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S Voiculescu

Publications and source records attributed to S Voiculescu.

At least 19 recordsLinked to original sources
PubMed1996

[Acute nonbiliary and nontraumatic pancreatitis. The diagnostic and treatment characteristics].

Deeper knowledge of the etiopathogenesis of acute pancreatitis and the possibility to estimate the extend and gravity of pancreatic and peripancreatic lesions determined essential fluctuations in treatment evolution. Etiology of nonbiliary and nontraumatic A.P. recognises in the first place alcoholism (20-25% of A.P.) and in the second place less common causes such as: hypercalcemic states, hyperlipidemia (about 5-10% of A.P.). Diagnosis of nonbiliary A.P. leans upon: antecedents of chronic alcoholism, alteration on liver function tests and serum put levels and the results of cholecystocholangiography, abdominal ultrasonography and duodenum tubing. These reveal the absence of gallstones, cholesterolosis or anomalies of papilla of Vater (sphincter of Oddi). A number of 128 patients with acute pancreatitis were admitted to the clinic in the period 1984-1994 from which 48 with a non-biliary and non-traumatic. A complex medical treatment was applied to all patients but only 25 responded favourably, the remaining 23 necessitating surgical intervention, which was effected on de-shocked and re-equilibrated patients, diminishing thus the number or repeat interventions in the complications which may appear in such cases. Thus postoperative mortality fell from 58, 33 to 30, 76.

Adult↗
PubMed1995

[Preliminary results after the transperitoneal laparoscopic treatment of the first 50 inguinal hernias].

The authors are presenting the results of first 50 inguinal hernias treated laparoscopically trough the transperitoneal approach (39 men, 11 women, mean age--42,5 years, 44 uncomplicated and 6 epiploon's incarceration). After the dissection of the hernia's pouch, the parietal defect was covered with Prolène meche in 15 cases, with Marlex in 10 cases and Plastex prosthesis in 25 cases, all of them without fixation. The prosthesis itself was covered with the parietal peritoneum in running suture. The immediate postoperative evolution was good, the patients being able to walk soon after being awake, and without any urinary problems (even in elder patients). The patients left the hospital 24-48 hours after surgery. They were followed-up 2 to 10 months, periodically. The results were good, except 4 patients: 1 case with port-site hematoma (in the right lower quadrant, necessitating open surgery). 2 patients with seromas (vulvar and scrotal) in case of section and abandoning the hernial pouch. 1 patient with prosthesis migration with precocious recidive (24 hours after the operation). We consider the transperitoneal approach as very good in the treatment of uncomplicated and not very large hernias. The easiest and safest technic is that using Prolène prosthesis.

Adult↗
PubMed1994

[The different indications for the Roux-en-Y jejunal loop].

On an unitary series of 64 patients with a gastro-jejunal anastomosis, en Y "à la Roux", 24 had the special indications: reconversion of a anastomotic gastro-duodenal or gastro-jejunal fistula, large gastric resection for cancer, postbulbar ulcers, hemorrhage duodenal ulcer associated with diverticula, stump duodenal fistula, desinsertion of Vater papilla, giant pancreatic pseudocysts, inextirpable principal duct tumors, complexes biliary fistula, and central hepatic hydatic cysts. The results were good. On discuss the general and special advantages and the disadvantages of this method.

Adult↗
PubMed1994

[Nonparasitic serous cysts of the liver].

On the occasion of the presentation of four cases of serous hepatic cysts, of non parasitic origin, the authors comment on the rarity of this affection, although in the last time, asymptomatic cases can have a frequency of 1% after screening with ultrasounds and CT Scan. Is presented a series of data concerning the etiopathogenesis, the clinic and the treatment of such cases.

Aged↗
PubMedDate not supplied

[The surgical possibilities in locally advanced gastric cancer (LAGC)].

Most frequently the diagnostic of gastric cancer is established in advanced stages. Practically, was noticed that local evolution advances the appearance of metastases. The authors are presenting 159 cases of locally advanced gastric cancer (LAGC) out of 211 gastric cancers submitted to surgery between 1984-1995. The surgical possibilities in such situation specifically adapted to each case, are discussed. The operation has an important role in appreciating local and regional extension, solving complications and even performing radical resections.

Adult↗
PubMedDate not supplied

[Strategy and tactic in the treatment of local advanced rectal cancer].

