Biomedical subjects
Publications and source records attributed to S Voiculescu.
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.
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AIM: Results evaluation in two trials of patients undergoing classical or laparoscopic surgery for inguinal hernia. MATERIAL AND METHOD: We compared 2 homogeneous trials of 80 patients with inguinal hernias treated by classic procedures: Bassini, Shouldice, Lichtenstein (trial I) or by laparoscopic approach with Plastex, Mercilene or Prolene prosthesis (trial II) between 1995-1997. RESULTS: Postoperative morbidity consisted in trial I in 5 seromas, 2 hematomas, 4 cases with neuralgic pain, 1 with testicular hypotrophy and 4 recurrences. In this trial the mean operative time was 22 min. and the mean hospitalization was 7 days. In trial II we registered a parietal bleeding at a lateral port imposing the conversion, 3 serohematomas, 2 recurrences by displacement of the prosthesis and 2 cases of neurologic pain. The mean operative time was 50 minutes and the mean hospitalization was 3 days. CONCLUSION: In spite of the longer operative time and the higher cost (the price of the prosthesis), in trial II the benefits of shorter hospitalization, lower morbidity and rapid socioprofessional reintegration are significant.
The study is considering a trial of 87 patients (61 women 17 and 76 years old) admitted in our clinic between 1995-1996. The preoperative diagnosis was coincident with the laparoscopic one in 10 cases the laparoscopic one in 10 cases the laparoscopy completed the diagnosis and in 12 cases it showed out other organ's disease, evicting useless operations. In the 87 patients we performed: 53 appendectomies, 20 oophorectomies, 15 partial oophorectomies, 9 right adnexectomies, 2 adhesiolysis, 2 lymph node biopsies, 1 epiploic fringe excision for necrosis, 1 appendicular stump removal. The evolution was favourable in all patients, the mean postoperative hospitalization was 48 hours.
AIM: Results evaluation of laparoscopic cholecystectomy in acute cholecystitis. MATERIAL AND METHOD: Between 1994-1997 we performed 65 laparoscopic cholecystectomies for histopathologically proved acute lithiasic cholecystitis. We studied clinic and echographic diagnosis, operative moment, conversion rate, operative time, postoperative morbidity and hospitalization. The cholecystectomy was performed within 72 hours in 18 patients (trial I), 4 to 7 days in 25 patients (trial II) and over 7 days in 22 patients (trial III). RESULTS: Diagnosis of acute lithiasic cholecystitis was always possible by clinical examination and ultrasonography. We performed 8 conversions in patients of trial II (2) and III (6). The mean operative time was 68 min. Postoperative morbidity consisted in 4 bile leakages in the liver bed, 1 subhepatic abscess, 5 right pleural effusions. The mean hospitalization was 4.4 days. CONCLUSIONS: Urgent laparoscopic cholecystectomy is a beneficial act for acute lithiasic cholecystitis. The operative moment is the most important factor of influence on conversion rate, operative time and postoperative morbidity.