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Biomedical subjects

N Dănilă

Publications and source records attributed to N Dănilă.

At least 19 recordsLinked to original sources
PubMed1995

[The Shouldice procedure in the surgical treatment of inguinal hernias].

The Shouldice repair gained a major importance in the treatment of inghinal hernias provided by the excellent results that had been obtained in the Shouldice Hospital on more than 200,000 cases. This study analyze prospectively 101 cases of inguinal hernias that had been treated using the Shouldice procedure with in a 3 year period, comparative with a control cohort of 102 cases of inguinal hernias treated using classic procedures (Bassini, Kimbarowski). The data analyze was performed using Kruskal-Wallis H test and t Student test. The immediately postoperative results have been favorable in 95% cases and the long term postoperative results have been very good in 99% cases (a unique recurrence in a multiple recidivated patient). The result of this study proves that Shouldice repair has advantages comparative with classic treatment: short postoperative hospitalization, low incidence of complication and recurrence.

Adolescent↗
PubMedDate not supplied

[Adenocarcinoma in Barrett esophagus: its recurrence and long-term survival].

Adenocarcinoma arising in ectopic gastric mucosa has been reported more than 40 years ago. This report reviews our experience with Barrett's adenocarcinoma over 8 years. The definition remains subject to controversy. More than 50% of patients in our study had unfavorable course of disease. The hope for cure lies almost in early detection of tumors at which point a truly curative resection could be done. There is no difference in terms of survival comparing to the adenocarcinoma arising on normal esophagus.

Adenocarcinoma↗
PubMedDate not supplied

[Cephalic duodenopancreatectomy with pyloric preservation in the treatment of pancreatic cancer].

UNLABELLED: Is the application of DPCPP in the treatment of pancreatic neoplasia a good reason? We have analysed 30 patients with cephalic duodenopancreatectomy (DPC) for biliopancreatic neoplasia between 1995-1999 in Ist Surgical Clinic of Iassy (13 with pyloric preservation). The indications were:--cephalic pancreatic neoplasia (adenocarcinoma--4 cases (one with cephalic chronic pancreatitis on the intraoperative microscopical examination);--Vater ampulloma (7 cases);--inferior common biliary duct (CBD 1 case);--duodenal adenocarcinoma (1 case). In the same time was operated 265 biliopancreatic diseases (203 mechanical jaundice with 132 neoplastic jaundice). RESULTS: --Better early postoperatively status of the patients--DPCPP does not give better prognosis;--there are necessary some technical skills to depase the important phases of DPCPP.

Adenocarcinoma↗
PubMedDate not supplied

[Rare location of a hydatid cyst- in the upper mediastinum migrating into the spinal channel].

The authors report a rare and difficult case of hydatic cyst. The case was rare due to the location of the hydatic disease in the upper mediastinum and because of the onset of the disease with a complication: a spinal cord compression syndrome produced by the migration of the hydatic cyst into the spinal channel. The case was difficult because of the diagnostic problems--especially to establish the topography of the lesion and surgical management.

Cervical Vertebrae↗
PubMedDate not supplied

[Splenic hydatic cyst. Observations upon 38 cases of splenic echinococcosis].

15 patients with spleen hydatic cysts have been operated between 1986-1998, in percentage of 4.6% from the total number of hydatic cysts--8 females and 7 males with mean age of 44 years (17-70). They have been admitted for abdominal pain (66.6%) and at the clinical examination they presented a cystic tumor at the level of the spleen. In all the patients we performed splenectomy. In conclusion the hydatic cyst of the spleen is rare, but possible, the treatment being only surgical.

Adolescent↗
PubMedDate not supplied

[Stapled esophago-jejunal anastomosis after total gastrectomy in gastric neoplasm].

A number of 1031 patients with gastric cancer have been admitted in the First Surgical Clinic of Iasi between 1986-2001. The operability index was 86%, 52% being resectable and 36% having potential curative resection. In this group, 222 patients benefited from total gastrectomies. We consider the introduction of stapled eso-jejunal anastomosis (38 patients) as the most important moment in this development, as the manual performance anastomosis is considered difficult due to the problems imposed by suturing in a deep space. Postoperative course of patients who benefited from stapled anastomosis was simple although many patients had a poor biological status. We encountered only one small fistula, which was dealt with conservative. Patients in this group had immediate postoperative results significantly better than the comparative group with manually performed anastomosis. Introduction of stapler techniques increased the proportions of patients who benefited from palative total gastrectomies for advanced gastric cancer. We consider that a method to solve the frequent complications, insured an increased intraoperative comfort, reduced the number of postoperative complications, increased survival and improved patients quality of life.

Adult↗
PubMedDate not supplied

[Giant retroperitoneal lipoma].

70 retroperitoneal tumors (10 with an adipous origin out of which 8 were lipomas) have been operated upon in our clinic since 1985. Four cases of giant lipomas are presented in this paper. They weighed 4.5-7.5 kg. and had a diameter over 15 centimeters. Their close proximity with the kidney, duodenum, colon, inferior vena cava etc made there extirpate difficult. The post-operative condition of the patients was good. Although the histopathological tests proved that all these giant lipomas were benign after two to four years, their relapse required a new surgical intervention. The histopathology of the relapsed lipomas revealed a malign degeneration in 3 out of the four cases. The origin of this malign degeneration was in the fibrous part of the tumors.

Female↗
PubMedDate not supplied

[Hydatic cyst of the liver. Considerations on 337 cases].

