Pub Date : 2021-06-30DOI: 10.7438/jsurg.2021.02.07
M. Dranga, C. Mihai, C. Cijevschi, Iulian Bejinariu, A. Andronic, O. Gavrilescu
Stromal tumors are the most common mesenchymal tumors in the digestive tract. Epidemiological data have shown an incidence of 11-20 per million people, the average age of diagnosis being 58 years. The location of these tumors can be anywhere on the gastrointestinal tract. The positive diagnosis is established by histopathological and immunohistochemical examination. The evolution of patients is correlated with the size of the initial tumor, the mitotic index and the topographic location. We present the case of a patient with an old anemic syndrome, considered deficiency anemia, with multiple hospitalizations, without response to substitution therapy that suddenly developed ascites. CT scan of the abdomen revealed a large abdominal tumor with jejunal origin. The positive diagnosis was established postoperatively by correlating the histopathological aspects with the immunohistochemical tests. The postoperative evolution was marked by complications, and one week later, the patient died secondary to a jejuno-colic fistula.
{"title":"Gastrointestinal stromal tumor","authors":"M. Dranga, C. Mihai, C. Cijevschi, Iulian Bejinariu, A. Andronic, O. Gavrilescu","doi":"10.7438/jsurg.2021.02.07","DOIUrl":"https://doi.org/10.7438/jsurg.2021.02.07","url":null,"abstract":"Stromal tumors are the most common mesenchymal tumors in the digestive tract. Epidemiological data have shown\u0000an incidence of 11-20 per million people, the average age of diagnosis being 58 years. The location of these tumors\u0000can be anywhere on the gastrointestinal tract. The positive diagnosis is established by histopathological and\u0000immunohistochemical examination. The evolution of patients is correlated with the size of the initial tumor, the\u0000mitotic index and the topographic location. We present the case of a patient with an old anemic syndrome,\u0000considered deficiency anemia, with multiple hospitalizations, without response to substitution therapy that suddenly\u0000developed ascites. CT scan of the abdomen revealed a large abdominal tumor with jejunal origin. The positive\u0000diagnosis was established postoperatively by correlating the histopathological aspects with the\u0000immunohistochemical tests. The postoperative evolution was marked by complications, and one week later, the\u0000patient died secondary to a jejuno-colic fistula.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124669148","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 : 2021-06-30DOI: 10.7438/jsurg.2021.02.03
A. Nicolau
The use of laparoscopy in traumatic and non-traumatic abdominal surgical emergencies is unanimously accepted due to the well-known advantages of minimally invasive surgery. In the period 1961-1966 in the Clinical Emergency Hospital of Bucharest (CEHB) the first diagnostic laparoscopes were performed in the acute surgical abdomen, respectively in the obstructive jaundice by dr. Gh.Popovici, respectively dr.C.Petrescu.In the modern era, the first laparoscopic cholecystectomy was performed in 4 dec. 1993 by A.E.N.In 1994 the first laparoscopic appendectomies, gynecological emergencies, exploration in traumatic abdominal contusion, followed by perforated ulcer (1995), intestinal occlusion (1997), were performed. In the specialized literature, out of the 42 emergency laparoscopy articles published in the journal “Chirurgia” (1994-2019), 16 (38,08%) belonged to the CEHB team, 11 of AEN. In 2004 the original monograph "Laparoscopic Emergency Surgery" appeared. Specialized chapters are added in different volumes of surgical pathology. At the Romanian Assocation of Endoscopic Surgery Congress (RAES) of 2008, the international participation course “Laparoscopy in the acute abdomen” was organized. Since 2013, annual trauma workshops (DSTC ™) and non-traumatic abdominal emergencies have been organized with international participation by CEHB, the surgery clinic, and the UMFCarol Davila Department of Anatomy. CEHB surgeons presented papers at EAES,EATES and ESTES congresses. Of the 1699 laparoscopic operations performed in the clinic in 2018, accounting for 31.27% of the total operations, 493 (29.01%) were in emergency. The SCUB surgeons have had and have a major contribution in preparing the residents, implementing and developing emergency laparoscopy within the miniminvasive therapy, the therapy of the future.
