Pub Date : 2022-09-30DOI: 10.7438/jsurg.2022.02.10
Dana Baran
{"title":"\"Recenzie 48th CONGRESS OF THE INTERNATIONAL SOCIETY FOR THE HISTORY OF MEDICINE,15-18 September, 2022IASI – ROMANIA \"","authors":"Dana Baran","doi":"10.7438/jsurg.2022.02.10","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.10","url":null,"abstract":"","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125516937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.7438/jsurg.2022.03.04
D. Drăghici
{"title":"Predictive factors of postoperative outcome for patients with gastric resections following emergency presentation for gastric cancer","authors":"D. Drăghici","doi":"10.7438/jsurg.2022.03.04","DOIUrl":"https://doi.org/10.7438/jsurg.2022.03.04","url":null,"abstract":"","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131472210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.02
Ana Mișina, S. Zaharia, Corina Șcerbatiuc-Condur, V. Gheorghița, I. Mișin
Umbilical endometriosis. Umbilical endometriosis (UE) is attributed to the rare forms of extragenital endometriosis presented in the literature through unique clinical trials or limited series. UE is a very rare condition with an estimated prevalence of <1% of all ectopic endometriosis. The first description of a primary umbilical endometrioma is credited to Villar in 1886, hence the term Villar’s nodule. UE is even more difficult to diagnose due to the extreme lack of clarity in clinical signs. Given the location of the given pathology, a differential diagnosis with other umbilical surgical diseases is necessary. A review of the literature of the last 10 years was generated based on PubMed and Google Scholar research, selecting some specific keywords. Several lesions can occur in the umbilical region, and endometriosis has to be ruled out even in patients without any surgery in their medical history. Surgery is the gold standard treatment for this condition. Considering the multitude of pathologies of the umbilical region that may look similar to EO, this condition must be considered in the differential diagnosis. Radical surgical excision is the preferred treatment aimed at preventing recurrence and reducing the risk of malignant transformation.
{"title":"Endometrioza ombilicală","authors":"Ana Mișina, S. Zaharia, Corina Șcerbatiuc-Condur, V. Gheorghița, I. Mișin","doi":"10.7438/jsurg.2022.02.02","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.02","url":null,"abstract":"Umbilical endometriosis. Umbilical endometriosis (UE) is attributed to the rare forms of extragenital endometriosis presented in the literature through unique clinical trials or limited series. UE is a very rare condition with an estimated prevalence of <1% of all ectopic endometriosis. The first description of a primary umbilical endometrioma is credited to Villar in 1886, hence the term Villar’s nodule. UE is even more difficult to diagnose due to the extreme lack of clarity in clinical signs. Given the location of the given pathology, a differential diagnosis with other umbilical surgical diseases is necessary. A review of the literature of the last 10 years was generated based on PubMed and Google Scholar research, selecting some specific keywords. Several lesions can occur in the umbilical region, and endometriosis has to be ruled out even in patients without any surgery in their medical history. Surgery is the gold standard treatment for this condition. Considering the multitude of pathologies of the umbilical region that may look similar to EO, this condition must be considered in the differential diagnosis. Radical surgical excision is the preferred treatment aimed at preventing recurrence and reducing the risk of malignant transformation.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132477036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.07
Dana Baran
