Laparoscopy in Abdominal Emergencies. Romanian Association for Endoscopic Surgery Consensus. Part I (Trauma).

laparoscopy has emerged as a pivotal tool for the management of acute abdominal pathologies. It provides diagnostic and therapeutic advantages, enabling surgeons to evaluate and address diverse acute abdominal conditions using minimally invasive techniques. The aim of this consensus was to obtain evidence-based guidance for surgeons regarding the utilization of laparoscopy in emergency medical settings, and has been divided into trauma and non-trauma emergencies.

Sternal Metastasis from Serous Ovarian Carcinoma - A Narrative Review Highlighting the Importance of Multidisciplinary Management in These Cases.

Sternal metastases of serous ovarian carcinoma are extremely rare conditions, with less than 10 articles published in the medical literature on this subject. The aim of this article is to present a case of late-onset sternal metastasis of serous ovarian carcinoma in a patient who underwent surgery for serous ovarian carcinoma approximately 6 years before and to provide a review of the literature regarding the importance of multidisciplinary management in such cases. Material and Method: We aimed to conduct a review of the specialized literature concerning published articles on sternal metastases from ovarian serous carcinoma over a period of approximately 30 years, from January 1, 1994, to December 31, 2023.

Early Versus Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis: A Single Center Experience.

Acute cholecystitis (AC) represents a public health problem, increasing hospitalization costs, especially determined by the surgical treatment of these patients. Laparoscopic cholecystectomy (LC) has become the therapeutic gold standard, the timing of the intervention: early (ELC) versus late (DLC), is still debated, impacting the results. The primary objective of the study was to compare postoperative outcomes between ELC and DLC.

Early outcomes of open anterior versus posterior components separation with transversus abdominis release for large median incisional hernias: a retrospective stepwise analysis.

Background: Complex incisional hernia is still a debatable topic, with increasing incidence and an increased local and systemic postoperative morbidity and mortality. The size of the defect is a risk factor for both difficult closure and 30-day readmission due to complications. The main option for closure such defect is a mesh augmented component separation technique.

Neutrophil‑to‑lymphocyte, platelet‑to‑lymphocyte and lymphocyte‑to‑monocyte ratios are associated with amputation rates in patients with peripheral arterial disease and diabetes mellitus who underwent revascularization: A Romanian regional center study.

Inflammation plays an important role in peripheral artery disease (PAD), contributing to the onset and progression of atherosclerosis, as well as to the rupture of atherosclerotic plaques. Studies have revealed that due to their inflammatory nature, leucocytes play an important role in the development of atherosclerosis. A retrospective study was conducted involving 203 patients with PAD admitted to Targu Mures Emergency County Hospital for revascularization surgery between January 2017 and June 2019 (of which 47 were treated by endovascular intervention, and 156 underwent classical surgical intervention).

V-set and immunoglobulin domain containing 1 (VSIG1) as an emerging target for epithelial-mesenchymal transition of gastric cancer.

V-set and Immunoglobulin domain containing 1 (VSIG1) is a cell-cell adhesion molecule which role in the genesis and evolution of gastric cancer (GC) is not understood. Only three Medline-indexed papers have focused on the role of VSIG1 in GC. The clinicopathological features of 94 GCs were examined in association with immunohistochemical (IHC) patterns of VSIG1, E-cadherin, and β-catenin which were assessed in the tumor core (central) vs.

Importance of the neutrophil‑to‑lymphocyte ratio as a prognostic factor in patients with spleen trauma: A single center experience.

Abdominal trauma is a common diagnosis for patients admitted to the emergency room. Evaluation of the severity of such patients can sometimes be difficult due to rapid hemodynamic changes caused by the activation of inflammatory and anti-inflammatory regulatory mechanisms. To evaluate the prognosis of trauma patients, it is crucial to identify these changes and adapt various treatment strategies.

Incisional Hernias with Loss of Abdominal Domain: A New Look to an Older Issue or the Elephant in the Living Room. Literature Review.

