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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Organ transplantation is a multidisciplinary speciality that has undergone a remarkable development in the last two decades, saving the lives of patients in advanced failure of various organs. Medical management of organ donors is an essential component of achieving success in transplantation. It requires a good knowledge and understanding of the pathological changes caused by brain death, changes that usually require a diagnosis and a rapid treatment. ⋯ Hypovolemia, insipid diabetes, pulmonary edema, maintaining viability of organs in optimal conditions are important aspects which influences donation success to a large number of recipients. Between January 2007 - July 2009 in the ICU department of Bagdasar Arseni Emergency Hospital, Bucharest we had 47 potential organ donors, of which only 20 actually came to organ donation. A significant percentage of potential donors are lost due to complications and/or because of denial of consent by the family.