Professor Dr. Alexandru Moruzi lived in the first half of the XX century. Born in an aristocratic family, he studied in Paris where he graduated from both high school and the Faculty of Medicine. It was also in Paris that Moruzi worked as a young doctor and specialised in general surgery and neurosurgery, a domain that just then was being born as an independent field. He was trained in Dr. Maurice Robineau`s service and in Professor Thierry de Martel`s surgery clinic, two outstanding French medical personalities of the time. In October 1929, Dr. Moruzi returned to Bucharest, where he completed his military service and enrolled as a reserve medical officer lieutenant. In 1930 he was a secondary surgeon in the Third Surgical Clinic of the Coltea Hospital in Bucharest, directed by the great surgeon, Prof. Dr. Amza Jianu, a pioneering Romanian neurosurgeon. One year later, in 1931, Moruzi started his brilliant career in Iasi, when he was appointed senior [primar] doctor in the Surgery Service of the “Caritatea” [Charity] Hospital. A complex medical personality, he systematically opened new fields of surgical activity and teaching, in keeping with the latest advances of Western European medicine. Due to his qualities and expertise, Prof. Dr. Leon Ballif, director of the “Socola” Hospital of Nervous and Mental Diseases in Iasi, decided to set up a separate pavilion for neurosurgical interventions in 1933, and Moruzi was appointed coordinator of this first Neurosurgery Service ever established in Romania. Little by little, similarly to his masters, De Martel and Robineau, Moruzi enabled neurosurgery to gain the status of an autonomous branch of surgery in his country, too. An assistant professor since 1935, he was promoted full professor of the Faculty of Medicine of Iasi, in 1938. He became professor of External Pathology and Surgery and Orthopedic, as well as professor of Surgery Clinic and Diseases of the Urinary Tract. During World War II he assisted the wounded with great devotion. This article outlines several aspects of Professor Moruzi`s professional life and points out the main ideas of his inaugural lecture, given in November 1938. Not only outstanding medical personalities and their work were sketched, but concepts, trends, tendencies and debates were pointed out, reflecting the complex surgery metamorphoses of those days. Alexandru Moruzi lived in a revolutionary era of surgery and he took part in the important modernisation of medical teaching and practice in Iasi. Until now, his lecture illustrates a substantial and personally experienced lesson of history of medicine.
Alexandru Moruzi博士教授生活在20世纪上半叶。他出生在一个贵族家庭,在巴黎学习,并从高中和医学院毕业。也是在巴黎,Moruzi作为一名年轻的医生,专门从事普通外科和神经外科,这是一个刚刚作为独立领域诞生的领域。他曾在莫里斯·罗比诺医生和蒂埃里·德·马特尔教授的外科诊所接受培训,这是当时两位杰出的法国医学人士。1929年10月,Moruzi博士回到布加勒斯特,在那里他完成了他的兵役,并被登记为预备役中尉医务官。1930年,他是布加勒斯特Coltea医院第三外科诊所的二级外科医生,由罗马尼亚神经外科先驱、伟大的外科医生Amza janu教授指导。一年后,也就是1931年,Moruzi在雅西开始了他辉煌的职业生涯,当时他被任命为“Caritatea”[慈善]医院外科部门的高级[初级]医生。作为一个复杂的医学人格,他系统地开辟了外科活动和教学的新领域,与西欧医学的最新进展保持一致。由于他的素质和专业知识,雅西“索科拉”神经和精神疾病医院的主任Leon Ballif教授决定在1933年建立一个单独的神经外科干预馆,Moruzi被任命为罗马尼亚有史以来第一个神经外科服务中心的协调员。就像他的导师德·马特尔和罗比诺一样,莫鲁齐逐渐使神经外科学在他的国家获得了独立分支的地位。1935年起担任助理教授,1938年晋升为雅西医学院正教授。他成为外部病理学、外科和矫形学教授,以及外科临床和泌尿道疾病教授。第二次世界大战期间,他以极大的奉献精神帮助伤员。本文概述了Moruzi教授职业生涯的几个方面,并指出了他1938年11月就职演讲的主要思想。不仅概述了杰出的医学人物及其工作,而且指出了概念、趋势、趋势和争论,反映了当时复杂的外科变化。亚历山德鲁·莫鲁兹生活在外科手术的革命时代,他参与了雅西医学教学和实践的重要现代化。到目前为止,他的演讲展示了医学史上一个实质性的个人经验教训。
{"title":"Prof. dr. Alexandru Moruzi s life cues and opening lesson at the Faculty of medicine of iași","authors":"Dana Baran","doi":"10.7438/jsurg.2022.02.07","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.07","url":null,"abstract":"Professor Dr. Alexandru Moruzi lived in the first half of the XX century. Born in an aristocratic family, he studied in Paris where he graduated from both high school and the Faculty of Medicine. It was also in Paris that Moruzi worked as a young doctor and specialised in general surgery and neurosurgery, a domain that just then was being born as an independent field. He was trained in Dr. Maurice Robineau`s service and in Professor Thierry de Martel`s surgery clinic, two outstanding French medical personalities of the time. In October 1929, Dr. Moruzi returned to Bucharest, where he completed his military service and enrolled as a reserve medical officer lieutenant. In 1930 he was a secondary surgeon in the Third Surgical Clinic of the Coltea Hospital in Bucharest, directed by the great surgeon, Prof. Dr. Amza Jianu, a pioneering Romanian neurosurgeon. One year later, in 1931, Moruzi