Incisional hernia (IH) is a postoperative defect of the abdominal wall through which the contents of the peritoneal cavity are externalized beneath the skin in a peritoneal sac. IH differs in anatomic complexity, but also in its associated comorbidities and surgical history. As IH enlarges, complications occur and these become part of its natural history.

Clinical-Pathological Correlations in the Acute Surgical Abdomen in the Pre and Post-Pandemic Period Covid-19.

In the case of patients admitted with acute abdomen at the emergency department, interstitial pulmonary pathology (Covid-19 infections) represents a significant operative risk for the patients. The rate of postoperative complications is high with increased morbidity and mortality, a real challenge for the medical staff and surgical/intensive care unit teams. In emergency settings, patients were examined with targeted clinical and paraclinical parameters that assure a fast diagnosis to optimize a rapid medical and surgical treatment.

Perioperative complications and short-term outcomes of sacrocolpopexy using self-adhesive mesh.

Background And Objectives: The aim of this study was to investigate the perioperative complications and short-term outcomes of patients who underwent sacrocolpopexy using a self-adhesive mesh.

Materials And Methods: This is a prospective, monocentric study conducted between October 2019 and December 2020. We included 20 consecutive patients on whom sacrocolpopexy using the Parietex ProGripTM Self-Fixating Mesh (Medtronic, Minneapolis, MN, USA) was performed.

Multiple Hepatic Hydatid Cysts - Review of the Literature and Case Report.

Hydatid disease is a parasitic disease caused by and is commonly met in clinical practice. The most common location for hydatic cysts is the liver, while the lung is the second organ in terms of localization frequency. Case report: We present the case of a 40-year-old patient with pulmonary hydatid cysts (two hydatid cysts located in the upper and lower pulmonary left lobes), and multiple hepatic hydatid cysts (ten cysts located in both hepatic lobes).

LAR vs VLAR in Low Rectal Cancer - Postoperative Results - A Single-Center Experience.

The management of rectal cancer recognizes surgical resection as the most important step towards a permanent cure. Respecting the oncological principles, functional preservation represents a priority in achieving an acceptable quality of life for the patient. This study aimed to compare the results after low anterior resection (LAR) versus very low anterior resection (VLAR), in terms of postoperative outcome.

Calcification patterns in femoral and carotid atheromatous plaques: A comparative morphometric study.

This comparative study was designed to focus on the mineral patterns in human atherosclerotic plaques based on quantitative measurements of calcium deposits through the morphometric method. A total of 101 atherosclerotic plaques were harvested by conventional transluminal angioplasty from the carotid artery (CA) and different segments of the femoral-popliteal axis (FPA), fixed in formalin and sent for histological processing. The histological grade of the atherosclerotic plaque and the calcification pattern were evaluated, followed by a morphometric analysis of the mineral deposits.

HER2 Heterogeneity in Gastric Cancer: A Comparative Study, Using Two Commercial Antibodies.

Background: Although amplification of the gene encoding human epidermal growth factor receptor 2 (HER2) is used as an indicator for response to trastuzumab, the reported response rate is low, and few patients with gastric cancer (GC) benefit from this individualized therapy. The aim of this study was to examine the expression of c-erbB-2 oncoprotein (HER2), in GC samples, using two commercial immunohistochemical (IHC) antibodies, and to validate the results by checking 2 gene amplification by fluorescence in situ hybridization (FISH).

Methods: We assessed the IHC expression of HER2 using the polyclonal antibody from Dako and CB11 clone from Leica, in 93 consecutive cases of GC samples.

Duplication of Inferior Vena Cava, Possible Cause of Internal Hernia? Literature Review and Rare Case Presentation.

Duplication of inferior vena cava (DIVC) is a rare congenital malformation of extreme importance for vascular and urology surgeons, interventional radiologists. Oftentimes it goes unnoticed and is diagnosed incidentally at a routine or emergency CT-scan when complications occur due to associated congenital malformations. We present a case of a 70-year-old male patient who was admitted into the emergency room (ER) accusing abdominal pain.

Parietex ProGrip™ Self-Fixating Mesh in Surgical Treatment of Pelvic Organ Prolapse.

