Chirurgia最新文献

{"title":"Ramp Lesions with ACL Injuries Between MRI and Arthroscopic Evaluation.","authors":"Mohamed Samir, Ehab Alieldin, Ahmed T Ashour, Ahmed Abouelnaga, Ahmed Attia, Ahmed Ashour, Ahmed Ismail, Ahmed Waly, Tarek Elkhadrawy","doi":"10.21614/chirurgia.119.eC.3032","DOIUrl":"https://doi.org/10.21614/chirurgia.119.eC.3032","url":null,"abstract":"<p><strong>Objective: </strong>To compare the accuracy of arthroscopy with MRI in diagnosing ramp lesions associated with anterior cruciate ligament (ACL) injuries.</p><p><strong>Design: </strong>Prospective observational study. Material and <b>Methods:</b> We included 100 patients with complete ACL tear.</p><p><strong>Exclusion criteria: </strong>1) Partial ACL tear, 2) ACL revision surgery or previous knee surgery, 3) Multi-ligamentous knee injury, 4) Extensive medial meniscus tear. <b>Results:</b> Nine patients were diagnosed with ACL-associated ramp lesions. All nine had magnetic resonance imaging (MRI) signs, but these were not statistically significant ( 2=1.884, FEp=0.348). Mean medial meniscal slope for patients with ramp lesions was 2.88 +- 0.46, without was 2.47 +- 0.55 (T=2.146, P=0.034), implying statistical significance as visualized by arthroscopy. Arthroscopy is superior in diagnosing ramp lesions.</p><p><strong>Conclusion: </strong>Arthroscopy is superior in diagnosing ramp lesions due to cost-effectiveness, direct visualization, and immediate treatment capability. The absence of specific MRI signs for ramp lesions further supports this conclusion.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563844","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}

{"title":"Polymorphisms of CD44 rs187115 as a Predictive Biomarker in Early Colorectal Cancer Diagnostic.","authors":"Raluca Dumache, Alexandra Mihailescu, Dana Liana David, Flavius-Lucian Herlo, Gabriel Verdeş, Dan Brebu, Ionuţ Faur, Vlad Braicu, Amadeus Dobrescu, Ciprian Duţă","doi":"10.21614/chirurgia.3007","DOIUrl":"10.21614/chirurgia.3007","url":null,"abstract":"<p><p><b>Introduction:</b> Colorectal cancer (CRC) has exhibited an increasing incidence worldwide in recent years, underscoring the importance of early diagnosis methods. This study aimed to assess the influence of CD44 gene polymorphism rs187115 on CRC susceptibility. Material and <b>Methods:</b> The study encompassed 470 CRC patients and 165 healthy controls. Genotyping of all biological blood samples was conducted using the TaqMan assay on the ABI 7500 Real Time PCR System (Applied Biosystems, USA). <b>Results:</b> The genotyping revealed that carriers of the variant G allele, including the genotypes AG and GG, exhibited a heightened risk of CRC occurrence, with an odds ratio (OR) of 1.89 (95% confidence interval [CI] = 1.57-1.97; p = 0.047) compared to those carrying the AA genotype. <b>Conclusions:</b> The findings underscore the potential utility of CD44 rs187115 polymorphisms as a novel predictive biomarker for CRC prognosis.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307228","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}

{"title":"Burn Injuries in the Pediatric Population - The Experience of a Single Center Over a Period of Two Years.","authors":"Denisa Maria Canut, Marius Eugen Ciurea","doi":"10.21614/chirurgia.3012","DOIUrl":"10.21614/chirurgia.3012","url":null,"abstract":"<p><p><b>Introduction:</b> The study investigated the therapeutic approach and clinical management of pediatric burn patients admitted to the Pediatric Surgery and Orthopedics Clinic of the County Emergency Hospital Craiova over a two-year period (2017-2018). The primary objective was to evaluate the effectiveness of the treatments applied, including grafting procedures and their impact on long-term prognosis. Material and <b>Methods:</b> The cases of 80 children with burns of varying severity were retrospectively analyzed. Patients were classified according to the severity and the mechanism of burn injury. The collected data were processed using Microsoft Excel 2021. Patients were classified into three categories based on the affected body surface area (BSA): Category 1 patients, with a BSA = 10%, showed very good results and required less intensive care. Category 2 patients, with a BSA between 10% and 50%, had good outcomes but needed more prolonged care. Category 3 patients, with a BSA = 50%, had satisfactory results but faced more challenges in recovery, highlighting the need for enhanced prevention measures and better treatment protocols. <b>Results:</b> The majority of patients came from rural areas, and thermal burns were the most common. The effectiveness and safety of the treatments applied were highlighted, with a generally favorable impact on long-term prognosis. Treatment included both surgical and non-surgical approaches, with generally favourable clinical outcomes. Conclusion: The study highlights significant differences between rural and urban environments, suggesting the need for prevention and education campaigns regarding pediatric burns and improved access to medical services. It also emphasizes the need for integrated management to reduce the severity and complications associated with burns. The results provide a solid foundation for future strategies aimed at improving the care of paediatric burn patients.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307227","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}