started his brilliant career in Iasi, when he was appointed senior [primar] doctor in the Surgery Service of the “Caritatea” [Charity] Hospital. A complex medical personality, he systematically opened new fields of surgical activity and teaching, in keeping with the latest advances of Western European medicine. Due to his qualities and expertise, Prof. Dr. Leon Ballif, director of the “Socola” Hospital of Nervous and Mental Diseases in Iasi, decided to set up a separate pavilion for neurosurgical interventions in 1933, and Moruzi was appointed coordinator of this first Neurosurgery Service ever established in Romania. Little by little, similarly to his masters, De Martel and Robineau, Moruzi enabled neurosurgery to gain the status of an autonomous branch of surgery in his country, too. An assistant professor since 1935, he was promoted full professor of the Faculty of Medicine of Iasi, in 1938. He became professor of External Pathology and Surgery and Orthopedic, as well as professor of Surgery Clinic and Diseases of the Urinary Tract. During World War II he assisted the wounded with great devotion. This article outlines several aspects of Professor Moruzi`s professional life and points out the main ideas of his inaugural lecture, given in November 1938. Not only outstanding medical personalities and their work were sketched, but concepts, trends, tendencies and debates were pointed out, reflecting the complex surgery metamorphoses of those days. Alexandru Moruzi lived in a revolutionary era of surgery and he took part in the important modernisation of medical teaching and practice in Iasi. Until now, his lecture illustrates a substantial and personally experienced lesson of history of medicine.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116238337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.04
Serghei Cumpata, V. Guzun, Vladimir Iacub, E. Gutu
Redo surgery in failed fundoplication in patients with gastroesophageal reflux disease. Background. Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of refractory gastroesophageal reflux in surgical clinics, with excellent and good symptomatic results in 90% to 95% of cases. Despite a high rate of success, the failure of laparoscopic fundoplication occurs in 2-17% of cases. When some patients can be treated conservatively, in approximately 3% to 6% cases the revision surgery is required due to recalcitrant and recurrent symptoms or appearance of complications. Methods. From 2011 to 2019, revision surgery was performed on 10 patients (all women) between the ages of 18 and 63 years. Patient demographics, primary and repeat surgery techniques, preoperative symptoms, anatomical pattern of failure, perioperative morbidity, operative complications, conversion rate, length of hospital stay, immediate and distant results were evaluated. Results. The first surgical procedure was laparoscopic Nissen-Rossetti fundoplication in 9 patients and Dor – in 1 patient. The types of fundoplication failure were: transhiatal wrap migration - 6 cases, „slipped” Nissen – 1 and paraesophageal hernia – 3. Eight patients were operated laparoscopically with the conversion rate of 50% (4 cases) – caused by dense adhesions – 3 cases, and perforation of gastric fundus – 1. Nissen fundoplication was redone in 4, converted to Toupet – in 3, newly formed after Dor fundoplication – in 1 and was left in place – in 2 patients. In all cases the repeated cruroplasty was performed, and in 3 cases - reinforcement with Gore-Tex patches. Laparoscopy operating room time was 146±54 minutes (from 95 to 240 minutes). Intraoperative complication occurred in one patient – gastric perforation. Length of hospital stay was 5 days for laparoscopic, 8 days for converted. Follow-up from 4 to 9 years: all patients without reflux symptoms, 1 – mild bloating, 2 – mild dysphagia without hernia and reflux recurrence. Conclusions. The redo surgery it is a more complex intervention, with higher technical requirements than primary one and is associated with a high rate of conversion and intraoperative complications. However, redo surgery can be carried out efficiently and safely by an experienced surgical team in dedicated centers.
