC as the method of choice in the treatment of gallbladder lithiasis.
[The surgical treatment of inguinal hernias. The Stoppa operation].
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[The treatment of rectal cancer--the optimizing possibilities].
The authors studies 280 rectal cancers treated in the first surgical clinic of Iaşi in the period 1981-1994. Although surgery is the main treatment of these tumors, it cannot be and it must be not used alone. Surgery must be associated with radio- and chemotherapy, because is the only way possible to increase the number of resections for rectal tumors and the survival rate. For the 263 tumors operated the resectability was 73, 5%: Milles's operation 101 (36, 7%), Dixon's operation 81 (30, 79%), other operation 91 (33, 11%). We consider that Dixon's operation is the best choice for the tumors in the stages A and B of Dukes classifications. Preoperative radiotherapy can influence the tumor volume (downstaging) and decrease local recurrences to about 10-15%. Surgery alone must be practiced only in emergencies. Postoperative chemotherapy is mandatory and it reduces local recurrences and delays metastasis evolution.
[Repeat hepatic resections].
Five cases of iterative liver resections are presented, out of a total of 150 hepatectomies performed between 1.01.1995-1.01.1998. The resections were carried out for recurrent adenoma (one case), cholangiocarcinoma (two cases), hepatocellular carcinoma (one case), colo-rectal cancer metastasis (one case). Only cases with at least one major hepatic resection were included. Re-resections were more difficult than the primary resection due, first of all, to the modified vascular anatomy. Intraoperative ultrasound permitted localization of intrahepatic recurrences. Iterative liver resection appears to be the best therapeutical choice for patients with recurrent liver tumors.