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[Surgical emergencies in elderly]. [老年外科急诊]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
M F Coroş, C Copotoiu, Sanda Copotoiu, Sanda Ioniţă, A Dobre, S Sorlea, R Georgescu, C Crăciun, Iulia Roşu
{"title":"[Surgical emergencies in elderly].","authors":"M F Coroş,&nbsp;C Copotoiu,&nbsp;Sanda Copotoiu,&nbsp;Sanda Ioniţă,&nbsp;A Dobre,&nbsp;S Sorlea,&nbsp;R Georgescu,&nbsp;C Crăciun,&nbsp;Iulia Roşu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A higher number of elderly are seeking surgical care in the last years for different affections. The aim of the study was to analyze the characteristics of surgical emergency pathology in elderly and to establish several prognostic factors.</p><p><strong>Materials and methods: </strong>We did a retrospective study on 22.803 patients admitted in the First and the Third Clinic of Surgery from Targu-Mures between 1999 and 2006. The data were statistically processed.</p><p><strong>Results: </strong>The elderly (> or =70 years) represented 15.10% of all cases and 20.70% of all emergencies. Almost half of them (47.80%) were admitted in emergency conditions, compared to only a third (32.53%) of the younger group. The malignancies represented 16.72%, meanwhile in the younger group only 6.98 %. Abdominal emergencies represented 83.59%, mostly due to intestinal occlusion and digestive hemorrhages. The operability ratio was 68%, close to the younger group (72%). The global mortality rate was 3.95%.</p><p><strong>Conclusions: </strong>Surgical emergencies affect elderly in a higher percentage than the younger group. The emergency condition, the elder age and neoplasia are the most important factors of negative prognosis, and more important when they cumulate, increasing the mortality rate up to fivefold compared to the elderly admitted in elective condition.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"283-90"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27608930","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}
引用次数: 0
[Pancreaticoduodenectomy in elderly patients--a safe operation?]. 老年患者胰十二指肠切除术——一种安全的手术?
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
C Stroescu, B Ivanov, A Dragnea, T Dumitraşcu, M Ionescu, I Popescu
{"title":"[Pancreaticoduodenectomy in elderly patients--a safe operation?].","authors":"C Stroescu,&nbsp;B Ivanov,&nbsp;A Dragnea,&nbsp;T Dumitraşcu,&nbsp;M Ionescu,&nbsp;I Popescu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this study was to analyze the impact of age in mortality and morbidity after duodenopancreatectomy (DPC), setting the age of 70 as a cut-off. A retrospective study was made of two groups of patients (under 70 and over 70 years old) who underwent DPC in the Center of General Surgery and Hepatic Transplantation, Fundeni, Bucharest between 2001 and 2006 for malignant and benign tumors of the pancreatic head, distal biliary tract, duodenum, Vater's ampulla and chronic pancreatitis. 245 DPC were performed, 207 in patients under 70 years old (group A) and 38 in patients over 70 years old. Postoperative global morbidity rate was 58% in group B vs 49,9 % in group A. Postoperative mortality rate was 5,2% in group B and 4,8 % in group A. No significant differences were recorded in survival when comparing the two groups, both in pancreatic head cancer or distal biliary tract cancer. Under these circumstances, increased age is not determining an increase in postoperative mortality after DPC, but is associated with a higher risk of postoperative medical complications.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"275-82"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27608929","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}
引用次数: 0
Intraperitoneal cerebrospinal fluid pseudocyst. A rare complication of ventriculoperitoneal shunt. 腹腔内脑脊液假性囊肿。脑室腹腔分流术的罕见并发症。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
Th Birbilis, K Kontogianidis, G Matis, E Theodoropoulou, E Efremidou, P Argyropoulou
{"title":"Intraperitoneal cerebrospinal fluid pseudocyst. A rare complication of ventriculoperitoneal shunt.","authors":"Th Birbilis,&nbsp;K Kontogianidis,&nbsp;G Matis,&nbsp;E Theodoropoulou,&nbsp;E Efremidou,&nbsp;P Argyropoulou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The abdominal intraperitoneal cerebrospinal fluid pseudocyst is a rare but important complication in patients with ventriculoperitoneal shunts. We report a case of a 31-year-old female, in which a large abdominal pseudocyst was developed 1 year after insertion of a ventriculoperitoneal shunt for hydrocephalus. The abdominal CT scan and the ultrasonographical evaluation of the abdomen showed a well defined, cystic mass lesion with a volume of 50 cm3, in the recessus hepato-renal. The peritoneal tip of the shunt was located within the mass lesion. A distal externalization of the peritoneal catheter without excision of the pseudocyst was performed. Cerebrospinal fluid culture demonstrated a Staphylococcus epidermis infection and adequate antibiotic treatment was administrated. The previous symptoms improved 4 weeks later and a new catheter was placed intraperitoneally in a different quadrant. The postoperative course was uneventful. We suggest that chronic inflammation or subclinical peritonitis is a predisposing factor for this complication.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"351-3"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609399","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}
引用次数: 0
[Left paraduodenal hernia with particular evolution]. [演变特殊的左侧腹正中疝]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
V Bâtcă, O Albiţa, O Sima, T Rogin, T Bîtcă