{"title":"Ovarian Carcinoma - A Single Centre Case-Series Descriptive Analysis of Surgical Procedures.","authors":"George Daniel Subtirelu, Andreea Steriu, Eugen Bratucu","doi":"10.21614/chirurgia.3023","DOIUrl":"https://doi.org/10.21614/chirurgia.3023","url":null,"abstract":"<p><p><b>Background:</b> Ovarian surface epithelial cancer (OSEC) are an entity in which, according to genomics and pathology data accumulated in the last couple of decades, several different nosological entities with distinct etiologies are aggregated. In ovarian cancer, surgery is the pivot of treatment, to which medical oncological treatment is added by recommendation in most cases. Material and <b>Methods:</b> This is a single centre sample of 263 cases with OSEC operated from January 2014 until December 2021 with a 28-month period of follow-up, until 30th April 2024. OSEC surgical procedures in stages IIB to III and IV of the disease are complex interventions in order to have the R0/optimal cytoreduction achieved, so we summarised and coded them as follows: 1 = biopsy (of the tumour/peritoneum); 2 = bilateral/unilateral adnexectomy (BA/UA) total hysterectomy (TH) omentectomy +- peritoneal biopsies; 3 = (2) with total hysterectomy with bilateral adnexectomy (THBA) +- by extraperitoneal/subperitoneal route+peritonectomies (exclusively diaphragmatic) and electrocauterization of peritoneal carcinomatous lesions; 4 = (3) with visceral (multiple) resections +- stoma; 5 = (4) with diaphragmatic peritonectomies/stripping/partial resection of the diaphragm; 6 = palliative surgery. <b>Results:</b> Debulking surgery (DS) was carried out for n = 182 patients with no residual tissue = R0 being registered in n = 41. Results for patients with residual tissue (n = 141) after DS recorded the following findings: 1 cm (49% cases), 1.1-2 cm (29%) and 2 cm (22%). Recorded results for endometrial ovarian carcinoma (EC) n = 27 shown a tumour free survival probability estimate (%) at 60 months of 66% as both surgery and platinum based chemotherapy are efficient. For clear cell ovarian carcinoma (CCC) n = 7 recorded results shown a tumour free estimate (%) at 60 months of 14%, being known the controversy as to whether or not paclitaxel is an active drug for CCC. Major complications were recorded in 25 patients with a fatality ratio of 5/25. Conclusion: Considering OSEC is a relatively rare disease and the importance of collecting substantial numbers of samples by histotypes to further knowledge about ovarian cancer it comes crucial to establish collaborative endeavour of tertiary centers with standardised and quality control strategies.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281161","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}

{"title":"Comparative Statistical Analysis of Surgical Procedures in the Management of Hirschsprung Disease.","authors":"Viorel Ţandea, Ionuţ Daniel Raducan, Razvan Constantin Datu, Silviu Constantinoiu","doi":"10.21614/chirurgia.3019","DOIUrl":"https://doi.org/10.21614/chirurgia.3019","url":null,"abstract":"<p><p>This study investigates the correlation between the histopathologically confirmed or refuted diagnosis of Hirschsprung Disease (HD) and the type of surgery performed on patients. Data from 24 patients were analyzed, divided into two categories: confirmed HD (n=17) and refuted HD (n=7). The results did not identify a statistically significant association between the diagnosis of HD and the sex of the patients (p-value = 1.000000). Further studies with larger samples are needed to clarify this relationship.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281160","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}

