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Biomedical subjects

N Angelescu

Publications and source records attributed to N Angelescu.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

[Vulvar cancer. The therapeutic aspects].

Even though it has a low frequency (4 - 5%) compared to genital cancers, it has certain biological features represented by the possibility of multicentric localisation what performs on the dystrophic lesions, the presence of the inguinal nodes, the sensibility of the irradiation of the cancer and nodes and the efficacity of the treatment of the treatment of the bleomicine which request many therapeutical problems. Between 1985-1994, in Colţea Surgery Clinic there were operated 13 vulvar carcinoma, in women between 45-69 years old, in stages II (6), III (4) and IV b (3). Primary lesion was on labia major (11), labia minor (1) and posterior fourchette (1). Preoperative radiotherapy was made in 9 patients. At 3 patients, valvar lesion represents the second cancer--in all cases were syndrome neoplasia, after cervix neoplasia (2) or ano-rectal neoplasia (1) which were operated. At histopathological exam all cancers were spinocellular epithelium keratosis in 10, non-keratosis in 2 or trabecular in 1. The surgical treatment was selective and consisted in total vulvectomy (9), vulvectomy with inguinal lymphadenectomy (3) and left colostomy (1) after ano-rectal invasions and intestinal obstruction. The postoperative mortality and complications were zero. Postoperative treatment consisted in radiotherapy in association with chemotherapy 93) or only chemotherapy (8). The survival rates at 3 years (2), 5 years (30, 7 years) (3) and 10 years (2), justify the complex treatment. In conclusion, vulvectomy represents the specific treatment associated with inguinal lymphadenectomy in case of lymph nodes metastasis. Postoperative radiotherapy and postoperative chemotherapy seem to increase the survival rate.

Animals↗
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[Laparoscopic appendectomy in obese patients. A comparative study with open appendectomy].

The aim of this study is to show the advantages of laparoscopic versus classic appendectomy in obese patients. The trial includes 32 obese patients which underwent laparoscopic surgery for appendicitis in our clinic, compared to a similar trial of patients with open surgery. In both o trials we followed-up the operating time, postoperative pain, hospitalization and social and professional reintegration. We noticed that in laparoscopic appendicectomy patients postoperative pain and hospitalization are reduced, the bowel transit restants rapidly and spontaneously, there are no wound complications and patients recover faster. The disadvantages consisted in longer operative time and higher cost of the laparoscopic operation versus classic appendectomy.

Acute Disease↗
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[A case of abdominal pregnancy--a case report].

Rare anatomical variety, the ectopic abdominal gestation involve a high maternal and foetal risk. On report an abdominal gestation in the 2nd quarter of evolution at a 42 yrs. age of a female with multiple uterine leiomyomas, the diagnosis being establish by ultrasonography. The attitude in the same cases is decided by the foetal viability: if the foetus is in a life, the pregnant women is hospitalised and followed each day; if the foetus is dead, there are indication of surgery, the major problem being represented by the total or partial removed of the placenta.

Adult↗
PubMedDate not supplied

[Cancer of the head of the pancreas with a unique evolution].

Case report of a 67-years-old man with cephalopancreatic carcinoma and a peculiar evolution, undergoing several operations. The diagnostic was established 3 years ago through a peroperative pancreatic bioptic puncture, followed by choledochoduodenostomy considering the tumor as inextirpable. After 2 1/2 years symptoms of high occlusion and upper digestive bleeding caused by duodenal invasion and a Wölfler precolic gastrojejunostomy was performed. After 4 month the upper digestive bleeding relapsed severely imposing the second reintervention (cephalic duodenopancreatectomy with a special montage). The evolution was favourable, the clinical, biological and imagistic control at 6 month showing the absence of recidive.

Adenocarcinoma↗
PubMedDate not supplied

[A comparative study of the laparoscopic and classic treatments of inguinal hernias].

AIM: of this study is to compare two similar groups presenting inguinal herniae, one group having laparoscopic herniography and the other having a Bassini or Fruchaud repair. METHOD: Since September 1994, in our department, patients presenting with symptoms of unilateral or bilateral inguinal herniae to our practice were offered the transperitoneal or preperitoneal approach as an alternative of open surgical repair. We considered the first 50 patients operated by laparoscopic technic (35 M and 15 F), age between 22-72 years (group A), and similar group operated by Bassini or Fruchaud technic (group B). All the patients had general anesthesia and perioperative antibiotics. In the group A we used Prolene, Mercilene or Plastex mesh. The following parameters were assessed: 1) operative time from incision to closure: 2) amount and type of analgesia required postoperatively; 3) morbidity related to the procedure; 4) interval before returning to full activity; 5) early recurrence rate; 6) hospital cost. RESULTS: The mean operative time for unilateral herniae in group A was 70 +/- 10 minutes versus 40 +/- 12 minutes in group B. Group A required to return to work was significantly shorter for the patients in group A (7 +/- 3 days) compared with group B patients (25 +/- 10 days). Although no recurrent herniae have yet been found in patients from either group; follow-up was only 2-18 months in the two groups. The cost of hospital care of group A patients exceeded that of group B by approximately 1.7 more. IN CONCLUSION: was consider that although is more expensive, the laparoscopic procedure in treatment of inguinal herniae, has more benefits for the patients.