{"title":"[Left paraduodenal hernia with particular evolution].","authors":"V Bâtcă,&nbsp;O Albiţa,&nbsp;O Sima,&nbsp;T Rogin,&nbsp;T Bîtcă","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paraduodenal hernia is a rare situation, less than 400 cases being published in literature. This condition is difficult to explore, diagnose appear within an occlusive syndrome. The etiopathology involves perturbation of intestinal rotation during the intrauterine life, producing paraduodenal fossa, which generates conditions for internal hernias and occlusive situations. We present the case of a 36 years old woman with chronic epigastric pain, diagnosed as duodenal ulcer, later as acute pancreatitis and in the end as high occlusion syndrome. Open laparotomy was performed, uncovering a strangulated left paraduodenal hernia, with severe pathologic lesions of the intestinal loops. Kelotomy and pure-string suture of parietal defect was performed. Post-operative evolution has been difficult with hepatic failure with coagulopathy and diffuse intestinal hemorrhage, threatening the patient's life. Intensive care lead eventually to a favorable condition. The rarity of this disease, difficulty of diagnosis and the particular evolution were the reasons to present this rare case.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"345-9"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609398","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}
引用次数: 0
[Demetrius Cantemir in the history of surgery: the first account of transabdominal approach to repair groin hernias]. [Demetrius Cantemir在外科历史上:首次报道经腹入路修复腹股沟疝]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
A E Nicolau
{"title":"[Demetrius Cantemir in the history of surgery: the first account of transabdominal approach to repair groin hernias].","authors":"A E Nicolau","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The first description of the transabdominal approach for hernia repair was written by Demetrius Cantemir, Prince of Moldavia and encyclopedic scholar, in his 1716 Latin manuscript \"Incrementa et Decrementa Aulae Othmanicae\". This manuscript was one of the most important of Eastern Europe at the time. It was first translated in English in 1734, and all subsequent translations into various other languages were based on this English version. The original manuscript now belongs to the Houghton Library of Harvard University, where it was recently rediscovered in 1984 by V. Candea. D. Sluşanschi has made the first Romanian translation of the first two volumes based on the original latin manuscript. This translation is now in press. Our article presents for the first time a fragment of this Romanian translation from the Annotations of Volume two, chapter four. In this fragment, Demetrius Cantemir describes the surgical procedure practiced by Albanian physicians in the prince's palace in Constantinopol. The patient was the secretary of the prince. There is a detailed description of the postsurgical therapy and the medical course to recovery. It was first partially reproduced by Mercy in his book on hernia published in 1892, and more recently by Meade in 1965. We consider useful to present to the medical community this valuable but less known contribution to the history of medicine.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"359-62"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609318","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}
引用次数: 0
[Renovascular hypertension: symptoms and signs. Clinical study on 20 patients]. 肾血管性高血压:症状和体征。20例临床研究[j]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
Gh Burnei, V T Grigorean, M Iacobini, S Duţescu, St Gavriliu, Ileana Georgescu, C Vlad, A R Stoian, C M Neacşu, D Hodorogea, Daniela Dan
{"title":"[Renovascular hypertension: symptoms and signs. Clinical study on 20 patients].","authors":"Gh Burnei,&nbsp;V T Grigorean,&nbsp;M Iacobini,&nbsp;S Duţescu,&nbsp;St Gavriliu,&nbsp;Ileana Georgescu,&nbsp;C Vlad,&nbsp;A R Stoian,&nbsp;C M Neacşu,&nbsp;D Hodorogea,&nbsp;Daniela Dan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>symptoms in renovascular hypertension can be wrong interpreted, which leads to a late diagnostic, after discover the determination disease.</p><p><strong>Materials and methods: </strong>the study on the renovascular hypertension was made on 20 patients, aged between 2 and 36 years old, diagnosed with reno-ureteral malformations, pyelonephritis, reno-ureteral reflux and renal trauma as a determination disease, leads to manifestation types that guide the diagnostic: neuro-psychiatric signs, weight loss, renal signs and digestive signs. Beginning from these signs the arterial hypertension was diagnosed and the investigations determined the causes.</p><p><strong>Results: </strong>Periodic postoperative evaluation at 3 months, during a period between 4 months and 7 years, individualised 4 evolutional clinical types: AHT with lumbar pain, AHT with no clinical signs, AHT with ophthalmologic signs and AHT with encephalitis like signs.</p><p><strong>Conclusions: </strong>symptoms in renovascular hypertension don't have pathognomonic clues and the identified signs, one type or all together, enforce the evaluation or even the monitoring of the arterial tension at least 30 days. If the values exceed the normal, complex investigations will be made in order to determine the specific cause of the AHT.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"301-7"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609390","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}
引用次数: 0
[Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency]. [慢性静脉功能不全患者静脉壁改变的临床-组织病理学相关性]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
A Mironiuc, L Palcau, O Andercou, L Rogojan, M Todoran, G Gordan