{"title":"A Case Report of Modified Cabrol Technique in a 60-Year-Old Male with Coronary Origin Anatomical Variant.","authors":"Horaţiu Moldovan, Maria Sabina Safta, Liliana Mirea, Aida Badea, Elena Nechifor, Andrada Guţă, Lucian Dorobanţu, Cristian Voica, Mircea Robu, Daniela Gheorghiţă, Mihaela Crăciun, Alexandru Zăman, Raluca Ciomag","doi":"10.21614/chirurgia.2967","DOIUrl":"10.21614/chirurgia.2967","url":null,"abstract":"<p><p><b>Introduction:</b> Reconstruction surgery of the proximal aorta in most cases involves the use of an aortic conduit, followed by reimplantation of the coronary ostia. Although uncommon, the origin of the coronary arteries in certain anatomical variants poses additional difficulties when performing surgery on the aortic root and requires a different treatment rationale. Case report: We hereby present the case of a 60-year-old patient with multiple cardiovascular risk factors (smoking, arterial hypertension and dyslipidemia), suffering from severe degenerative stenosis of a bicuspid aortic valve, associated with ascending aorta aneurysm and a significant extrinsic stenosis of the left coronary artery caused by the aneurysm. The patient presented with severe degenerative bicuspid aortic valve stenosis associated with ascending aorta aneurysm and a significant extrinsic stenosis of the left coronary artery caused by the aneurysm. Following the preoperative assessment, it was decided that the best course of action was to perform surgery on the aortic valve and ascending aorta. During the surgery, the origin of the right and left coronary ostia were found at the level of the left coronary cusp, both forming a common coronary button. Due to this particular anatomical variant, it was decided to reimplant them as a common button onto the main conduit by means of an interposed No.10 PTFE (Polytetrafluoroethylene) vascular prosthesis. Conclusion: A rare case of aortic root surgery associated with coronary ostia origin variant \"shotgun barrel\", which required a different method of reimplantation: modified Cabrol technique.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281162","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}

{"title":"Romanian Surgery between Tradition and Innovation: The Priorities of the 2024-2028 Mandate at the Romanian Society of Surgery.","authors":"Viorel Scripcariu","doi":"10.21614/chirurgia.3030","DOIUrl":"https://doi.org/10.21614/chirurgia.3030","url":null,"abstract":"<p><p>img src=\"/images/viorel_scripcariu.jpg\" alt=\"Viorel Scripcariu\" style=\"float: right;max-width: 30%;\"/ Assuming the leadership of the Romanian Society of Surgery for the next four years is for me a moment of deep significance and responsibility. With a tradition of almost 130 years, this organization is at the foundation of the Romanian surgeon community, and my role is to continue this legacy and open new paths for the future of Romanian surgery. I would like to share the priorities I have set for this mandate, given our shared commitment to promote excellence in surgical practice and to respond to contemporary challenges. An essential aspect of my mandate is to respect the rich tradition and history of Romanian surgery. The Romanian Society of Surgery was founded at the end of the 19th century in Bucharest, with the surgeon Constantin Severeanu at its head. At the meeting on January 27, 1899, the society constituted its first board, with Thoma Ionescu as president, together with other founding members such as Dr. Leonte, Dr. Racoviceanu-Pitesti, Dr. Duma and Dr. Staicovici. Over the years, numerous meetings were organized at the Institute of Topographic Anatomy in Bucharest, where clinical cases, new surgical methods and lectures by medical personalities from abroad were presented. Over the years, the society has continued to promote international collaboration, organizing congresses and inviting renowned surgeons from abroad to lecture and perform innovative surgery in Romania. This rich history and respect for traditional values are fundamental to preserving and enhancing the standards of excellence we have inherited. We will continue our efforts to honor our mentors and their achievements, ensuring that their legacy will continue to inspire and guide new generations of Romanian surgeons. [ a href=\"https://revistachirurgia.ro/pdfs/2024-4-357.pdf\" read more /a ].</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281168","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}

