[Progressive interstitial calcinosis. Considerations on a clinical case].
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Adult↗
Biomedical subjects
S Simion
Publications and source records attributed to S Simion.
[Late results after the Mark Belsey IV antireflux procedure in achalasia].
Cardial achalasia (cardiospasm, megaesophagus) represents the failure or lack of relaxation capacity of the inferior esophageal sphincter; it is the second esophageal disease and is considered a premalignant lesion. Treatment of achalasia is surgical but palliative, considering the lack of an etiopathogenic therapy for this moment. We present a retrospective study done on 19 patients (10 males and 9 females, with a mean age of 49 years) operated in "Colentina" Surgical Clinic in the period of 1996-1999 for achalasia (presenting symptoms-dysphagia, regurgitation, weight loss) by extramucosal esocardiomyotomy practiced on a length of 5-10 cm, by thoracic approach, followed by the Mark Belsey IV antireflux procedure. Results were good, without reflux pathology or dysphagia in the postoperative evolution.
Adult↗
[Pancreatic insulinomas].
In the period of 1980-1999 (20 years) were operated 18 patients (8 males and 10 females) in "Colentina" Surgical Clinic, the average age being of 45 years, with hystopathologically confirmed insulinomas. The topography of these lesions was in the head of the pancreas (4), in the isthmus (5), in the body and tail (9). The classical clinical and biochemical signs were presented in 13 cases, the rest of the patients presenting atypical signs of disease. These patients had benefit from the surgical treatment. The approach was bi-subcostal in 11 cases and by upper and lower midline incision in the rest of cases. We practiced enucleation in 5 cases, corporeal-caudal pancreatico-splenectomy in 10 cases and cephalic pancreatico-duodenectomy in 3 cases. The malignancy of the tumour was hystopathologically confirmed in 30% of the situations. The postoperative mortality was in 3 cases, by acute pancreatitis, MSOF and myocardial infarction. We consider that in case of these generally benign tumours the most efficient therapy is the surgical one.
Adult↗
[Surgical procedures in penis cancer].
In the period of 1980-1999 (20 years) in Colentina Surgical Clinic were admitted and operated 16 patients with the diagnosis of pennial cancer (histopathology--squamocellular carcinoma), 13 of whom being from Colentina Dermatological Clinic. The mean age was about 64 years old, 10 cases presenting phimosis. Surgical procedures undergone were represented by partial pennial amputation with bilateral superficial inguinal lymphadenectomy (10 cases), total pennial amputation with superficial inguinal lymphadenectomy (4 cases), respectively emasculation with bilateral inguinal-iliopelvic lymphadenectomy (2 cases). In the postoperative period 3 patients presented lymphedema and lymphorrhagia, solved by conservative management. All the patients benefited of favorable evolution on the period they have responded to the controlled postoperative follow up (1-3 years).
Adult↗
[Sugiura's procedure--a treatment modality for esophageal varices].
This study present the "N. Gh. Lupu" surgical experience with Sugiura technic for bleeding caused by oesophageal varicose. Is a 5 years retrospective study with 30 patients who are submitted of this operation. After the results analysis our opinion is to do this operation in stabilised patient, but she is possible even in emergency.
Digestive System Surgical Procedures↗
[Therapeutical options in pancreatic pseudocysts].
This paper presents the "N.Gh.Lupu" surgical clinic's experience, that consists in 65 cases of pancreatic pseudocysts operated in the last 10 years (1989-1998), 30 females and 35 males, with a mean age of 52 years old. The diagnosis was mainly based on the classical echography and CT-scanner, the clinical picture being non specific in the majority of cases. Although the predominant use of the nonsurgical interventional procedures is recommended, this presents the maiden attempts of the authors in this field, the surgical techniques used being as it follows: cephalic pancreaticoduodenectomy, distal pancreatectomy, cystodigestive anastomosis, external drainage. The perioperative mortality was null, the postoperative one consisting in 3 cases (2 cases in the early period and 1 case in the later period).
Adult↗
[Surgical treatment of pelvic subperitoneal tumors].
In the last 5 years in our hospital was operated 25 patients with pelvisubperitoneal tumors. Major clinical symptoms are compression and body mass effect. The localization and tumors dimensions, are established by CT and RMI. Surgical resection, difficult by the relations with iliac vessels and nerves, was do it in sub capsular manners and followed by chemo and radiotherapy. Our results are good, with 6 patients who passed 4 years postoperatively.
Female↗
[One case of multiple abdominal hydatidosis].
It is presented the case of a 45 years old female patient transferred in our clinic from Parasitology Clinic with the diagnosis of hepato-splenic hydatidosis. Preoperative echography presented 3 abdominal hydatid cysts (hepatic, splenic and free in the peritoneal cavity--greater omentum). Intraoperative exam confirmed the preoperative evaluation. The operation consisted in two ideal cystectomies associated with one partial cystectomy with evacuation and drainage. Postoperative evolution was simple.