Advanced pelvic organ prolapse is a public health problem, and its treatment can be difficult, requiring a multidisciplinary approach. Aim: The main objective of this article is to describe particular aspects of the use of Parietex ProGrip trade; Self-Fixating Mesh for abdominal sacrocolpopexy or sacrocervicopexy. The secondary objective is to present the initial results of the use of these self-fixating meshes.

Analysis of Clinical-Pathological Data with Impact on Overall Survival in Male Breast Carcinoma: An International Multi-Institutional Study of 217 Cases.

The aim of this study was to evaluate clinical-pathological parameters with impact on overall survival (OS) in male breast carcinoma (MBC). Methodology: We assessed OS at 5 years and at 10 years respectively, as well as OS according to age, tumor size, microscopic type, histological grade, axillary lymph node status, and molecular profile. Two hundred seventeen cases, with a mean age of 62 (range: 18- 85), right breast involvement (52.

Comparative oncological outcomes and survival following surgery for low rectal cancer - a single center experience.

In patients with low rectal cancer, intersphincteric resection (ISR) technique is a better alternative of abdominoperineal resection (APR), but is recommended to be done in non-locally advanced stages (=T2) only. The aim of this study was to evaluate the long-term oncological outcome and survival rate in patients with early and locally advanced stages that underwent ISR, as compared to APR. In order to assess the quality of life and prognosis of patients with low rectal cancer, the 5-year follow-up was done in 72 consecutive cases diagnosed in pT1-T4 stage that underwent ISR or APR.

Long Term Results of Modified Intersphincteric Resections for Low Rectal Cancer: A Single Center Experience.

Background And Objectives: The objective of this article is to evaluate the long-term oncological and functional outcomes following modified intersphincteric resections (ISR) for low rectal cancer. The modified technique consisted of the abandonment of colonic J-pouches, transverse coloplasty, or defunctioning temporary stoma in favor of a direct handsewn coloanal anastomosis (CAA).

Material And Methods: Sixty consecutive patients with type II and III (juxta-anal or intra-anal) low rectal tumors underwent modified ISR by the same surgical team and were followed for a period of five years.

Monobloc Total Thyroidectomy Using Sealing Devices: Preliminary Results and Comparative Analysis.

The desire for perfect haemostasis has led the medical equipment industry to produce ideal instruments for safe thyroidectomy. Thus, haemostasis and sealing instruments such as the LigaSureTM Small Jaw, ThunderbeatTM Open Fine Jaw and HarmonicTM Focus have been indicated for thyroid surgery. Aim: The purpose of this study is to present the initial results of using these three surgical instruments for performing monobloc thyroidectomy.

[Gallbladder agenesis - A rare congenital anomaly mimicking cholelithiasis in an adult woman].

Gallbladder agenesis is a rare congenital malformation due to an embryological defect of the biliary system. In most cases it is asymptomatic, but it can also mimic biliary colic. We report the case of a 72-year-old Caucasian woman with a medical history of cardiovascular disease and hypercholesterolemia, under cholesterol-lowering and hypotensive treatment, who presented symptoms suggesting biliary colic.

Upper Gastrointestinal Tract Hemorrhage: Unexpected Discovery.

Pica is a serious condition that is characterized by ingesting inedible things which can prove to be fatal (glass, pebbles, etc.) We present the case of a 64-year-old male patient who is admitted to the emergency room with the following complaints: upper GI tract bleeding manifested through hematemesis and melena, epigastric pain, lack of bowel movements. A contrast computed tomograohy is performed showing the presence of a hyper-dense stomach content, gastric wall thickening, abdominal fluid but with no signs of intestinal occlusion.

Gastrointestinal Carcinoma with Plasmacytoid Morphology: Positivity for c-MET, Arylsulfatase, and Markers of Epithelial-Mesenchymal Transition, as Indicators of Aggressivity.

Background: Plasmacytoid urothelial carcinoma is a rare and aggressive histologic variant of high-grade carcinoma of the urinary bladder. Few than 250 cases have been reported in the urinary bladder till January 2019. In this paper, a case series of unusual gastrointestinal carcinomas with plasmacytoid morphology was included.