{"title":"The Emergency Hospital Bucharest to the Forefront of the Emergency Laparoscopic Surgery Development","authors":"A. Nicolau","doi":"10.7438/jsurg.2021.02.03","DOIUrl":"https://doi.org/10.7438/jsurg.2021.02.03","url":null,"abstract":"The use of laparoscopy in traumatic and non-traumatic abdominal surgical emergencies is unanimously accepted\u0000due to the well-known advantages of minimally invasive surgery. In the period 1961-1966 in the Clinical Emergency\u0000Hospital of Bucharest (CEHB) the first diagnostic laparoscopes were performed in the acute surgical abdomen,\u0000respectively in the obstructive jaundice by dr. Gh.Popovici, respectively dr.C.Petrescu.In the modern era, the first\u0000laparoscopic cholecystectomy was performed in 4 dec. 1993 by A.E.N.In 1994 the first laparoscopic\u0000appendectomies, gynecological emergencies, exploration in traumatic abdominal contusion, followed by perforated\u0000ulcer (1995), intestinal occlusion (1997), were performed. In the specialized literature, out of the 42 emergency\u0000laparoscopy articles published in the journal “Chirurgia” (1994-2019), 16 (38,08%) belonged to the CEHB team, 11\u0000of AEN. In 2004 the original monograph \"Laparoscopic Emergency Surgery\" appeared. Specialized chapters are\u0000added in different volumes of surgical pathology.\u0000At the Romanian Assocation of Endoscopic Surgery Congress (RAES) of 2008, the international participation\u0000course “Laparoscopy in the acute abdomen” was organized. Since 2013, annual trauma workshops (DSTC ™) and\u0000non-traumatic abdominal emergencies have been organized with international participation by CEHB, the surgery\u0000clinic, and the UMFCarol Davila Department of Anatomy. CEHB surgeons presented papers at EAES,EATES and\u0000ESTES congresses. Of the 1699 laparoscopic operations performed in the clinic in 2018, accounting for 31.27% of\u0000the total operations, 493 (29.01%) were in emergency. The SCUB surgeons have had and have a major\u0000contribution in preparing the residents, implementing and developing emergency laparoscopy within the\u0000miniminvasive therapy, the therapy of the future.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127150868","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 : 2021-06-30DOI: 10.7438/jsurg.2021.02.05
Postoperative pancreatic fistulas are one of the most serious postoperative complications, with important implications for the prognosis, postoperative evolution and quality of life. Patients' comorbidities play an important role in the process of producing this postoperative complication. Methods: a retrospective study was performed that included 109 patients with pancreatic resections for malignant pathology. the incidence of pancreatic fistula in relation to the associated pathology was analyzed: obesity, diabetes, hypertension and non-hypertensive cardiac pathology. Results: the incidence of pancreatic fistula on the entire study group was 11.01%. Obesity was the only factor with which a statistically significant association was obtained, the incidence of pancreatic fistula being 3.59 times higher in the group of obese patients. Conclusions: obesity is an important and independent predictive factor, which increases the risk of postoperative pancreatic fistula by increasing the difficulty of pancreatic dissection and anastomosis.
