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Biomedical subjects

E Bobocescu

Publications and source records attributed to E Bobocescu.

14 recordsLinked to original sources
PubMedDate not supplied

[Current problems of surgical tactics and technics in gastric neoplasms].

The authors have investigated 413 cases with gastric neoplasms that have been operated over a period of 20 years. It was noted that the operability index, and the resectability index have not improved in time. Only in 39,3 percent of the patients subtotal gastrectomy was possible, while 12,1 percent underwent total gastrectomy, 6,2 percent palliative interventions, and the remaining 42,4 percent had only exploratory laparotomy. The authors conclude that the principle of exeresis within the limits of oncological security applies only to limited tumours, without extraparietal extension. The maintenance of a gastric sector, either in the para-cardial or in the juxta-pyloric area, depending on the location of the tumour, is almost always possible, providing a good-quality anastomosis without diminishing the oncologic characteristics of the intervention.

Adult↗
PubMedDate not supplied

[Surgery of operative lesions of the principal biliary passages].

The authors present their experience acquired in 30 cases of surgical interventions performed for the correction of accidental lesions of the main biliary pathway. The essential parameters are discussed in this paper, which determine the degree of difficulty of the corrective interventions. Indications are also discussed concerning tactical and technical aspects depending on the level of the lesion, as well as in relation with its type. The authors present some particular aspects of prostheses used in the derivations which they have made with a corrective purpose.

Adult↗
PubMedDate not supplied

[Particular operations in surgery of gastric ulcer under the protection of vagotomy].

There are particular situations in the frame of the surgery of gastric ulcers, when the use of classical techniques--such as extensive resections, or sub-total resections--represents a risk factor and raising doubts about the vital prognosis of the patient (dehiscence, fistula, etc.). This is especially true for highplaced lesions, the removal of which supposes either an upper polar resection, or an almost total gastrectomy. This raises some problems with suture which are doubtful, as well as the risk of the "small stomach" syndrome or the risk of accelerated evacuation. The authors suggest several possibilities for the surgery of gastric ulcers under the protection of vagotomy, which allow a good immediate and late evolution. These include the medio-gastric resection, the so-called "saddle" resection, and the excision-suture resection, all being carried out under the protection of vagotomy associated to piloro-plastia. Making use of these procedures the authors have been able to maintain a more conservative attitude with regard to the stomach pouch, and to avoid some of the sequellae of the operated stomach.

Gastrectomy↗
PubMedDate not supplied

[Splenic hemangiosarcoma].

The authors present a case of splenic hemangiosarcoma which was encounter-a group including some 600 splenectomies. Hemangiosarcomas represent only 3% of all malignant splenic tumours. This clinical observation is of particular interest because of the extreme rarity of such cases. It is also interesting because of the conditions which have determined the intervention, as well as by the prolonged survival of the patient.

Hemangiosarcoma↗
PubMedDate not supplied

[Decompression of the duodenum, using the extraperitoneal route, in upper digestive tract fistulas].

Over the last 20 years a total of 45 cases with digestive fistulae of various origins have been hospitalized in the Surgery Clinic of the "Caritas" Hospital. In this paper a group of 21 cases with gastro-duodenal and anastomotic fistulae are considered, for the solution of which re-interventions were necessary. The authors present a procedure for temporary decompression of the duodenum, according to an original technique. The method allows to recover the digestive segment involved by healing of the fistulae in satisfactory conditions. The technical simplicity of the procedure is stressed, as well as the possibilities for postoperative radiological control, the strictly extraperitoneal traject of the tube, all representing qualities which give the technique considerable credit.

Adult↗
PubMedDate not supplied

[Oddi's sphincterotomy in treatment of primary sclerous cholangitis].

In the paper are presented a total of 9 patients with primitive sclerous cholangitis that were hospitalized in the Surgical Department of the "Caritas" Hospital with this rare nosologic entity. The etiology of the disease is neither precise nor incontroversial. Primitive sclerous cholangitis raises particularly difficult problems, because of the high mortality rate (all patients die before the 6-th year after the diagnosis has been established. The ineluctable evolution of the disease toward secondary billiary cirrhosis has generated major difficulties in the choice of the treatment. Corticoid therapy and immunosuppressive drugs have been proven inefficient in improving the prognosis. The classical surgical therapy includes methods that are not followed by stable results since the icteric syndrome will show temporary remission, in spite of the fact that the chronic hepatopathy will continue its independent evolution. The authors have not achieved satisfactory results with the classical surgical techniques, which include external biliary draining and peri-hepatic artery neurectomia (either isolated or combined), not with the internal derivations. Since 1971 the authors have used oddian sphincterectomy in the treatment of sclerous cholangitis. The method was introduced following a long clinical and histopathologic study. The immediate and the late results obtained with this technique recommend it as a choice one because it will lead to disappearence of the jaundice and to stabilization of the hepatic lesions.

Adult↗
PubMedDate not supplied

[Gastroesophageal patching with a jejunal loop in subtotal resections of the stomach].

The authors present a technical variant for re-establishing transit following sub-total gastric resections performed for extensive juxta-cardial lesions in which exeresis on the gastric wall also involves the right side of the terminal oesophagus. A "patch" of anastomotic jejunal loop is used in which the right segment of the assembly (the oesophagus and the right side of the gastric portion) does not take a direct part to the formation of the stoma. Two cases of gastric carcinoma are presented in which the extension of the lesions made necessary a strictly oesocardial proximal sectioning. The technique provides a wide stoma, without any risks of oesocardial obstruction. The method can be used in the gastric ulcers that are sited immediately under the cardia, allowing a sub-total resection with extirpation for the lesion. The authors suggest the use of this technique for the lesions high on the small curvature that cannot be extirpated with the classical technique due to the risk of stenosis of the cardial stoma as a result of the preparation of the oeso-cardial assembly. In this way the disadvantages of the exclusion technique introduced by Kelling and Madlener are avoided, as well as the risks of the high polar gastrectomy practiced by the Deloyers technique.

Esophagus↗
PubMedDate not supplied

[Benign gastric tumors. Unusual forms. Therapeutic considerations].

The authors present a study preformed on 38 patients with benign gastric tumours, representing 8.4% of the total number of gastric neoformations. Aspects related to the site of the tumours are discussed, as well as data concerning frequency, clinical and radiologic aspects, histologic characteristics, and the possible relationship with gastric cancers. A series of cases are described, the particularities of which may lead to diagnosis errors, and aspects are discussed in relation to surgical treatment of benign gastric tumours. The authors have mostly performed the excision of the tumours or a limited gastric resection, and obtained good results with this conservative attitude.

Adult↗
PubMedDate not supplied

[A controversial problem: Oddi sphincterotomy in cholangitis].

The classical treatment of angiocholitis consists in desobstruction of the hepatic choledocus duct followed by external biliary drainage. However, this technique is unsuccessful in 66% of the cases, and this leads to difficult surgical reinterventions. In our casuistics are included 196 suppurated angiocholitis of various etiologies : lithiasis, hidatic cyst, post-hidatic angiocholitis, pure oddian angiocholitis etc. The Oddian component is present in a remarkable high number of cases (66%) and this is the reason why neglecting sphincterotomy may be followed by unfavourable results. In the paper the authors present their viewpoint, and the results of 128 interventions on the Oddi sphincter in patients with angiocholitis.

Ampulla of Vater↗