胃食管反流病患者复底失败的再手术治疗。背景。腹腔镜抗反流手术是外科诊所治疗难治性胃食管反流的常用方法,90% ~ 95%的病例症状效果优异。尽管成功率很高,但2-17%的病例发生腹腔镜下盆底复制失败。当一些患者可以保守治疗时,约3%至6%的病例由于顽固性和复发性症状或并发症的出现而需要翻修手术。方法。从2011年到2019年,对10名年龄在18岁至63岁之间的患者(均为女性)进行了翻修手术。评估患者人口统计学、初次和重复手术技术、术前症状、失败的解剖模式、围手术期发病率、手术并发症、转换率、住院时间、近期和远期结果。结果。第一次手术是腹腔镜下Nissen-Rossetti底折叠,9例,Dor - in 1例。手术失败类型为:经膈膜移位6例,滑移型尼森1例,食管旁疝3例。腹腔镜下手术8例,转化率50%(4例),其中粘连致密3例,胃底穿孔1例。4例患者重新进行了Nissen底复制,3例患者转为Toupet底复制,1例患者在Dor底复制后重新形成,2例患者保留原位。所有病例均行重复成形术,其中3例用Gore-Tex补片加固。腹腔镜手术时间为146±54分钟(95 ~ 240分钟)。术中并发症1例,胃穿孔。腹腔镜组住院时间5天,转换组住院时间8天。随访4 ~ 9年:所有患者无反流症状,1例轻度腹胀,2例轻度吞咽困难,无疝和反流复发。结论。重做手术是一种更复杂的干预,比初次手术有更高的技术要求,并且有较高的转换率和术中并发症。然而,重做手术可以在专门的中心由经验丰富的外科团队高效安全地进行。
{"title":"Redo surgery in failed fundoplication in patients with gastroesophageal reflux disease","authors":"Serghei Cumpata, V. Guzun, Vladimir Iacub, E. Gutu","doi":"10.7438/jsurg.2022.02.04","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.04","url":null,"abstract":"Redo surgery in failed fundoplication in patients with gastroesophageal reflux disease. Background. Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of refractory gastroesophageal reflux in surgical clinics, with excellent and good symptomatic results in 90% to 95% of cases. Despite a high rate of success, the failure of laparoscopic fundoplication occurs in 2-17% of cases. When some patients can be treated conservatively, in approximately 3% to 6% cases the revision surgery is required due to recalcitrant and recurrent symptoms or appearance of complications. Methods. From 2011 to 2019, revision surgery was performed on 10 patients (all women) between the ages of 18 and 63 years. Patient demographics, primary and repeat surgery techniques, preoperative symptoms, anatomical pattern of failure, perioperative morbidity, operative complications, conversion rate, length of hospital stay, immediate and distant results were evaluated. Results. The first surgical procedure was laparoscopic Nissen-Rossetti fundoplication in 9 patients and Dor – in 1 patient. The types of fundoplication failure were: transhiatal wrap migration - 6 cases, „slipped” Nissen – 1 and paraesophageal hernia – 3. Eight patients were operated laparoscopically with the conversion rate of 50% (4 cases) – caused by dense adhesions – 3 cases, and perforation of gastric fundus – 1. Nissen fundoplication was redone in 4, converted to Toupet – in 3, newly formed after Dor fundoplication – in 1 and was left in place – in 2 patients. In all cases the repeated cruroplasty was performed, and in 3 cases - reinforcement with Gore-Tex patches. Laparoscopy operating room time was 146±54 minutes (from 95 to 240 minutes). Intraoperative complication occurred in one patient – gastric perforation. Length of hospital stay was 5 days for laparoscopic, 8 days for converted. Follow-up from 4 to 9 years: all patients without reflux symptoms, 1 – mild bloating, 2 – mild dysphagia without hernia and reflux recurrence. Conclusions. The redo surgery it is a more complex intervention, with higher technical requirements than primary one and is associated with a high rate of conversion and intraoperative complications. However, redo surgery can be carried out efficiently and safely by an experienced surgical team in dedicated centers.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"1982 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120847195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.03
Alexandru Năstase, A. Trofin, M. Zabara, Ramona Cadar, Oana Lovin, Anda Năstase, G. Balan, Corina Ursulescu-Lupașcu, L. Marian, C. Lupașcu
Management of intraductal papillary and mucinous pancreatic neoplasms. Mucinous and papillary pancreatic cystic neoplasm is a controversial pathology both from a diagnostic point of view and from a management point of view. These recommendations will include diagnostic modalities and criteria (endoscopic, imaging and histopathological), conservative management of cystic pancreatic, mucinous and papillary neoplasm and its absolute and relative surgical indications. High risk factors (high risk stigmata) for which surgery is indicated without further exploration are positive cytology for malignancy, jaundice, dilation of the main pancreatic duct over 10 mm in diameter and the presence of the wall nodule over 5 mm. For patients with a diameter of the main pancreatic duct between 5 and 9.9 mm or a cyst larger than 4 cm, surgery has a relative indication, and for asymptomatic patients with a cyst smaller than 4 cm without parietal nodules, a Conservative management is more appropriate.Our goal is to develop a protocol based on the new European recommendations published by the European Study Group on Cystic Pancreatic Tumors, in order to facilitate the early diagnosis and treatment of patients. We also want to sensitize the specialists and make them aware of the need to develop centers dedicated to hepato-biliary-pancreatic pathology and to improve the logistical means.
