Laparoscopic Approach to Primary Splenic Cyst: Case Report and Review of the Literature.

Splenic cysts are rare benign lesions of the spleen, often asymptomatic and incidentally discovered during imaging studies. While many splenic cysts remain asymptomatic and do not require intervention, surgical management becomes essential in cases of symptomatic cysts, large cysts, or when malignancy cannot be ruled out. Laparoscopic surgery has emerged as a minimally invasive and effective approach for treating splenic cysts, offering advantages such as shorter hospital stays, reduced postoperative pain, and faster recovery.

Laparoscopic Hartmann Procedure-A Surgery That Still Saves Lives.

Background: A Hartmann operation, which is the intervention by which the lower part of the sigmoid and the upper part of the rectum are resected with the closing of the rectal stump and end colostomy, has as its indications: advanced or complicated rectosigmoid neoplasm, moderate biological condition of the patient, peritoneal sepsis, intestinal occlusion and fragile colonic wall, especially in the context of inflammatory changes. The Hartmann procedure can save lives even at the cost of a stoma reversal failure.

Methods: The cases operated with the Hartmann procedure by an open approach or laparoscopic approach in our clinic, between 1 January 2016 and 31 December 2020, were admitted in this study and their medical records were reviewed, also making a comparison between the two types of approach.

Laparoscopic approach for nonparasitic splenic cysts and splenic abcesses.

Unlabelled: Splenic cysts are classified as primary (parasitic and nonparasitic) or secondary cysts. The aim of this study was to evaluate the efficacy of laparoscopic approach in surgical treatment of splenic cysts and abscesses.

Methods: Between 2002 and 2017, 17 patients underwent laparoscopic approach for splenic cysts and abscesses: 9 laparoscopic splenectomies (4 hydatid cysts, 3 primitive nonparasitic cysts, one posttraumatic cysts and one abscess) and conservative laparoscopic treatment 8 patients (2 hydatid cysts, 2 primitive nonparasitic cysts, 2 secondary cysts and 2 abscesses).

Does the Overall Survival of the Resectable Periampullary Carcinomas Correlate with High Expression of p53 and ki67?

Periampullary carcinomas represent a group of tumors that develop in a complex area, implying different anatomical structures. The most common histological type of periampullary carcinomas is the adenocarcinoma. The pancreatic type of periampullary adenocarcinomas has the worst prognosis.

Abdominopelvic Actinomycosis-The Diagnostic and Therapeutic Challenge of the Most Misdiagnosed Disease.

Unlabelled: Abdominopelvic actinomycosis is a rare chronic or subacute bacterial infection caused by , a Gram-positive anaerobic bacterium that normally colonizes the digestive and genital tracts, clinically presented as an inflammatory mass or abscess formation.

Methods: We reviewed the medical records of the patients from our clinic with abdominopelvic actinomycosis who underwent surgery between 2002 and 2022. In this period, 28 cases (9 men and 19 women) were treated.

Spontaneous Biliary-Enteric Fistulas and Associated Complications: An Overview.

Spontaneous biliary-enteric fistula (SBEF) is an abnormal communication between the biliary tree and the gastrointestinal tract which develops as a result of biliary or gastrointestinal disease. Iatrogenic fistulas, due to surgery or instrumental exploration, are not included in this definition. R.

Gallstone Ileus. What therapeutic options are there?

Unlabelled: Gallstone ileus is a rare disorder in emergency surgical practice with diagnosis usually difficult and only achieved at surgery. The current approaches are: enterolithotomy, cholecystectomy and fistula repair (one-stage surgery), enterolithotomy with cholecystectomy performed later (two-stage surgery) and only enterolithotomy (most reported surgical procedure).

Methods: The clinical, operative and follow-up data on 14 consecutive patients treated in our clinic for gallstone ileus was retrospectively reviewed.

Protective or Risk Factors for Postoperative Pancreatic Fistulas in Malignant Pathology.

Introduction: Malignant tumors are associated with a low incidence of postoperative pancreatic fistulas. The presence of peritumoral fibrosis is considered the protective factor for the development of postoperative pancreatic fistulas after pancreatic resections for pancreatic ductal adenocarcinomas.

Methods: We analyzed a series of 109 consecutive patients with pancreatic resections for malignant pathology: pancreatic ductal adenocarcinomas and periampullary adenocarcinomas.

Laparoscopic Approach of Primary Hydatid Cyst of the Pancreas - Case Report and Literature Review.

The pancreatic localization of the hydatid cyst is exceptional, even in countries where hydatid disease is considered endemic. We describe a female patient, 63 years old, with hydatid cyst of the pancreas. The diagnosis was difficult because the presentation was that of an epigastric cyst of unknown origin, with no suggestive radiological and ultrasonography features.

Laparoscopic Cholecystectomy in Cirrhotic Patients.

Laparoscopic cholecystectomy is the gold standard procedure in patients with cirrhosis and symptomatic gallbladder disease or acute cholecystitis. In this retrospective study we evaluated laparoscopic cholecystectomy in patients with cirrhosis based on Child-Pugh score as a predictor of morbidity. In the First Surgical Clinic of Iasi, from 01 jan 2010 to 31 jan 2020, we performed 111 laparoscopic cholecystectomies in Child-Pugh A, B, and C cirrhotic patients.

The Pancreatic Endocrine Tumors - Experience of First Surgical Clinic Iasi.

