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Biomedical subjects

M Chifan

Publications and source records attributed to M Chifan.

120 records · Page 7Linked to original sources

[The cardiac manifestations in hyperthyroidism. The surgical implications].

In a statistics including 954 patients with hyperthyroidism [correction of Huprotoncoses] treated between 1966-1989, the authors found 522 cases (54) with various associated cardiac disorders. Of these cases, 199 presented rhythm disturbances: extrasystolic arrhythmia, auricular fibrillation and flutter to which 34 postoperative arrhythmias are added. Cardiac insufficiency present in 46 cases was the main complication and end point of the various myocardial conditions. Ischemic cardiopathy (181 cases), arterial hypertension (98 cases) and rheumatic valvulopathies (9 cases), either isolated or dominating the clinical picture, complete the nosological spectrum of these disturbances. The frequency of associated conditions and the absence of some specific morphologic lesions suggest that thyrotoxicosis is rather an aggravating factor although in many cases the presence of a previous cardiac disease is excluded. The two objectives in the management of thyrocardiac diseases are the amelioration of cardiac condition and an endocrine balance. In the conditions of a careful selection and preoperative preparation, surgery gave good results consisting, in this series, in over 70% cures and ameliorations.

Adult↗

[Mechanical anastomoses in esophagogastric surgery for malignant tumors].

The authors present their experience in employing for the first time the mechanical circular suture with I.L.S. stapler in the surgery of 10 malignant esophagogastric tumors sited in C (4 cases) and M areas (6 cases). The disease was in stage II in 2 patients and in stage III in the remainder of 4. Three upper polar esophagogastrectomies (Akiyama technique) and 7 total gastrectomies were performed in old patients (mean age 63 years) at high surgical risk. Neither death nor fistulas were recorded. The average hospital stay was 14 days. A series of 17 patients (mean age 59 years), at medium surgical risk, with total gastrectomy for gastric carcinoma and classical suture served as controls. Five fistulas, two deaths and a two times longer hospital stay were recorded. Although the high cost of staplers prohibits the routine use of this technique, the authors demonstrate the great advantages resulting from mechanical suture in esophagogastric surgery.

Anastomosis, Surgical↗

[Choledochal cyst in adults and cancer of the biliary tract].

We presented 3 cases of cystic dilatation of common bile duct classified as type IC, IVB an IVA. All 3 were women, admitted for right upper quadrant pain and jaundice. Two cases proved malignant degeneration in cystic dilatation in first cas and in gallbladder in third. Only the 3rd case had a positive preoperative diagnosis achieved through echography, TPHC, ERPC. Surgical treatment consisted of cysto-jejunal derivation in the cas of the common duct malignant cyst inoperative and cholecystectomy associated with the excision of the dilatation followed by the hepato-jejunal anastomosis in the other 2 cases. Adenocarcinoma of the gallbladder was a pathological surprise. A better knowledge of the risk of cancer on cystic dilations of the common bile duct should lead to an earlier diagnosis of this disease and a preventive treatment by radical excision of the dilatation.

Adenocarcinoma↗

[The treatment of rectal cancer--the optimizing possibilities].

The authors studies 280 rectal cancers treated in the first surgical clinic of Iaşi in the period 1981-1994. Although surgery is the main treatment of these tumors, it cannot be and it must be not used alone. Surgery must be associated with radio- and chemotherapy, because is the only way possible to increase the number of resections for rectal tumors and the survival rate. For the 263 tumors operated the resectability was 73, 5%: Milles's operation 101 (36, 7%), Dixon's operation 81 (30, 79%), other operation 91 (33, 11%). We consider that Dixon's operation is the best choice for the tumors in the stages A and B of Dukes classifications. Preoperative radiotherapy can influence the tumor volume (downstaging) and decrease local recurrences to about 10-15%. Surgery alone must be practiced only in emergencies. Postoperative chemotherapy is mandatory and it reduces local recurrences and delays metastasis evolution.

Adult↗

[Thyroid cancers].

We have analysed factors that influenced on the patient survival in 195 cases of thyroid cancer. The survival is essentially influenced by the histology, the papillary forms (survival after 15 years: 83.1-93%) and follicular cancers (survival after 15 years: 84-94%) having an excellent evolution. The non-differentiated and mixed cancers have a very severe prognosis that is independent of the complex therapy that have been used (survival after 5 years: 17.1% in non-differentiated forms and 32.5% in mixed ones). The prognosis is better in subjects under the age of 45 and in female subjects. The cancers in the 1-st and 2-nd stage of tumor extension have a better evolution that those in the 3-rd stage. In differentiated cancers, the total or subtotal thyroidectomy followed by radioiodine administration determine the best survival.

Adenocarcinoma, Follicular↗