Biomedical subjects

A Croitoru

Publications and source records attributed to A Croitoru.

9 recordsLinked to original sources

PubMedDate not supplied

[Late results after the Mark Belsey IV antireflux procedure in achalasia].

Cardial achalasia (cardiospasm, megaesophagus) represents the failure or lack of relaxation capacity of the inferior esophageal sphincter; it is the second esophageal disease and is considered a premalignant lesion. Treatment of achalasia is surgical but palliative, considering the lack of an etiopathogenic therapy for this moment. We present a retrospective study done on 19 patients (10 males and 9 females, with a mean age of 49 years) operated in "Colentina" Surgical Clinic in the period of 1996-1999 for achalasia (presenting symptoms-dysphagia, regurgitation, weight loss) by extramucosal esocardiomyotomy practiced on a length of 5-10 cm, by thoracic approach, followed by the Mark Belsey IV antireflux procedure. Results were good, without reflux pathology or dysphagia in the postoperative evolution.

Adult↗

PubMedDate not supplied

[Pancreatic insulinomas].

In the period of 1980-1999 (20 years) were operated 18 patients (8 males and 10 females) in "Colentina" Surgical Clinic, the average age being of 45 years, with hystopathologically confirmed insulinomas. The topography of these lesions was in the head of the pancreas (4), in the isthmus (5), in the body and tail (9). The classical clinical and biochemical signs were presented in 13 cases, the rest of the patients presenting atypical signs of disease. These patients had benefit from the surgical treatment. The approach was bi-subcostal in 11 cases and by upper and lower midline incision in the rest of cases. We practiced enucleation in 5 cases, corporeal-caudal pancreatico-splenectomy in 10 cases and cephalic pancreatico-duodenectomy in 3 cases. The malignancy of the tumour was hystopathologically confirmed in 30% of the situations. The postoperative mortality was in 3 cases, by acute pancreatitis, MSOF and myocardial infarction. We consider that in case of these generally benign tumours the most efficient therapy is the surgical one.

Adult↗

PubMedDate not supplied

[Sugiura's procedure--a treatment modality for esophageal varices].

This study present the "N. Gh. Lupu" surgical experience with Sugiura technic for bleeding caused by oesophageal varicose. Is a 5 years retrospective study with 30 patients who are submitted of this operation. After the results analysis our opinion is to do this operation in stabilised patient, but she is possible even in emergency.

Digestive System Surgical Procedures↗

PubMedDate not supplied

[Therapeutical options in pancreatic pseudocysts].

This paper presents the "N.Gh.Lupu" surgical clinic's experience, that consists in 65 cases of pancreatic pseudocysts operated in the last 10 years (1989-1998), 30 females and 35 males, with a mean age of 52 years old. The diagnosis was mainly based on the classical echography and CT-scanner, the clinical picture being non specific in the majority of cases. Although the predominant use of the nonsurgical interventional procedures is recommended, this presents the maiden attempts of the authors in this field, the surgical techniques used being as it follows: cephalic pancreaticoduodenectomy, distal pancreatectomy, cystodigestive anastomosis, external drainage. The perioperative mortality was null, the postoperative one consisting in 3 cases (2 cases in the early period and 1 case in the later period).

Adult↗

PubMedDate not supplied

[Neoadjuvant radiochemotherapy in the treatment of esophageal squamous carcinoma:Preliminary results in a series of 15 patients].

The purpose of this study is to analyze the experience of the Center of General Surgery and Liver Transplantation from Fundeni Clinical Institute (Bucharest) regarding the results of neoadjuvant radiochemotherapy in the squamous carcinoma of the esophagus. During 01.01.2001-09.07.2003, 15 patients with squamous carcinoma of the esophagus were treated using neoadjuvant radiochemotherapy (RCT); 13 patients (86%) underwent esophageal resection (in 2 patients resection was not possible due to the mediastinal invasion). Complete histological response (the lack of malignant tissue on the esophagectomy specimens) was noted in 5 cases. The morbidity and mortality rates were 48%, respectively 6%. RCT increases the resectability in esophageal cancer and decreases the postoperative morbidity and mortality.