Hydatid disease of the liver is still endemic in certain parts of the world. The modern treatment of hydatid cyst of the liver varies from surgical intervention to percutaneous drainage or medical therapy. Surgery is still the treatment of choice and can be performed by the conventional or laparoscopic approach. The aim of the study is to analyze the results of the surgical treatment in hydatid disease of the liver in First Surgical Clinic, Iaşi. The study concerned a period of 12.5 years (1992 - 31.07.2004) and it included 337 cases. There were performed radical procedures (ideal cystectomy - 17 cases - 5.04%, hepatic segmentectomy - 8 cases - 1.48%, atypical hepatectomy - 10 cases - 2.96%) or conservative procedures (de-roofing - 37 cases - 10.97%, subtotal pericystectomy - 34 cases -10.80%, total pericystectomy - 19 cases - 5.63%, partial pericystectomy - 212 cases -62.90%). In 35 cases (10.38%) the operation was started laparoscopically and 12 cases needed conversion. Postoperative course was complicated in 112 cases (33.32%) (external biliary fistula, cavity suppuration, residual cavity hydatid relapse). Radical methods constituted operations that had excellent results, but they are feasible in few cases. Conservative procedures, relatively simple and still accepted, have a higher rate of morbidity. The laparoscopic approach is more and more used, with good results.

Adolescent↗
PubMedDate not supplied

[The value and limits of subtotal gastrectomy in gastric cancer].

In the interval 1970-1988, in 321 of 670 patients with gastric neoplasm admitted to the 1st Surgical Clinic of Iaşi a subtotal gastrectomy was performed. Most patients were males (68.9%), more commonly aged between 50 and 70 years and in advanced evolutive stages. The gastric neoplasm were sited in order of frequency in the antrum (46.9%), body of the stomach (34.6%), eso-cardio-tuberosity (11.5%), linitis (4%), gastric stump and malignant ulcer (3%). Surgery was possible in only 59% of the cases (25% curative and 34.1% palliative). The surgical technique and its difficulties are detailed. In the 321 subtotal gastric resections 20 complications, 4 deaths (1.2%) and 20% survivals over 5 years were recorded. It is concluded that radioendoscopic and microscopic investigations, with their possibility of an early diagnosis, may cause a limitation of the indications of total gastric resection in the treatment of gastric neoplasm in favour a subtotal resection, more satisfactory from the functional viewpoint.

Adolescent↗
PubMedDate not supplied

[A rare neurogenic tumor with thoracic growth].

Of 70 operated mediastinal tumors, 15 were neurogenic tumors, one of them clepsydra-shaped, which manifested from the very beginning with spastic paraparesis of the legs. The treatment consisted in a two-steps surgery, the first at the Neurosurgical Clinical of Iaşi (laminectomy and ablation of the rachidian tumor) and the second one, one month later, at the I-st Surgical Clinic of Iaşi (excision of mediastinal tumor and parenchymal bridge within the conjugation hole). The microscopic examination confirmed the diagnosis of neurinoma (schwannoma) Antoni A and B with haemorrhagic areas. Examined at one year interval, the patient was clinically cured with normal thoracic aspect. The clinical peculiarities and therapeutical possibilities of the clepsydra-shaped neurogenic mediastinal tumors are detailed.

Adult↗
PubMedDate not supplied

[Cholecystosis, the diagnostic and treatment problems].

In the interval 1981-1989 at the Ist Clinic of Surgery of Iaşi 230 cases of chronic cholecystitis were admitted and operated upon (cholesterolosis--24 cases, dysmorphosis--84 cases, dysplasia--22 cases). Most cases had a morphologic--dysmetabolic substrate--strawberry gallbladder, alone or associated with other lesions (lithiasis, cirrhosis, pancreatitis), rare cases being also found (porcelain gallbladder--1 case, calcium bile--2 cases, gallbladder diverticulosis--3 cases, longitudinal complete obstruction of cystic duct by gallstone--2 cases). This condition is more frequent in women in the 3rd dad 4th decade, the symptoms being discrete, uncharacteristic, but persistent. The diagnosis is based on duodenal catheterization, cholecysto-cholangiography and ultrasonography, the intraoperative and histo-pathologic confirmations being required. The increasing frequency of chronic cholecystitis makes necessary a more minute diagnosis and exigent surgical indication, pledges for long-term favourable results.

Adult↗
PubMedDate not supplied

[Choristomas].

The authors present 21 cases of aberrant pancreas with gastric and duodenal location (heterotopias under the shape of inclusions, nodules or true adenomas) included besides the rare cases of adenoma developed from Brunner and Lieberkühn glands in the "choristomas" category. Asymptomatic or with clinical phenomena and complications "borrowed" from the associated peptic ulcers (15 cases) the diagnosis of pancreatic heterotopias is usually an interoperatory or even histopathological surprise, the X-ray examination with the classical image "in cocard" and the endoscopy being rarely evocative. The surgical treatment is generally conservative and is dominated by the presence or lack of the concomitant peptic ulcer.

Adult↗
PubMedDate not supplied

[Isolated traumatic lesions of the abdominal wall musculature].

Six cases of isolated traumatic lesions of the abdominal wall muscles (2 ruptures of the right abdominal muscle and 4 of the anterolateral muscles) are reported. The presence of a "fixed" hematoma or even of a true subcutaneous eventration, the case history (for finding out the injury mechanism or unusual muscular effort), the X-ray examination of the abdomen and especially the ultrasonography can establish the diagnosis. The treatment of this lesion is usually conservative, surgery (performed in 3 cases) being indicated only in those ruptures with large parietal defects or hematomas or in case of diagnostic doubts.

Abdominal Muscles↗
PubMedDate not supplied

[Torsion of the great epiploon].

The diagnosis of epiploic torsion was made intraoperatively. Apart from resection of the necrotized epiploon, appendicectomy was also performed as the appendix presented acute inflammatory lesions. This anatomoclinical and etiopathogenic characteristics of this rare affection are briefly described.

Adult↗