In local advanced rectal cancer (LARC) was defined at the work group in rectal cancer as a tumour what invade the serosa or neighbouring organs, associated with invaded perirectal or mezorectal nodes, with internal fistulae, peritoneal carcinomatosis and locoregional recidives. On a trial of 97 patients, the authors present personal experience, in comparison with literature data regarding therapeutic strategy and tactic of parameters: operability and the moment of operation, indication of preoperative radiotherapy, the type of operation, excision of the metastasis, adjuvant therapy and attitude of locoregional recidives. The survival of the patients was 21.6% at 3 years and 15.4% at 5 years.

Adenocarcinoma↗
PubMedDate not supplied

[Analysis of 3100 laparoscopic cholecystectomies].

AIM: To evaluate the results of laparoscopic cholecystectomy (LC) in the 8 years period. PATIENTS AND METHODS: First LC in Coltea Hospital was performed in September 1993 and introduced for treatment of patients with gallbladder disease. From September 1993 to February 2001 LC was performed in 3100 patients. Mean age 51.2 years (ranged from 8 to 87 years) among 2512 women and 588 men. 232 (7.48%) of the cases were patients with acute cholecystitis. Intraoperative cholangiography was performed in 112 cases (3.6%). RESULTS: Conversion to open cholecystectomy (OC) was necessary in 111 patients (3.58%). Operative complications occurred in 16 (0.5%) patients: CBD lesions in 4 (0.12%) patients, bleeding from cystic artery--12 (0.38%) patients. In one patient CBD injuries was recognized at the time of operation and after conversion to OC primary ductal repair was performed. Postoperative complications occurred in 44 (1.41%) patients: a) local infection--in 15 (0.48%) patients (subhepatic abcess-3, wound infection-9. b) bile leakage--in 21 (0.67%) patients. c) haemoperitoneum because of the bleeding: from the abdominal wall at the trocar insertion site--in 2 patients, from a. cystica-one patient. d) obstructive jaundice due to stone in CBD--in 5 patients (endoscopic papillosphincterotomy and stone extraction was performed). There 21 reoperations due to complications: 13 laparatomies and 8 relaparascopies. Two patients (52 and 64 years old) died after LC-mortality 0.06 per cent. Mean hospitalisation day was 3.8. CONCLUSIONS: To prevent iatrogenic CBD injuries correct preparation with a clear identification of the anatomic structures is essential. Relaparascopy and endoscopic retrograde cholangyopancreatography can be successfully used in the treatment of complications after LC.

Adolescent↗
PubMedDate not supplied

[The capacity of preoperative ultrasonography in predicting technical challenges in laparoscopic cholecystectomy].

UNLABELLED: Ultrasonography is a nonsophisticated, cheap and safe exploration, that makes it the most used non-invasive method in the diagnosis of biliary diseases. Present study aims to evaluate preoperative ultrasonography's capacity of predicting technical challanges in laparoscopic cholecystectomy (LC). MATERIAL AND METHOD: The trial is represented by a sequence of 100 patients undergoing LC in 2001. The conversions to open procedure were excluded. Patients with certified lithaisis were re-examined by ultrasonography the day before surgery. The sonographic features as size, volume (scleroatrophic gallbladder), function (distension, contraction), wall thickness, hydrops, number and size of stones, infundibular position (impactation) of the stones, perivesicular liquid collections hepatic and pancreatic aspects, main bile duct caliber were registered. During LC, the difficulty in performing the procedure was measured using a 10 points-score of following parameters: 1 peritoneal and perivesicular adhesions; 2. Difficult grasping of the gallbladder; 3. Cystic duct's dissection; 4. Cystic artery; 5. Liver bed; 6. Difficult cystic stappling; 7. Gallbladder's wall efraction; 8. Need for intraoperative cholangiography; 9. operative bleeding; 10. Operative time. RESULTS: Gallbladder's and the number, the size and infundibular impactation of the stones was significantly associated to ultraoperative difficulties (p < 0.05), the other parameters having not a sensitive influence upon LC procedure. CONCLUSION: Preoperative ultrasonography is able to furnish valuable data in predicting LC challenges.

Biliary Tract Diseases↗
PubMedDate not supplied

[Incidents, accidents and complications in laparoscopic surgery].