Echinococcosis↗
[Therapeutic options in gallstone ileus].
Gallstone ileus is a rare, serious condition, requiring emergency surgery, specific to elderly age. The present study deals with 16 cases operated in 25 years period, with median age about 64 years old. The patients had clinical evidence of intestinal obstruction, confirmed by radiological examination and ultrasonography. Emergency operations were performed. In 7 cases had been treated radically both the obstruction (entero-lithotomy) and the bilio-digestive fistula (cholecystectomy, duodenal closure, enteral closure, colon-suture) with good results (only one death). In 9 cases, it had been treated only the intestinal obstruction, with only 2 cases of persistent cholangitis. Generally, we have used biliary drainage with Kehr tube in the presence of biliary stones and cholangitis. The biliodigestive fistula may close in evolution or become a harmless secondary route for internal biliary drainage.
Aged↗
[Cancer of the head of pancreas--resection vs. palliative surgery].
Pancreatic cancer remains a disease with high mortality. The unspecific symptoms for a long time make the diagnostic difficult. Between 1995-2004, only 85 from 465 patients with this diagnosis, had pancreatic resection. To them, we performed Whipple pancreaticoduodenectomy (60), pylorus preserving pancreaticoduodenectomy (15), pancreatico-duodenectomy with preserving of duodenum (2), pancreaticoduodenectomy with associated resections (5), subtotal pancreatico-duodenectomy (30). The reconstruction after pancreatic resection was pancreatico-jejuno anastomosis (26) and pancreatico-gastro-anastomosis (59). Morbidity was about 34% and the mortality was about 9%.
Adult↗
[Transtumoral drilling--an efficient solution and in many cases the only one available in the surgical treatment of Klatskin tumors].
PURPOSE: Reviewing the cases and evaluate the efficacity of the trans-tumoral drilling in the Klatskin tumours which were operated in Colentina Surgical Department. MATERIAL AND METHOD: This is a clinical retrospective study on 109 cases of Klatskin tumours operated between 1998-2004. in 80 cases of them we could practice a biliary drainage using a trans-tumoral drilling. SURGICAL INDICATION: Malignant tumours of the main biliary duct developed at the level and above the junction of the two hepatic ducts , extended to the liver in many cases. SURGICAL TECHNIQUE: Through the choledochostomy, we performed with a special instrument the trans-tumoral drilling with the setting of a biliary axial drainage (40 cases), external biliary drainage through a semirigid trans-choledochal tube (25 cases), Kehr tube (9 cases), U tube (3 cases), internal drainage with intra-choledochal stent (2 cases), lost tube (1 case). RESULTS: In all cases we observed the early decrease of the jaundice. In the cases in which we used internal drainage, we had to perform a replacement of the closed tubes in 1-2 months after the first operation. Instead, the external biliary drainage, less expensive and periodically washed to preserve his permeability, proved his high efficiency. The average survival time was 8,9 months (between 5-20 months). CONCLUSIONS: The external biliary drainage through trans-tumoral drilling remains in many cases the only one available therapeutical solution for the Klatskin tumours.
Aged↗
[Surgical treatment in liver metastases of colorectal cancer].
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Colorectal Neoplasms↗
["Combined treatment" in the liver metastases of colorectal cancer].
Patients with liver metastasis after colo-rectal cancers are, from the point of une of their disease evolution in the final stadium (the IV th. stadium). Hence, we consider the attempt for liver metastasis treatment, as being desperate experiments to extend the patient's life, taking high risks and having chances of immediate failure. Since 1995 me've started a study about patients operated for colo-rectal cancers that will stand transarterial chemoembolization of their hepatic metastasis, 2-4 weeks before the surgical intervention for hepatectomy. We expose 17 cases to which we performed such a combined therapy, between 1995-1997. We had to postoperative death after major hepatectomies. The other patients are survived by our clinics.
Chemoembolization, Therapeutic↗
[The indications for and limits to the surgical treatment of congenital dilatations of the intra- and extrahepatic bile ducts].
Congenital cystic dilatations of the biliary ducts are defects in the genetic program which are transmitted in an autosomal recessive way. Todani classified cystic dilatations of extra and intrahepatic ducts in 5 types. In classified cystic dilatations of extra and intrahepatic ducts in 5 types. In "N. Gh. Lupu" Surgical Clinical were treated 9 cases of congenital dilatations of the biliary tree during the last 40 years (1958-1998); five of them were belonging to the type V Todani (Caroli's disease), three to the type I Todani and one case in the type IV a of Todoni's classification. The mean age of the patients was 42.4 years, five of them being men and 4 women. Surgical treatment was particular to each case depending on age, associated diseases, the length of disease's evolution and the general state of the patient. The prognosis of this disease is a reserved one.
Adolescent↗