{"title":"Splenic Hydatid Cysts Treated by Partial Splenectomy: Case Series and Literature Review.","authors":"Beatrice M Tivadar, Corina E Minciună, Cătălin Vasilescu","doi":"10.21614/chirurgia.3010","DOIUrl":"https://doi.org/10.21614/chirurgia.3010","url":null,"abstract":"<p><strong>Purpose: </strong>Hydatic cysts (HC) rarely occur primarily in the spleen. Partial splenectomy (PS) is an established procedure for preserving spleen parenchyma, but rarely used in the treatment of HC. We aim to present our experience with PS for HC and to review the literature of splenic HC treated by PS. Material and <b>Methods:</b> The databases of PS performed between 2000 and 2023 in the Department of General Surgery of Fundeni Clinical Institute (Bucharest) for HC have been reviewed retrospectively. Searching the PubMed, Medline, and Google Scholar databases for keywords such as \"partial splenectomy\", \"splenic hydatid cyst\" etc, we retrieved publications from 2000 to December 2023 in English for a literature review. We excluded studies which were not published in English and studies which did not provide accurate or specific data regarding the treatment of splenic HC by PS. <b>Results:</b> There were 10 PS for HC. Six females and 4 males, ages between 16 and 41 (31Ã+-8.43), 9 with HC in the upper splenic pole (UP) treated by PS with lower pole (LP) preservation and one inferior pole HC treated by LP PS. There were 4 open, 2 laparoscopic and 4 robotic PS. There were no complications or recurrences at follow up (2 years). The literature review consists of 14 full-text articles, presenting 42 PS for HC.</p><p><strong>Conclusion: </strong>PS for HC is feasible, achieves complete removal of the cyst, while preserving splenic function. The procedure can be performed laparoscopically or robotically with the advantages of minimally invasive surgery.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281169","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}

{"title":"Evaluating VATS versus Open Surgery for Non-Small Cell Lung Cancer: A 5-year Retrospective Study.","authors":"Alin Ionut Burlacu, Bogdan Cosmin Tanase, Iolanda Augustin, Gabriel Veniamin Cozma","doi":"10.21614/chirurgia.2999","DOIUrl":"https://doi.org/10.21614/chirurgia.2999","url":null,"abstract":"<p><strong>Background and objectives: </strong>The efficacy and safety of video-assisted thoracoscopic surgery (VATS) versus open thoracotomy in the treatment of non-small cell lung cancer (NSCLC) were evaluated with a focus on mediastinal lymph node dissection, postoperative recovery, and longterm outcomes including survival rates and disease-free intervals. <b>Materials and Methods:</b> This retrospective study analyzed data from 228 NSCLC patients treated at the Institute of Oncology Bucharest from 2016 to 2022. Both VATS and open surgical approaches were compared, with variables including demographic data, comorbidities, surgical outcomes, and postoperative complications meticulously recorded. Statistical significance was assessed using chi-square and independent samples t-tests. <b>Results:</b> Among the findings, VATS demonstrated significantly better two-year progression-free survival rates for patients in early stages (Stages 1-3) of NSCLC compared to open surgery, with p-values 0.01 and 0.001, respectively. In contrast, no significant difference was observed in Stage 4. Furthermore, VATS resulted in shorter operative times (mean 299 vs. 347 minutes, p 0.001), less estimated blood loss (98.68 mL vs. 160.88 mL, p 0.001), reduced chest tube duration (5.78 days vs. 12.17 days, p 0.001), and decreased hospital stays (12.0 days vs. 27.7 days, p 0.001). <b>Conclusions:</b> VATS is associated with improved long-term disease-free survival for early-stage NSCLC and more favorable short-term surgical outcomes, highlighting its advantages over open thoracotomy. Despite its benefits, VATS did not significantly reduce postoperative complications compared to open surgery.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281164","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}

{"title":"Case Report: An Unreported Presentation of Lemmel Syndrome Highlighting Diagnostic Challenges of Duodenal Masses.","authors":"Océane Wautelet, Nicolas Tinton, Emanuel Cambier, Francisco da Rocha","doi":"10.21614/chirurgia.119.eC.2998","DOIUrl":"10.21614/chirurgia.119.eC.2998","url":null,"abstract":"<p><p>We present a case involving a 67-year-old patient with a medical history of gastric bypass who was recently diagnosed with a 6-centimeter duodenal mass causing biliary duct stenosis. Despite our best efforts, we were unable to access this tumor endoscopically, necessitating surgical intervention. During the surgical exploration, we discovered a duodenal diverticulum filled with stones, leading to the obstruction of the biliary ductâ?\"a manifestation of Lemmel syndrome. This rare condition is characterized by obstructive jaundice in the absence of choledocholithiasis or tumors and is secondary to dilatation of peri-ampullary diverticula. While it is typically managed through endoscopy, our diagnostic and therapeutic approach was complicated by the patient's history of bariatric surgery (gastric bypass), making endoscopic access impossible despite our multiple attempts. This case report sheds light on the challenges posed by the concurrence of a rare pathology and surgically modified anatomy, which is increasingly encountered in daily surgical practice. In such situations, exploratory surgery continues to play a significant role.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901100","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}