{"title":"[Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency].","authors":"A Mironiuc,&nbsp;L Palcau,&nbsp;O Andercou,&nbsp;L Rogojan,&nbsp;M Todoran,&nbsp;G Gordan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The interest manifested for the conjunctive tissue pathology leaded to the study of the structural disorder that appears in the varicose veins walls. The study is a prospective one initiated in March 2007 made on 11 patients with varicose disease hospitalized at Cluj-Napoca within Surgery Clinic no. II. The purpose of this study is to point out the histopathological modifications in the varicose venous wall (great saphenous vein cross, communicating veins, perforating veins), as well as the correlation of histopathological results with the evolutive stage of chronic vein insufficiency (CEAP classification) and with the clinical score at these patients. The histopathological (HP) results for 2 of the patients revealed hypertrophy of the media, intimal hyperplasia (stage II) corresponding to a CEAP 3. Six patients were integrated in HP stage III due to the partial intimal fibrosis corresponding to a CEAP 6 for one case, CEAP 4 one case, CEAP 3 four cases. One patient had HP stage I with CEAP 3 and two patients had HP stage IV corresponding to CEAP 5, respectively CEAP 6.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"309-12"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609391","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}
引用次数: 0
Neck nodal metastases from unknown primary: case series. 原发不明的颈部淋巴结转移:病例系列。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
D Tamiolakis, T S Chimona, E Proimos, G Georgiou, G Perogamvrakis, C E Papadakis
{"title":"Neck nodal metastases from unknown primary: case series.","authors":"D Tamiolakis,&nbsp;T S Chimona,&nbsp;E Proimos,&nbsp;G Georgiou,&nbsp;G Perogamvrakis,&nbsp;C E Papadakis","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Neck nodal metastases from occult primary constitute about 5%-10% of all hosts harboring carcinoma of unknown primary site. Metastases in the upper and middle neck (levels I-II-III-IV-V) are generally attributed to head and neck cancers, whereas the lower neck (level IV) involvement is often associated with primaries below the clavicles. Diagnostic procedures include a careful clinical evaluation and a fiberoptic endoscopic examination of the head and neck mucosa, biopsies from all suspicious sites or blindly from the sites of possible origin of the primary, computerized tomography (CT) scan, and magnetic resonance radiology (MRI). The most frequent histological finding is squamous cell carcinoma, particularly when the upper neck is involved.</p><p><strong>Settings: </strong>We report three cases of patients presented with nodal metastases of the neck from unknown primary site and we also describe the diagnostic and therapeutic approach employed in each one.</p><p><strong>Results: </strong>One patient harbored a neuroendocrine metastatic deposit, the second patient a poorly differentiated carcinoma and the third one a malignant melanoma.</p><p><strong>Conclusions: </strong>Diagnostic procedures should be aimed at clarifying the histology of the nodal metastases and detecting the primary tumor site.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"331-5"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609393","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}
引用次数: 0
[Colectomy for sigmoid colon volvulus. 1941]. 乙状结肠扭转的结肠切除术。1941]。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
N Constantinescu
{"title":"[Colectomy for sigmoid colon volvulus. 1941].","authors":"N Constantinescu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"323-9"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27609396","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}
引用次数: 0
[Guidelines for the management of painful endometriosis]. 【疼痛性子宫内膜异位症治疗指南】。
IF 0.6
Chirurgia (Bucharest, Romania : 1990) Pub Date : 2008-05-01
H Roman, L Puscasiu
{"title":"[Guidelines for the management of painful endometriosis].","authors":"H Roman,&nbsp;L Puscasiu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To establish guidelines for the medical and surgical management of painful endometriosis.</p><p><strong>Material and methods: </strong>An exhaustive review on Medline and Cochrane Database between 1980 and 2006 was performed.</p><p><strong>Results: </strong>GnRH agonists, progestins, continuous monophasic oral contraceptives and danazol have a suppressive effect on dysmenorrhoea, nonmenstrual pain and dyspareunia (grade A). Surgical treatment is effective in painful endometriosis (grade B). Complete surgical excision of deep endometriotic lesions with conservation of uterus and ovaries has a limited term efficacy on pain relief (grade C). A multidisciplinary approach is recommended (grade C). The use of the psychotherapy improves the management of chronic pain (grade A). There is a lack of information concerning the therapeutic strategy able to prevent recurrences. Whether endometriosis recurrences occur, medical treatment should be the first line approach (expert opinion). A hysterectomy with salpingo-oophorectomy and complete excision of the lesions is efficient in women with pain recurrence who no longer desire pregnancy (grade C).</p><p><strong>Conclusions: </strong>Medical and surgical treatments have a limited term efficacy on painful endometriosis (grade A). The benefit/risk ratio, depending on side-effects, should be assessed on a case to case basis.</p>","PeriodicalId":520588,"journal":{"name":"Chirurgia (Bucharest, Romania : 1990)","volume":" ","pages":"265-74"},"PeriodicalIF":0.6,"publicationDate":"2008-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27608928","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}
引用次数: 0
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