{"title":"The impact of obesity on the risk of postoperative pancreatic fistula in malignant surgical pathology","authors":"","doi":"10.7438/jsurg.2021.02.05","DOIUrl":"https://doi.org/10.7438/jsurg.2021.02.05","url":null,"abstract":"Postoperative pancreatic fistulas are one of the most serious postoperative complications, with important\u0000implications for the prognosis, postoperative evolution and quality of life. Patients' comorbidities play an important\u0000role in the process of producing this postoperative complication. Methods: a retrospective study was performed\u0000that included 109 patients with pancreatic resections for malignant pathology. the incidence of pancreatic fistula\u0000in relation to the associated pathology was analyzed: obesity, diabetes, hypertension and non-hypertensive\u0000cardiac pathology.\u0000Results: the incidence of pancreatic fistula on the entire study group was 11.01%. Obesity was the only factor\u0000with which a statistically significant association was obtained, the incidence of pancreatic fistula being 3.59 times\u0000higher in the group of obese patients. Conclusions: obesity is an important and independent predictive factor,\u0000which increases the risk of postoperative pancreatic fistula by increasing the difficulty of pancreatic dissection and\u0000anastomosis.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125999737","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 : 2021-06-30DOI: 10.7438/jsurg.2021.02.08
Paul Anghel was an outstanding surgeon of the Iași Faculty of Medicine illustrating its first decennia of existence. He contributed to the development of the Romanian medical school by his activity and disciples. Trained in Iasi, Bucharest and also in Paris, as was the case with many of his remarkable compatriots, Anghel practiced general surgery but specialized in orthopedics, where his creative mind and experience enabled him to imagine and achieve new surgical techniques, including bone transplant, and prosthetic devices. He was a university professor at the Iași Faculty of Medicine, head of clinic at the ‟St. Spyridon” Hospital in the same city and member of important scientific societies. Dr. Anghel equally dealt with basic topics such as antisepsis and asepsis, wound treatment and war medicine that continued to be main concerns at the dawn of the XX-th century. A silent introspect with a poetic spirit, a cultivated and knowledgeable analyst of his time, Paul Anghel was interested in medical history, too. His scientific reviews always included retrospective glances into history. He pointed out some aspects of the history of the Faculty of Medicine of Iași and of the national medical tradition, and sketched the portraits of several Romanian medical and cultural personalities, proving his affective attachment to their memory. A skilled doctor, an innovative specialist, an empathetic teacher, and an emotional character, Professor Anghel was awarded medals and orders in recognition of his human qualities and civic involvement. He remained a personality of the Iași surgical school, a forerunner of modern orthopedics in his country and a role model.
{"title":"Paul ANGHEL (1869 – 1937) - a reputed surgeon, an empathetic teacher and a poetic spirit","authors":"","doi":"10.7438/jsurg.2021.02.08","DOIUrl":"https://doi.org/10.7438/jsurg.2021.02.08","url":null,"abstract":"Paul Anghel was an outstanding surgeon of the Iași Faculty of Medicine illustrating its first decennia of existence. He\u0000contributed to the development of the Romanian medical school by his activity and disciples. Trained in Iasi, Bucharest\u0000and also in Paris, as was the case with many of his remarkable compatriots, Anghel practiced general surgery but\u0000specialized in orthopedics, where his creative mind and experience enabled him to imagine and achieve new surgical\u0000techniques, including bone transplant, and prosthetic devices. He was a university professor at the Iași Faculty of\u0000Medicine, head of clinic at the ‟St. Spyridon” Hospital in the same city and member of important scientific societies.\u0000Dr. Anghel equally dealt with basic topics such as antisepsis and asepsis, wound treatment and war medicine that\u0000continued to be main concerns at the dawn of the XX-th century. A silent introspect with a poetic spirit, a cultivated\u0000and knowledgeable analyst of his time, Paul Anghel was interested in medical history, too. His scientific reviews always\u0000included retrospective glances into history. He pointed out some aspects of the history of the Faculty of Medicine of\u0000Iași and of the national medical tradition, and sketched the portraits of several Romanian medical and cultural\u0000personalities, proving his affective attachment to their memory. A skilled doctor, an innovative specialist, an empathetic\u0000teacher, and an emotional character, Professor Anghel was awarded medals and orders in recognition of his human\u0000qualities and civic involvement. He remained a personality of the Iași surgical school, a forerunner of modern\u0000orthopedics in his country and a role model.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"273 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115667274","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 : 2021-06-30DOI: 10.7438/jsurg.2021.02.02