{"title":"Management of intraductal papillary and mucinous pancreatic neoplasms","authors":"Alexandru Năstase, A. Trofin, M. Zabara, Ramona Cadar, Oana Lovin, Anda Năstase, G. Balan, Corina Ursulescu-Lupașcu, L. Marian, C. Lupașcu","doi":"10.7438/jsurg.2022.02.03","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.03","url":null,"abstract":"Management of intraductal papillary and mucinous pancreatic neoplasms. Mucinous and papillary pancreatic cystic neoplasm is a controversial pathology both from a diagnostic point of view and from a management point of view. These recommendations will include diagnostic modalities and criteria (endoscopic, imaging and histopathological), conservative management of cystic pancreatic, mucinous and papillary neoplasm and its absolute and relative surgical indications. High risk factors (high risk stigmata) for which surgery is indicated without further exploration are positive cytology for malignancy, jaundice, dilation of the main pancreatic duct over 10 mm in diameter and the presence of the wall nodule over 5 mm. For patients with a diameter of the main pancreatic duct between 5 and 9.9 mm or a cyst larger than 4 cm, surgery has a relative indication, and for asymptomatic patients with a cyst smaller than 4 cm without parietal nodules, a Conservative management is more appropriate.Our goal is to develop a protocol based on the new European recommendations published by the European Study Group on Cystic Pancreatic Tumors, in order to facilitate the early diagnosis and treatment of patients. We also want to sensitize the specialists and make them aware of the need to develop centers dedicated to hepato-biliary-pancreatic pathology and to improve the logistical means.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128309132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.05
O. Badulescu, Diana Dimitriu, S. Georgescu, D. Vintilă, M. Buna-Arvinte, I. Abdulan, D. Timofte, B. Ciuntu
Portal vein thrombosis (PVT) is the blockage or narrowing of the portal vein by a thrombus being a relatively rare condition, linked to the presence of an underlying liver disease or prothrombotic disorders. We present the case of a 55-year-old woman, who was rushed to a territorial hospital for abdominal pain in her right flank, accompanied by nausea and vomiting for about a week. Following clinical, paraclinical investigations and exploratory laparoscopy, the suspicion of transverse colon tumor was raised, later refuted by exploratory laparotomy that detected an enteromesenteric infarction in the ileum, with localized peritonitis, for which a segmental enterectomy with termino-terminal anastomosis was performed, with a slow favorable evolution. Two months later, the patient went to the "Sf Spiridon" Hospital in Iasi for transit disorders associated with rectal hemorrhages. Following paraclinical investigations, a co-infection with Clostridium Difficile and Sars-Cov-2 was identified, for which adequate treatment was lead, but with the persistence of rectorages, which is why a computed tomography (CT) scan was performed. Imaging revealed thrombosis of the port system and the superior mesenteric vein, and it was initiated anticoagulant therapy. The paper will help raise awareness of the complexity of cases associated with portal vein thrombosis.
