Chirurgia Bucharest
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Chirurgia Bucharest · Nov 2010
[Video-assisted thoracoscopic extended thymectomy (VATET) with cervical approach for myasthenia gravis--initial experience].
Complete thymectomy plays an important role in the myasthenia gravis (MG) pacient's treatment. Many different surgical techniques have been developed to achieve thymectomy. Of these, thoracoscopic technique is the most recent. ⋯ It was a single case with a thoracoscopic second look for hemothorax from intercostals bleeding. At this time, due to the reduced number of cases, we can't evaluate the therapeutic effectiveness of the VATET. We consider VATET as a valuable surgical option to treat myasthenic patients, with an optimal report between radicality and invasiveness.
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bariatric surgery presented a dramatic increase due to the obesity epidemics and the laparoscopic approach. General surgeons might face acute or chronic complications of bariatric surgery, considering the increasing figures of obesity procedures performed every year in USA, as well as in Europe. ⋯ General surgeon has to know the most diffuse bariatric procedures and their complications and to treat them as other gastrointestinal surgical procedures. Minimally-invasive approach should be considered in most of the cases, but the approach depends on the general surgeon's experience.
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Chirurgia Bucharest · May 2010
Review[Selective nonoperative management of solid abdominal visceral lesions].
Selective nonoperative management of abdominal visceral lesions is one of the most important and challenging changes that occurred in the traumatized patient care over the last 20 years. The main advantage of this type of management is the avoidance of unnecessary/nontherapeutic laparotomies. ⋯ This literature review discusses the main elements of selective nonoperative management of principle solid visceral lesions (liver, spleen, kidney). We highlight the advantages and limitations of the main diagnostic instruments used for evaluation of trauma patiens allocated to nonoperative management.
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Amyand's hernia, a rare entity in the surgical pathology, presupposes the presence of the vermiform appendix inside a inguinal hernia sac (1). The hernia sac peritonitis by appendix swelling is even more rare, very few cases being presented in the surgical literature (1). The preoperatory diagnosis of Amyand's hernia is therefore very difficult. We herein present the case of a 71-year old male patient, operated on an emergency basis for hernia, which eventually turned out to be Amyand's hernia, a case which determined us to research the literature dedicated to this topic.
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Chirurgia Bucharest · Mar 2010
Problems concerning diagnosis and treatment of compartment syndromes after lower limb trauma.
Compartment Syndrome (CS) is characterised by an imbalance produced by increased pressure in an inextensible space (called "the Compartment"). Without being specific for orthopaedics, CS has increasing frequency in modern traumatology. Microcirculation disturbances generate the syndrome's self-augmenting physiopathological character. ⋯ The correct treatment is surgical, consisting in early and large decompressive fasciotomy. Without proper treatment, CS endangers not only the vitality of the limb (due to Acute Peripheral Ischemia with onset in microcirculation and centripetal extension), but also the patient's life, thus becoming a life-threatening disorder. The authors underline the importance of correct clinical evaluation and early treatment in order to prevent the serious local and general complications of the CS.