Pancreatic neuroendocrine tumors (PNETs) are rare and characterized by widely variable clinical presentation and often challenging surgical management. Retrospective study conducted during the last 15 years at the First Surgical Clinic of the Iasi St Spiridon University Hospital, and which included all the patients diagnosed with pancreatic endocrine tumors by immunohistochemistry. There were 26 cases diagnosed with PNET.

Abdominal Actinomycosis Mimicking Colon Cancer.

Abdominal actinomycosis is a rare granulomatous inflammatory disease caused by a Gram-positive anaerobic bacterium Actinomyces israelii, manifesting as inflammatory mass, or abscess formation. Evolution is slow and steady in inflammatory contiguous extension without limit organ that lends itself to confusion with abdominal malignancies. We performed a retrospective study on the patients with abdominal actinomycosis operated in the First Surgical Clinic, "St.

Laparoscopic Management in Morgagni Hernia - Short Series and Review of Literature.

Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. We prospectively evaluated a series of 8 patients admitted to First Surgical Clinic, St.

Laparoscopic Treatment of Intraabdominal Cystic Lymphangioma.

Unlabelled: The abdominal cystic lymphangioma (CL) in adults is a rare benign tumor of the lymphatic system.

Methods: We report a retrospective study from January 2002 to Decemberr 2014 concerning 18 patients who underwent surgical removal of a CL, 9 patients with laparoscopic approach included. The localization, size, and number, diagnostic, treatment and results have been reported for patients approached laparoscopically.

Lymph node status assessed through the log odds ratio - a better tool in the prognosis of colorectal cancer relapse.

The current literature related to colorectal cancer shows there is a great inhomogeneity in patient outcome, even between patients in the same stage, which means that the TNM staging does not seem enough anymore to make a therapeutic decision. This is why many of the recent studies focus on the study of prognostic and predictive factors that would make the therapeutic decision-making process more accurate. In the current study, we focused on the study of two lymph node based scores - the lymph node ratio and the log odds ratio and the morphological characteristics of the tumor to try to see if any of them can predict a more aggressive tumor behavior in order to approach the patient in an appropriate way.

Gastric heterotopic pancreas: an unusual case and review of the literature.

Heterotopic pancreas is a rare condition and its preoperative diagnosis is difficult. It is generally asymptomatic, but it may become clinically evident depending on the size, location and the pathological changes. Heterotopic pancreas can occur anywhere in the gastrointestinal tract, but most commonly is found in the antrum of the stomach.

Preoperative warm-up using a virtual reality simulator.

Background And Objectives: All modern surgical procedures require a high level of cognitive and psychomotor skills achieved using different training methods, but could be influenced by fatigue and other psychological factors. We evaluated the effect of warm-up exercises on operative laparoscopic performances.

Methods: The surgical team operated on a consecutive series of 20 patients with gallstones.

Posterior approach pancreaticoduodenectomy: best option for hepatic artery anatomical variants.

Pancreaticoduodenectomy is the best treatment for the patients with malignant tumors of the pancreatic head. However, the procedure is also recommended in some benign pancreatic tumors. The posterior approach allows early dissection of the superior mesenteric artery, portal vein and retroportal pancreatic lamina, before any pancreatic or digestive transection.

Incomplete deployment of an expandable metallic stent in a patient with esophageal malignant stenosis.

The use of self expandable metallic stents (SEMS) in the palliation of dysphagia due to malignant esophageal stenosis is a gold standard. Covered stents are used in all cases with overt air-digestive fistula or high potential for fistula development. The procedure is associated with a low incidence of procedure-related complications.

A European surgeon: Thoma Ionescu (Thomas Jonnesco)--founder of the Romanian school of surgery (1860-1926).

Thoma Ionescu, the distinguished surgeon and anatomist, is rightly considered the founder of the Romanian school of surgery and topographic anatomy whose achievements became well-known in Europe and North America. He introduced several new surgical techniques, as wall as rachianaesthesia, and identified and formulated the main principles of rectal and uterine oncologic surgery. Moreover, he was the first to describe the paraduodenal fossae and the internal retroperitoneal hernias.

Adrenal schwannoma.

Background: Adrenal schwannomas are very rare tumors that are difficult to diagnose preoperatively. We report the case of a left adrenal schwannoma incidentally discovered in a 55-year-old man during a postoperative checkup for a cutaneous malignant melanoma.

Methods: The biological evaluation was unremarkable, and the radiological examination revealed the adrenal mass that was first considered a metastatic lesion.

Multiple peritoneal hydatid disease after rupture of a multivesicular hepatic hydatid cyst. Case report.

We report the peculiar case of a young woman with hepatic hydatid cysts, with numerous peritoneal disseminations (56 cysts) incidentally diagnosed during a caesarian section. The case was managed, surgically preceded and followed by systemic treatment with albendazole. Surgical treatment addressed both the hepatic cyst and the peritoneal hydatid disease aiming to preserve involved abdominal organs.

Minimally invasive treatment of hepatic hydatid cysts.

Background: Hydatid cyst is a parasitosis caused by Taenia Echinococcus. In the last 10 years, new methods of treatment of the hydatid cyst have been proposed (percutaneous or laparoscopic).

Method: This retrospective study includes 24 patients with hepatic hydatid cyst (HHC) who were treated by a minimally invasive approach, 18 women and 6 men (average age 49.