Between 1995-1999 in Colţea Surgical Clinic were performed 2498 laparoscopic operations (1957 cholecystectomies, 541 other procedures). The laparoscopic approach consisted in 1 to 6 ports of 5 to 12 mm. Conversional rate was, 176% and reintervention was required in 0.76% of cases. In 4 cases (0.10%) parietal bleeding imposed conversion or early reintervention. Parietal emphysema was not significant in our trial. Wound infection or chondritis occurred in 0.72% of cases; only one patient had to be reoperated. Post-incisional hernia developed in 0.08% of patients. We don't treat patients with cancer by laparoscopic approach, but the 4 patients with unknown neoplasia in our trial didn't develop port metastases. Our trial suggests the real benefit of the laparoscopic approach also concerning parietal morbidity.

Adolescent↗
PubMedDate not supplied

[Considerations on 988 breast cancers].

AIM: Therapy schedule improvement. MATERIAL & METHOD: The study includes 988 patients (which 16 men) with breast cancer who underwent surgery between 1984-1998. Out of them 63.2% were in advanced stages. The patients were divided in 2 homogenous groups: trial A = 520 patients treated between 1984-1991 (in stade: I = 2, II = 240, III = 246, IV = 32) studied retrospectively, and trial B = 468 patients treated between 1992-1998 (in stade I = 3, II = 212, III = 235, IV = 18) studied prospectively. In trial B the complex therapy schedule was improved according to disease's stade, local breast aspect and patient's biological status, straining on neoadjuvant therapy. To the entire group 945 radical mastectomies (95.6%) were performed. Only 628 (63.5%) could be properly followed up. RESULTS: Global 5 years survival rate was 72% (improved from 69% in trial A to 72% in trial B). The survival rate varied according the stage from 100% (stade I), 88% (stade II), to 22% (stade III) and 2% (stade IV). In the advanced states, the local recurrencies at 5 years were of 22% and the methastases of 17%. CONCLUSIONS: The neoadjuvant therapy, selectively applied upon stade and patient improves the 5 year survival rate. Every patient with an advanced breast cancer can benefit of a complex, differentiated and well guided treatment. The adequate operation earn the important role in powering the neoadjuvant and adjuvant therapies. Further results improvement requires restarting the collectivities and high risk persons screening.

Adenocarcinoma↗
PubMedDate not supplied

[The place of conservative surgery in the complex oncologic treatment of breast cancer].

For a long time, breast-conserving surgery has been a subject of great interest and debate. Many researchers have tried to find strict criteria in selecting the patients who can benefit from such a treatment but this remains a goal to achieve in the future. In our surgical department, from 1984 to 2000, 1152 patients were diagnosed with breast cancer. 741 patients (64.1%) had advanced breast cancer and 411 patients (35.6%) were diagnosed in I and II stages. From the patients with early breast cancer only 57 (14.1%) had benefited of conservative surgery combined with adjuvant radiotherapy and chemotherapy. All patients received hormonotherapy. The surgical treatment consisted in a broad sectorectomy and axillary lymphadenectomy in all cases. We present the criteria for selecting patients in our study. The patients were followed for 2-5 years, with a mean period of 48 months and there were no significant differences between the trial with mamectomy and that with conservative surgery. There is presented a brief review of the literature in this field. Our conclusion is that the conservative surgery for breast cancer is a good method, which can be applied for selected patients and with a good follow-up.

Adult↗
PubMedDate not supplied

[Vulvar cancer. The therapeutic aspects].

Even though it has a low frequency (4 - 5%) compared to genital cancers, it has certain biological features represented by the possibility of multicentric localisation what performs on the dystrophic lesions, the presence of the inguinal nodes, the sensibility of the irradiation of the cancer and nodes and the efficacity of the treatment of the treatment of the bleomicine which request many therapeutical problems. Between 1985-1994, in Colţea Surgery Clinic there were operated 13 vulvar carcinoma, in women between 45-69 years old, in stages II (6), III (4) and IV b (3). Primary lesion was on labia major (11), labia minor (1) and posterior fourchette (1). Preoperative radiotherapy was made in 9 patients. At 3 patients, valvar lesion represents the second cancer--in all cases were syndrome neoplasia, after cervix neoplasia (2) or ano-rectal neoplasia (1) which were operated. At histopathological exam all cancers were spinocellular epithelium keratosis in 10, non-keratosis in 2 or trabecular in 1. The surgical treatment was selective and consisted in total vulvectomy (9), vulvectomy with inguinal lymphadenectomy (3) and left colostomy (1) after ano-rectal invasions and intestinal obstruction. The postoperative mortality and complications were zero. Postoperative treatment consisted in radiotherapy in association with chemotherapy 93) or only chemotherapy (8). The survival rates at 3 years (2), 5 years (30, 7 years) (3) and 10 years (2), justify the complex treatment. In conclusion, vulvectomy represents the specific treatment associated with inguinal lymphadenectomy in case of lymph nodes metastasis. Postoperative radiotherapy and postoperative chemotherapy seem to increase the survival rate.