Adult↗

PubMedDate not supplied

[Therapeutic options in gallstone ileus].

Gallstone ileus is a rare, serious condition, requiring emergency surgery, specific to elderly age. The present study deals with 16 cases operated in 25 years period, with median age about 64 years old. The patients had clinical evidence of intestinal obstruction, confirmed by radiological examination and ultrasonography. Emergency operations were performed. In 7 cases had been treated radically both the obstruction (entero-lithotomy) and the bilio-digestive fistula (cholecystectomy, duodenal closure, enteral closure, colon-suture) with good results (only one death). In 9 cases, it had been treated only the intestinal obstruction, with only 2 cases of persistent cholangitis. Generally, we have used biliary drainage with Kehr tube in the presence of biliary stones and cholangitis. The biliodigestive fistula may close in evolution or become a harmless secondary route for internal biliary drainage.

Aged↗

PubMedDate not supplied

[Cancer of the head of pancreas--resection vs. palliative surgery].

Pancreatic cancer remains a disease with high mortality. The unspecific symptoms for a long time make the diagnostic difficult. Between 1995-2004, only 85 from 465 patients with this diagnosis, had pancreatic resection. To them, we performed Whipple pancreaticoduodenectomy (60), pylorus preserving pancreaticoduodenectomy (15), pancreatico-duodenectomy with preserving of duodenum (2), pancreaticoduodenectomy with associated resections (5), subtotal pancreatico-duodenectomy (30). The reconstruction after pancreatic resection was pancreatico-jejuno anastomosis (26) and pancreatico-gastro-anastomosis (59). Morbidity was about 34% and the mortality was about 9%.

Adult↗

PubMedDate not supplied

[Transtumoral drilling--an efficient solution and in many cases the only one available in the surgical treatment of Klatskin tumors].

PURPOSE: Reviewing the cases and evaluate the efficacity of the trans-tumoral drilling in the Klatskin tumours which were operated in Colentina Surgical Department. MATERIAL AND METHOD: This is a clinical retrospective study on 109 cases of Klatskin tumours operated between 1998-2004. in 80 cases of them we could practice a biliary drainage using a trans-tumoral drilling. SURGICAL INDICATION: Malignant tumours of the main biliary duct developed at the level and above the junction of the two hepatic ducts , extended to the liver in many cases. SURGICAL TECHNIQUE: Through the choledochostomy, we performed with a special instrument the trans-tumoral drilling with the setting of a biliary axial drainage (40 cases), external biliary drainage through a semirigid trans-choledochal tube (25 cases), Kehr tube (9 cases), U tube (3 cases), internal drainage with intra-choledochal stent (2 cases), lost tube (1 case). RESULTS: In all cases we observed the early decrease of the jaundice. In the cases in which we used internal drainage, we had to perform a replacement of the closed tubes in 1-2 months after the first operation. Instead, the external biliary drainage, less expensive and periodically washed to preserve his permeability, proved his high efficiency. The average survival time was 8,9 months (between 5-20 months). CONCLUSIONS: The external biliary drainage through trans-tumoral drilling remains in many cases the only one available therapeutical solution for the Klatskin tumours.

Aged↗

PubMedDate not supplied

[Palliative total gastrectomy].

Gastric cancer, because of lymphonodulary and local extension, often allows only palliative surgery. This study tries to present the total gastrectomy as an alternative meant to improve the life of the patients who cannot hope to radical cure. Thirty-one patients were submitted to this operation during the last five years. The main indication for surgery was cancer extended to the gastric corpus, mainly on the posterior aspects and almost reaching the cardia. Because of lymphonodulary invasion over N2, hepatic and pancreatic and colonic invasion over N2, hepatic and pancreatic and colonic invasion and because of the metastases, the resections were palliative. The operations consisted of total gastrectomy and omentectomy, without trying to reach lymphatic stations over NI. All cases presented evidence of restant cancerous tissue involving the pancreas, the liver or the other lymphatic stations, but the main purpose was the ablation of the gastric tumor. Postoperatively we recorded 3 deaths, 9 anastomotic fistulae and an average survival of 9 months (6-13 months).

Aged↗