{"title":"Portal vein thrombosis in a pandemic era","authors":"O. Badulescu, Diana Dimitriu, S. Georgescu, D. Vintilă, M. Buna-Arvinte, I. Abdulan, D. Timofte, B. Ciuntu","doi":"10.7438/jsurg.2022.02.05","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.05","url":null,"abstract":"Portal vein thrombosis (PVT) is the blockage or narrowing of the portal vein by a thrombus being a relatively rare condition, linked to the presence of an underlying liver disease or prothrombotic disorders. We present the case of a 55-year-old woman, who was rushed to a territorial hospital for abdominal pain in her right flank, accompanied by nausea and vomiting for about a week. Following clinical, paraclinical investigations and exploratory laparoscopy, the suspicion of transverse colon tumor was raised, later refuted by exploratory laparotomy that detected an enteromesenteric infarction in the ileum, with localized peritonitis, for which a segmental enterectomy with termino-terminal anastomosis was performed, with a slow favorable evolution. Two months later, the patient went to the \"Sf Spiridon\" Hospital in Iasi for transit disorders associated with rectal hemorrhages. Following paraclinical investigations, a co-infection with Clostridium Difficile and Sars-Cov-2 was identified, for which adequate treatment was lead, but with the persistence of rectorages, which is why a computed tomography (CT) scan was performed. Imaging revealed thrombosis of the port system and the superior mesenteric vein, and it was initiated anticoagulant therapy. The paper will help raise awareness of the complexity of cases associated with portal vein thrombosis.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125017674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.08
E. Târcoveanu
29th Congress of the Romanian Society of Surgery. Between June 8 and 11, 2022, the National Congress of Surgery, an event with international participation, was organized in Sinaia in the halls of the "Casino Sinaia" International Conference Center. The congress was organized by the Romanian Society of Surgery (prof. Dr. Traian Pătrașcu- acting president and prof. Dr. Viorel Scripcariu - elected president), in collaboration with the Romanian Academy of Medical Sciences, the Romanian Association of Hepato-Bilio Surgery -Pancreatic and Liver Transplant, Romanian Association of Endoscopic Surgery, Romanian Society of Emergency Surgery and Traumatology, UMF "Carol Davila" Bucharest, Romanian Society of Surgery students, Romanian Society of Surgery and Oncological Gynecology, Romanian College of Physicians, Hellenic Romanian Society of Surgery, Hernia traning Center. The congress had a generous theme: "Advances in the surgical treatment of cancer" and Varia. However, the scientific program also included many other topics of maximum interest for surgeons in Romania, hepato - biliary and pancreatic surgery, such as laparoscopic surgery, endocrine surgery, esogastric surgery. pediatric surgery, Almost 400 papers were presented in 40 scientific communication sessions, held in parallel in 4 rooms, during the four days of the Congress. This edition brought together about 1200 surgeons from the country and abroad and was characterized by an innovative, European change in the organization of the congress, in the sense that some papers were transferred to posters, the rest of the congress was based on state of the art conferences, round tables, plenary presentations, video sessions. Along with the experience of Romanian professionals and experts (200) presented at the congress, the participants benefited from the expertise of 30 European personalities of surgery. This congress, released by the pandemic, was a success, with the large participation of young people, with iscussions in permanently full halls, which allowed the participants to follow the areas of interest. One of the strengths of the congress was the organization of a number of 16 pre- congress postgraduate courses. This congress demonstrated the strength of Romanian surgery. The late spring in Sinaia, the special location, good organization, academic atmosphere, beneficial discussions, rich exhibition, book exhibitions, large presence of residents, special social program and perfect organization (EVENTER) made this congress an unforgettable event.