Animals↗
PubMedDate not supplied

[Laparoscopic appendectomy in obese patients. A comparative study with open appendectomy].

The aim of this study is to show the advantages of laparoscopic versus classic appendectomy in obese patients. The trial includes 32 obese patients which underwent laparoscopic surgery for appendicitis in our clinic, compared to a similar trial of patients with open surgery. In both o trials we followed-up the operating time, postoperative pain, hospitalization and social and professional reintegration. We noticed that in laparoscopic appendicectomy patients postoperative pain and hospitalization are reduced, the bowel transit restants rapidly and spontaneously, there are no wound complications and patients recover faster. The disadvantages consisted in longer operative time and higher cost of the laparoscopic operation versus classic appendectomy.

Acute Disease↗
PubMedDate not supplied

[A comparative study of the laparoscopic and classic treatments of inguinal hernias].

AIM: of this study is to compare two similar groups presenting inguinal herniae, one group having laparoscopic herniography and the other having a Bassini or Fruchaud repair. METHOD: Since September 1994, in our department, patients presenting with symptoms of unilateral or bilateral inguinal herniae to our practice were offered the transperitoneal or preperitoneal approach as an alternative of open surgical repair. We considered the first 50 patients operated by laparoscopic technic (35 M and 15 F), age between 22-72 years (group A), and similar group operated by Bassini or Fruchaud technic (group B). All the patients had general anesthesia and perioperative antibiotics. In the group A we used Prolene, Mercilene or Plastex mesh. The following parameters were assessed: 1) operative time from incision to closure: 2) amount and type of analgesia required postoperatively; 3) morbidity related to the procedure; 4) interval before returning to full activity; 5) early recurrence rate; 6) hospital cost. RESULTS: The mean operative time for unilateral herniae in group A was 70 +/- 10 minutes versus 40 +/- 12 minutes in group B. Group A required to return to work was significantly shorter for the patients in group A (7 +/- 3 days) compared with group B patients (25 +/- 10 days). Although no recurrent herniae have yet been found in patients from either group; follow-up was only 2-18 months in the two groups. The cost of hospital care of group A patients exceeded that of group B by approximately 1.7 more. IN CONCLUSION: was consider that although is more expensive, the laparoscopic procedure in treatment of inguinal herniae, has more benefits for the patients.

Adult↗
PubMedDate not supplied

[Diagnostic and treatment problems in primary malignant tumors of the small intestine].

Between 1984-1994, 8 cases of MTSI (7 males and one female, between 24-53 years age) have been operated in our Department, representing 2% from all malignant gastrointestinal tumours. The pain as a result of the obstruction, followed by chronic blood loss with anemia and perforation, (4 patients operated in emergency) were the most frequent symptoms, the tumors being localised on jejunum (3) and ileum (5) with a diameter to 3-15 cm. Lymphatic (4), hepatic (2) and peritoneal (I) metastases were present. We performed a wide resection of the bowel and mesentery, including lymph nodes (in 4 cases with radical intention). Histopathological findings: 4 adenocarcinoma, 3 leiomyosarcoma and a lymphoma. Postoperative treatment was selective and consisted in polychemotherapy (PCT) and cobalt therapy (60Co). There was no postoperative mortality, two local recurrences in 6 month. Survival rate at 5 patients was 32 month. At 5 years were in life 2 leiomyosarcoma and 1 adenocarcinoma and at 7 yrs, 1 leiomyosarcoma and 1 adenocarcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[High obstruction in strangulated diaphragmatic hernia].

Case report of a 57-year-old man, admitted in emergency, because of high occlusion and severe dyspnea. The physical examination and the imagistics explorations established the diagnostic of strangulated left diaphragmatic hernia. After a short re-equilibration, the surgical approach was made by left thoracophrenolaparotomy and on realize the visceral reduction, the treatment of visceral injuries and the plasty of the pretty high diaphragmatic defect with a nylon mesh. The postoperative evolution was difficult, with hemorrhagic gastropathy, blocked evisceration, pneumonia and left pleural empyema. The control at 10 months show a patient appearing very well, with a voluminous eventration (who need surgical treatment) with normal image on the chest radiography, left hemidiaphragm in normal position and immobile, the gastrointestinal tract sitting intraabdominal, without parietal injuries.

Emergencies↗