Nadia Aladari, Mihaela Perțea, Camelia Tamaş, Iulia Dabija Olaru, M. Palaghia, Ana-Maria Trofin, Valentin Bejan, T. Stamate
Breast augmentation with silicone implants is one of the most common procedures performed by plastic surgeons around the world. Capsular contracture is one of the complication in breast augmentation that requires invasive reparation surgery. The inflammatory response to the breast implants appears to be directly associated with capsular contracture. In addition to the type of material (saline vs. silicone) used and it’s texture (smooth vs. textured), a number of factors were detected related to their position and the existence of a history of radiotherapy after cancer treatment for breast cancer. It tries to identify ideal methods to prevent and minimize the risk of developing capsular contracture. Among the methods currently used were described: placement of the implant in the retropectoral plane, dissection of a larger pocket, performing a rigorous hemostasis, use of implants with textured surface, minimizing the exposure time, contact and handling of the implant, irrigation of the pocket with antiseptic solutions (5% betadine) or broad-spectrum antibiotic solution to prevent the infectious process, the use of talc-free gloves, the use of corticosteroids, immuno-modulators and anti-inflammatory drugs.
{"title":"Aspecte morfopatologice si strategii de preventie a contracturii capsulare după augmentarea mamara cu implante","authors":"Nadia Aladari, Mihaela Perțea, Camelia Tamaş, Iulia Dabija Olaru, M. Palaghia, Ana-Maria Trofin, Valentin Bejan, T. Stamate","doi":"10.7438/jsurg.2021.02.02","DOIUrl":"https://doi.org/10.7438/jsurg.2021.02.02","url":null,"abstract":"Breast augmentation with silicone implants is one of the most common procedures performed by plastic\u0000surgeons around the world. Capsular contracture is one of the complication in breast augmentation that requires\u0000invasive reparation surgery. The inflammatory response to the breast implants appears to be directly associated with\u0000capsular contracture.\u0000In addition to the type of material (saline vs. silicone) used and it’s texture (smooth vs. textured), a number\u0000of factors were detected related to their position and the existence of a history of radiotherapy after cancer treatment\u0000for breast cancer. It tries to identify ideal methods to prevent and minimize the risk of developing capsular\u0000contracture.\u0000Among the methods currently used were described: placement of the implant in the retropectoral plane,\u0000dissection of a larger pocket, performing a rigorous hemostasis, use of implants with textured surface, minimizing\u0000the exposure time, contact and handling of the implant, irrigation of the pocket with antiseptic solutions (5%\u0000betadine) or broad-spectrum antibiotic solution to prevent the infectious process, the use of talc-free gloves, the use\u0000of corticosteroids, immuno-modulators and anti-inflammatory drugs.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129926809","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 : 1900-01-01DOI: 10.7438/1584-9341-11-2-1
Ketan Vagholkar Jimmy Mirani
The natural history of typhoid fever poses both a diagnostic and a therapeutic challenge. Awareness of the clinical features of the primary presentation and of the complications are pivotal to early diagnosis. Typically, aggressive supportive care is all that is needed. However abdominal complications do occur and proper surgical care is required to lower morbidity and mortality.
{"title":"Abdominal Complications of Typhoid Fever","authors":"Ketan Vagholkar Jimmy Mirani","doi":"10.7438/1584-9341-11-2-1","DOIUrl":"https://doi.org/10.7438/1584-9341-11-2-1","url":null,"abstract":"The natural history of typhoid fever poses both a diagnostic and a therapeutic challenge. Awareness of the clinical features of the primary presentation and of the complications are pivotal to early diagnosis. Typically, aggressive supportive care is all that is needed. However abdominal complications do occur and proper surgical care is required to lower morbidity and mortality.","PeriodicalId":385372,"journal":{"name":"Jurnalul de Chirurgie","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121796876","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}
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