Adult↗
PubMedDate not supplied

[Diagnostic and treatment problems in primary malignant tumors of the small intestine].

Between 1984-1994, 8 cases of MTSI (7 males and one female, between 24-53 years age) have been operated in our Department, representing 2% from all malignant gastrointestinal tumours. The pain as a result of the obstruction, followed by chronic blood loss with anemia and perforation, (4 patients operated in emergency) were the most frequent symptoms, the tumors being localised on jejunum (3) and ileum (5) with a diameter to 3-15 cm. Lymphatic (4), hepatic (2) and peritoneal (I) metastases were present. We performed a wide resection of the bowel and mesentery, including lymph nodes (in 4 cases with radical intention). Histopathological findings: 4 adenocarcinoma, 3 leiomyosarcoma and a lymphoma. Postoperative treatment was selective and consisted in polychemotherapy (PCT) and cobalt therapy (60Co). There was no postoperative mortality, two local recurrences in 6 month. Survival rate at 5 patients was 32 month. At 5 years were in life 2 leiomyosarcoma and 1 adenocarcinoma and at 7 yrs, 1 leiomyosarcoma and 1 adenocarcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[The role of clivarin in the preventive therapy of thromboembolism].

UNLABELLED: Our paper represents a synopsis of the main mechanisms by which low-molecular-weight heparins act as pharmacodynamic stabilizing factors of the liquid coagulation balance, in the postoperative period. Today we note three main phases in the coagulation mechanism: 1. partial thrombin activation; 2. positive thrombin-mediated feedback; 3. explosive thrombin formation. Low-molecular-weight heparins (Clivarine-mean molecular weight = 3900 D) act as selective inhibitors an factor X a (anti-thrombotic action), and as weak inhibitors on factor II a. The authors' experience includes 321 patients, who received Clivarin as preventive therapy for thromboembolic disease. Most of the selected patients are included in groups 2 and 3 for thromboembolic risk--and have undergone general surgery and oncological surgery. The dosage and duration of the treatment have been the usual ones. The main clinical observations we noted are: 1. excellent tolerability of Clivarine; 2. no modifications of usual biological values; 3. no adverse reactions were noted. There were no deleterious interferences between Clivarine and the usual postoperative medication of the surgical patient, 4. among the incidents, we note 12 postinjection haematomas, which were spontaneously cured. CONCLUSIONS: Low-molecular-weight heparins are considered today drugs of election in the medical and surgical thrombosis prophylaxis.

Contraindications↗
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[High obstruction in strangulated diaphragmatic hernia].

Case report of a 57-year-old man, admitted in emergency, because of high occlusion and severe dyspnea. The physical examination and the imagistics explorations established the diagnostic of strangulated left diaphragmatic hernia. After a short re-equilibration, the surgical approach was made by left thoracophrenolaparotomy and on realize the visceral reduction, the treatment of visceral injuries and the plasty of the pretty high diaphragmatic defect with a nylon mesh. The postoperative evolution was difficult, with hemorrhagic gastropathy, blocked evisceration, pneumonia and left pleural empyema. The control at 10 months show a patient appearing very well, with a voluminous eventration (who need surgical treatment) with normal image on the chest radiography, left hemidiaphragm in normal position and immobile, the gastrointestinal tract sitting intraabdominal, without parietal injuries.

Emergencies↗
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[Left lumbar sympathectomy via the retro-pneumoscopic approach. The technical considerations].

Retropneumoscopic lumbar sympathectomy is performed with an increasing frequency as a treatment of chronic obstructive arteriopathies; though the method has limited indications. We present the operative technique as it was performed în the Colţea Surgical Department in 2 patients. We highlights on difficulties advantages and disadvantages of the method.

Arterial Occlusive Diseases↗
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[The repair of voluminous postoperative abdominal wall defects with synthetic mesh].

Important postoperative abdominal wall defects, especially recurrent or multirecidivated ones, are raising multiple problems to the surgeon. We are presenting a homogeneous trial of 209 patients with such lesions, in which the abdominal wall repair was made with different kind of synthetic materials, with good results. In a single case the mesh was rejected, because a silent quiescent infection. In three patients undergoing iterative abdominal operations for other diseases we performed optical and electronic microscopical studies showing out that the material integration was done by normal biological reaction. This provides the materials' tolerability and a normal reaction of the organism.

Abdominal Muscles↗
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[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↗