Biomedical subjects

D Cristian

Publications and source records attributed to D Cristian.

24 records · Page 2Linked to original sources

PubMedDate not supplied

[Hydatid cyst of the head of the pancreas--a clinical case].

Case report of a 41-year-old man, admitted because of intense sclero-tegumentar jaundice, epigastric pain and brings. The altered general state, because of obstructive jaundice (the total bilirubyne 9.6 mg%, with D 5.8 mg% and I 3.8 mg%, the alkaline phosphatase 650 u.i./l) determined the effectuation in emergency of an endoscopic retrograde cholangiopancreatography, which included also a minipapilosfincterothomy. On obtained the spectacular improvement of the jaundice (the total bilirubyne 1.3 mg%) which permitted the extension of the imagistics explorations, establishing the diagnostic of cystic tumour of the head of the pancreas, but on could't specify the etiology. On made the surgical approach, founding a hydatic cyst of the head of the pancreas; on practised the parasite inactivation, the cyst evacuation, pericysto-jejuno-anastomosis on a loop in Y "à la Roux" and cholecysto-gastro-anastomosis. The postoperative evolution was favourable.

Adult↗

PubMedDate not supplied

[Immediate and early reinterventions in the surgery of colorectal cancer].

Out of 584 cases submitted to colorectal surgery 461 (78.92%) were performed for cancer. Thirty-three patients (7.16%) necessitated immediate (1) or precocious reinterventions for bleeding, fistulae, peritoneal infections, bowel occlusion, necrosis or stenosis of the iliac anus. We are out the technical procedures chosen for each class of complications asking for reintervention. We registered 4 deaths, in aged patients with hard associated morbidity, with emergency reinterventions. We appreciate that a correct preoperative preparation reduces the rate of reintervention and an early reintervention reduces the post-operative mortality.

Adult↗

PubMedDate not supplied

[The place of surgery in the treatment of locally advanced rectal cancer].

We considered as local advanced rectal cancer (LARC) tumours invading the serosa or adherent to neighbouring organs, tumoral fistulas, histopathologically proved invasion of regional lymph nodes, peritoneal carcinomatosis with or without neoplastic ascites. Out of 146 rectal cancers submitted to surgery between 1984-1996, 47 had LARC (19 man and 28 women aged of 19 to 88 years) developed in the inferior 2/3 of rectum. We performed in these cases 11 Miles operations, 12 posterior pelvectomies, 3 Dixon resections, 16 colostomies and 5 exploratory laparotomies. To these were associated 4 partial cystectomies, 4 anexectomies, 4 partial enterectomies and 2 excisions of hepatic metastasis. In 27 patients adjuvant or neoadjuvant therapy was associated. We registered 3 deaths, 6 parietal infections and 1 stercoral fistula. Postoperative survival was 3-6 months for 12 patients, 6-12 months for 13 patients, 1-2 years for 6 patients. After the complex treatment 6 patients were alive at 5 years. Surgery is the essential therapeutic act of LARC. Chemo/radiotherapy association increases the survival, but not significantly.

Adolescent↗

PubMedDate not supplied

[The classical or laparoscopic operation in inguinal hernias].

AIM: Results evaluation in two trials of patients undergoing classical or laparoscopic surgery for inguinal hernia. MATERIAL AND METHOD: We compared 2 homogeneous trials of 80 patients with inguinal hernias treated by classic procedures: Bassini, Shouldice, Lichtenstein (trial I) or by laparoscopic approach with Plastex, Mercilene or Prolene prosthesis (trial II) between 1995-1997. RESULTS: Postoperative morbidity consisted in trial I in 5 seromas, 2 hematomas, 4 cases with neuralgic pain, 1 with testicular hypotrophy and 4 recurrences. In this trial the mean operative time was 22 min. and the mean hospitalization was 7 days. In trial II we registered a parietal bleeding at a lateral port imposing the conversion, 3 serohematomas, 2 recurrences by displacement of the prosthesis and 2 cases of neurologic pain. The mean operative time was 50 minutes and the mean hospitalization was 3 days. CONCLUSION: In spite of the longer operative time and the higher cost (the price of the prosthesis), in trial II the benefits of shorter hospitalization, lower morbidity and rapid socioprofessional reintegration are significant.

Hernia, Inguinal↗

PubMedDate not supplied

[The place of laparoscopy in assessing and treating a pain syndrome of the right iliac fossa].

The study is considering a trial of 87 patients (61 women 17 and 76 years old) admitted in our clinic between 1995-1996. The preoperative diagnosis was coincident with the laparoscopic one in 10 cases the laparoscopic one in 10 cases the laparoscopy completed the diagnosis and in 12 cases it showed out other organ's disease, evicting useless operations. In the 87 patients we performed: 53 appendectomies, 20 oophorectomies, 15 partial oophorectomies, 9 right adnexectomies, 2 adhesiolysis, 2 lymph node biopsies, 1 epiploic fringe excision for necrosis, 1 appendicular stump removal. The evolution was favourable in all patients, the mean postoperative hospitalization was 48 hours.

Abdominal Pain↗

PubMedDate not supplied

[Laparoscopic cholecystectomy in acute cholecystitis].

AIM: Results evaluation of laparoscopic cholecystectomy in acute cholecystitis. MATERIAL AND METHOD: Between 1994-1997 we performed 65 laparoscopic cholecystectomies for histopathologically proved acute lithiasic cholecystitis. We studied clinic and echographic diagnosis, operative moment, conversion rate, operative time, postoperative morbidity and hospitalization. The cholecystectomy was performed within 72 hours in 18 patients (trial I), 4 to 7 days in 25 patients (trial II) and over 7 days in 22 patients (trial III). RESULTS: Diagnosis of acute lithiasic cholecystitis was always possible by clinical examination and ultrasonography. We performed 8 conversions in patients of trial II (2) and III (6). The mean operative time was 68 min. Postoperative morbidity consisted in 4 bile leakages in the liver bed, 1 subhepatic abscess, 5 right pleural effusions. The mean hospitalization was 4.4 days. CONCLUSIONS: Urgent laparoscopic cholecystectomy is a beneficial act for acute lithiasic cholecystitis. The operative moment is the most important factor of influence on conversion rate, operative time and postoperative morbidity.

Acute Disease↗