{"title":"Recenzia Congresului Nașional de Chirurgie XXIX Sinaia 8-11 iunie 2022","authors":"E. Târcoveanu","doi":"10.7438/jsurg.2022.02.08","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.08","url":null,"abstract":"29th Congress of the Romanian Society of Surgery. Between June 8 and 11, 2022, the National Congress of Surgery, an event with international participation, was organized in Sinaia in the halls of the \"Casino Sinaia\" International Conference Center. The congress was organized by the Romanian Society of Surgery (prof. Dr. Traian Pătrașcu- acting president and prof. Dr. Viorel Scripcariu - elected president), in collaboration with the Romanian Academy of Medical Sciences, the Romanian Association of Hepato-Bilio Surgery -Pancreatic and Liver Transplant, Romanian Association of Endoscopic Surgery, Romanian Society of Emergency Surgery and Traumatology, UMF \"Carol Davila\" Bucharest, Romanian Society of Surgery students, Romanian Society of Surgery and Oncological Gynecology, Romanian College of Physicians, Hellenic Romanian Society of Surgery, Hernia traning Center. The congress had a generous theme: \"Advances in the surgical treatment of cancer\" and Varia. However, the scientific program also included many other topics of maximum interest for surgeons in Romania, hepato - biliary and pancreatic surgery, such as laparoscopic surgery, endocrine surgery, esogastric surgery. pediatric surgery, Almost 400 papers were presented in 40 scientific communication sessions, held in parallel in 4 rooms, during the four days of the Congress. This edition brought together about 1200 surgeons from the country and abroad and was characterized by an innovative, European change in the organization of the congress, in the sense that some papers were transferred to posters, the rest of the congress was based on state of the art conferences, round tables, plenary presentations, video sessions. Along with the experience of Romanian professionals and experts (200) presented at the congress, the participants benefited from the expertise of 30 European personalities of surgery. This congress, released by the pandemic, was a success, with the large participation of young people, with iscussions in permanently full halls, which allowed the participants to follow the areas of interest. One of the strengths of the congress was the organization of a number of 16 pre- congress postgraduate courses. This congress demonstrated the strength of Romanian surgery. The late spring in Sinaia, the special location, good organization, academic atmosphere, beneficial discussions, rich exhibition, book exhibitions, large presence of residents, special social program and perfect organization (EVENTER) made this congress an unforgettable event.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"945 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116433865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.06
Vlad Nuțu, E. Târcoveanu, Ana-Maria Axentioi, Samantha Varlot, Valeria Bătrineac, F. Crumpei, Delia Florina Rusu Andrieși, Cătălina Cucu, D. Ciobanu
Tumors in the pandemic era: giant ovarian mucinous cystadenoma. Mucinous cystadenoma is a benign tumor of the ovary originating from the surface epithelium of the ovary, characterized by mucin production. They represent 10-15% of ovarian tumors. The borderline variety represents 10% of mucinous cystadenomas. They can reach very large sizes. We present the case of a patient, aged 65, hospitalized at the end of pandemics with a giant abdominal cystic tumor (diameter 40 cm) with compression disorders. He had a subtotal hysterectomy for uterine fibroids at the age of 25. Laboratory tests are within normal limits except CA19-9 = 398 IU / ml. Abdomino-pelvic ultrasound shows a mid-abdominal liquid formation, inhomogeneous with septa inside that exceeds 30 cm. CT with the contrast substance highlights a multiloculated formation, developed from the left ovary to with iodophilic septa, with mass effect on anatomical elements, with overall dimensions of approx. 230/300/350 mm. With the suspicion of a giant left ovarian cyst suspected of being malignant, a median xipho-umbilical laparotomy was performed and a giant cystic tumor of the left ovary weighing 13 kg, reaching the supramesocolic floor without adhesions, with an ovarian pedicle one cm thick, was removed. Anexectomy was performed on the right side without complications. The postoperative evolution was simple. Histopathological examination determined the diagnosis of borderline mucinous cystadenoma. The epidemiology, clinical signs and imaging diagnosis and surgical treatment of these rare tumors with favorable evolution are discussed.
