Biomedical subjects
Publications and source records attributed to N Angelescu.
Close relationships between Rumanian surgery and French surgery have existed since the middle of the 19th century. This study evokes Rumanian surgeons whose contribution to the establishment of close links between our countries has been particularly valuable.
Deeper knowledge of the etiopathogenesis of acute pancreatitis and the possibility to estimate the extend and gravity of pancreatic and peripancreatic lesions determined essential fluctuations in treatment evolution. Etiology of nonbiliary and nontraumatic A.P. recognises in the first place alcoholism (20-25% of A.P.) and in the second place less common causes such as: hypercalcemic states, hyperlipidemia (about 5-10% of A.P.). Diagnosis of nonbiliary A.P. leans upon: antecedents of chronic alcoholism, alteration on liver function tests and serum put levels and the results of cholecystocholangiography, abdominal ultrasonography and duodenum tubing. These reveal the absence of gallstones, cholesterolosis or anomalies of papilla of Vater (sphincter of Oddi). A number of 128 patients with acute pancreatitis were admitted to the clinic in the period 1984-1994 from which 48 with a non-biliary and non-traumatic. A complex medical treatment was applied to all patients but only 25 responded favourably, the remaining 23 necessitating surgical intervention, which was effected on de-shocked and re-equilibrated patients, diminishing thus the number or repeat interventions in the complications which may appear in such cases. Thus postoperative mortality fell from 58, 33 to 30, 76.
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The authors are presenting the results of first 50 inguinal hernias treated laparoscopically trough the transperitoneal approach (39 men, 11 women, mean age--42,5 years, 44 uncomplicated and 6 epiploon's incarceration). After the dissection of the hernia's pouch, the parietal defect was covered with Prolène meche in 15 cases, with Marlex in 10 cases and Plastex prosthesis in 25 cases, all of them without fixation. The prosthesis itself was covered with the parietal peritoneum in running suture. The immediate postoperative evolution was good, the patients being able to walk soon after being awake, and without any urinary problems (even in elder patients). The patients left the hospital 24-48 hours after surgery. They were followed-up 2 to 10 months, periodically. The results were good, except 4 patients: 1 case with port-site hematoma (in the right lower quadrant, necessitating open surgery). 2 patients with seromas (vulvar and scrotal) in case of section and abandoning the hernial pouch. 1 patient with prosthesis migration with precocious recidive (24 hours after the operation). We consider the transperitoneal approach as very good in the treatment of uncomplicated and not very large hernias. The easiest and safest technic is that using Prolène prosthesis.
The authors are showing their experience on 394 locally advanced breast cancer in the last 10 years. In this trial were included the tumours larger than 5 cm, multiple tumours, tumours invading the skin or the thoracic wall with invaded or fixed axillary or supraclavicular nodes and acute carcinomatous mastitis. The optional therapeutic schedule was modified upon the stage. It consisted in pre- or postoperative radiotherapy, polychemotherapy or polychemo- or radiotherapy alone, associated with nonspecific immunotherapy and hormonotherapy. In patients with complex treatment the survival rate was 45.4% at 5 years and 12.3% at 10 years. The authors highlight the importance of the surgical treatment which offer a big potential in the context of the complex treatment.
On an unitary series of 64 patients with a gastro-jejunal anastomosis, en Y "à la Roux", 24 had the special indications: reconversion of a anastomotic gastro-duodenal or gastro-jejunal fistula, large gastric resection for cancer, postbulbar ulcers, hemorrhage duodenal ulcer associated with diverticula, stump duodenal fistula, desinsertion of Vater papilla, giant pancreatic pseudocysts, inextirpable principal duct tumors, complexes biliary fistula, and central hepatic hydatic cysts. The results were good. On discuss the general and special advantages and the disadvantages of this method.
On the occasion of the presentation of four cases of serous hepatic cysts, of non parasitic origin, the authors comment on the rarity of this affection, although in the last time, asymptomatic cases can have a frequency of 1% after screening with ultrasounds and CT Scan. Is presented a series of data concerning the etiopathogenesis, the clinic and the treatment of such cases.
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The paper reports on the clinical case of a mammary tumour, Abrikosov's tumour, a are histopathologic occurrence. Clinical, histopathologic and therapeutic aspects are revealed. This case enriches the literature data on this peculiar form of tumour with mammary location.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Most frequently the diagnostic of gastric cancer is established in advanced stages. Practically, was noticed that local evolution advances the appearance of metastases. The authors are presenting 159 cases of locally advanced gastric cancer (LAGC) out of 211 gastric cancers submitted to surgery between 1984-1995. The surgical possibilities in such situation specifically adapted to each case, are discussed. The operation has an important role in appreciating local and regional extension, solving complications and even performing radical resections.
Two cases of postcaustic antropyloric stenosis are reported. The lesions developed 3 and respectively 5 weeks after ingestion of the caustic substance and surgery for complete stenosis was performed 35 and 56 days after the initial accident. In both cases antropylorectomy with gastroduodenoanastomosis of the Péan-Billroth type I, in two layers, was performed. Integrity of the esophagus and good function of the anastomotic mouth, appraised by the clinical symptomatology and evolution of the radiologic aspect, showed that at least in some cases it is possible to apply the curative intervention 5-6 weeks after the accident, without a previous shunt being necessary.
In local advanced rectal cancer (LARC) was defined at the work group in rectal cancer as a tumour what invade the serosa or neighbouring organs, associated with invaded perirectal or mezorectal nodes, with internal fistulae, peritoneal carcinomatosis and locoregional recidives. On a trial of 97 patients, the authors present personal experience, in comparison with literature data regarding therapeutic strategy and tactic of parameters: operability and the moment of operation, indication of preoperative radiotherapy, the type of operation, excision of the metastasis, adjuvant therapy and attitude of locoregional recidives. The survival of the patients was 21.6% at 3 years and 15.4% at 5 years.