大流行时代的肿瘤:巨大卵巢粘液囊腺瘤。粘液囊腺瘤是一种卵巢良性肿瘤,起源于卵巢表面上皮,以分泌粘液蛋白为特征。它们占卵巢肿瘤的10-15%。交界型占黏液性囊腺瘤的10%。它们可以达到非常大的尺寸。我们报告一位65岁的患者,在大流行末期因腹腔巨大囊性肿瘤(直径40 cm)合并压迫障碍而住院。他在25岁时因子宫肌瘤做了子宫次全切除术。实验室检查除CA19-9 = 398 IU / ml外均在正常范围内。腹部-盆腔超声示腹部中部液体形成,不均匀,内部间隔超过30厘米。CT造影剂显示多房状构象,从左卵巢发展到嗜碘间隔,解剖结构上有肿块效应,总体尺寸约为。230/300/350毫米。怀疑左侧卵巢巨大囊肿疑似恶性,行剑脐正中开腹术,切除左侧卵巢巨大囊性肿瘤,重13 kg,达结肠上底无粘连,卵巢蒂1 cm厚。右侧行切除,无并发症。术后进展简单。组织病理学检查确定了交界性粘液囊腺瘤的诊断。本文就这些罕见肿瘤的流行病学、临床表现、影像学诊断和手术治疗进行了讨论。
{"title":"Tumors in a pandemic era: giant ovarian mucinous cystadenomas","authors":"Vlad Nuțu, E. Târcoveanu, Ana-Maria Axentioi, Samantha Varlot, Valeria Bătrineac, F. Crumpei, Delia Florina Rusu Andrieși, Cătălina Cucu, D. Ciobanu","doi":"10.7438/jsurg.2022.02.06","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.06","url":null,"abstract":"Tumors in the pandemic era: giant ovarian mucinous cystadenoma. Mucinous cystadenoma is a benign tumor of the ovary originating from the surface epithelium of the ovary, characterized by mucin production. They represent 10-15% of ovarian tumors. The borderline variety represents 10% of mucinous cystadenomas. They can reach very large sizes. We present the case of a patient, aged 65, hospitalized at the end of pandemics with a giant abdominal cystic tumor (diameter 40 cm) with compression disorders. He had a subtotal hysterectomy for uterine fibroids at the age of 25. Laboratory tests are within normal limits except CA19-9 = 398 IU / ml. Abdomino-pelvic ultrasound shows a mid-abdominal liquid formation, inhomogeneous with septa inside that exceeds 30 cm. CT with the contrast substance highlights a multiloculated formation, developed from the left ovary to with iodophilic septa, with mass effect on anatomical elements, with overall dimensions of approx. 230/300/350 mm. With the suspicion of a giant left ovarian cyst suspected of being malignant, a median xipho-umbilical laparotomy was performed and a giant cystic tumor of the left ovary weighing 13 kg, reaching the supramesocolic floor without adhesions, with an ovarian pedicle one cm thick, was removed. Anexectomy was performed on the right side without complications. The postoperative evolution was simple. Histopathological examination determined the diagnosis of borderline mucinous cystadenoma. The epidemiology, clinical signs and imaging diagnosis and surgical treatment of these rare tumors with favorable evolution are discussed.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127437117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.7438/jsurg.2022.02.01
R. Tiutiucă, Alina Ioana Năstase Pușcașu, Iuliana Zavadovsky, Nicoleta Stoenescu
Introduction: Despite the fact that damage control surgery (DCS) is generally accepted to reduce the mortality rate in critically ill patients, morbidity among survivors is still high, which is why it is essential to note that indications must be well established before implementation. The purpose of this paper is to raise awareness of the need for a holistic assessment of the status of the patient and the medical team involved in the Damage Control Surgery process. Material and method: Observational and retrospective studies were selected using the PubMed / MEDLINE database published between 2000-2021, and the keywords used to identify relevant articles were damage control surgery, military medicine, psychological. consequences, trauma. Conclusions: The concept of DCS needs to be used in well-evaluated conditions and it is important to remember that the psychological impact of medical decisions resonated not only among patients but also with the entire medical team.
{"title":"Damage control surgery- abord și implicații multidirecționale","authors":"R. Tiutiucă, Alina Ioana Năstase Pușcașu, Iuliana Zavadovsky, Nicoleta Stoenescu","doi":"10.7438/jsurg.2022.02.01","DOIUrl":"https://doi.org/10.7438/jsurg.2022.02.01","url":null,"abstract":"Introduction: Despite the fact that damage control surgery (DCS) is generally accepted to reduce the mortality rate in critically ill patients, morbidity among survivors is still high, which is why it is essential to note that indications must be well established before implementation. The purpose of this paper is to raise awareness of the need for a holistic assessment of the status of the patient and the medical team involved in the Damage Control Surgery process. Material and method: Observational and retrospective studies were selected using the PubMed / MEDLINE database published between 2000-2021, and the keywords used to identify relevant articles were damage control surgery, military medicine, psychological. consequences, trauma. Conclusions: The concept of DCS needs to be used in well-evaluated conditions and it is important to remember that the psychological impact of medical decisions resonated not only among patients but also with the entire medical team.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134295724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}