Changes in Pancreatic Cancer Management and Surgical Treatment During the COVID-19 Pandemic.

: This study evaluated the impact of the COVID-19 pandemic on the surgical management of pancreatic ductal adenocarcinoma (PDAC) at a tertiary care hospital in Romania. The objective was to compare surgical volumes, tumor characteristics, and patient outcomes across three periods: pre-COVID, pandemic, and post-COVID. : A retrospective analysis of 622 PDAC patients who underwent surgery between February 2018 and February 2024 was conducted.

Laparoscopic "Roux-en-Y" Fistulojejunostomy for Persistent External Pancreatic Fistulas.

Persistent external pancreatic fistulas post-acute pancreatitis are a relatively rare complication, in an era of endoscopic and minimally invasive treatment, which can present a high rate of morbidity. Although most of the cases require surgical treatment, the possibility of a minimally invasive approach is yet to be established. This article highlights a case in which persistent external pancreatic fistula (PEPF) was managed laparoscopically, indicating the key steps, as well as the postoperative follow-up.

A 3D-Printed, High-Fidelity Pelvis Training Model: Cookbook Instructions and First Experience.

Since laparoscopic surgery became the gold standard for colorectal procedures, specific skills are required to achieve good outcomes. The best way to acquire basic and advanced skills and reach the learning curve plateau is by using dedicated simulators: box-trainers, video-trainers and virtual reality simulators. Laparoscopic skills training outside the operating room is cost-beneficial, faster and safer, and does not harm the patient.

Predictive Factors of Transient Urinary Incontinence Following Holmium Laser Enucleation of the Prostate (HoLEP): Single-Center Experience.

: The aim of this study was to assess the predictive factors associated with transient urine incontinence (TUI) following holmium laser enucleation of the prostate (HoLEP). : A retrospective analysis was conducted on a prospectively maintained database containing the first 149 consecutive HoLEP cases between June 2022 and December 2023. The study recorded several patient characteristics, and preoperative data such as IPSS score, total gland volume, preoperative catheterization, Qmax, and PVR volume were collected.

Long-term results of multimodal treatment of the prostate using the Thulium Laser.

Background And Aims: To evaluate a novel multimodal treatment (TLP) that integrates the use of a thulium laser, bipolar transurethral resection of the prostate (TURP), and "button-type" bipolar plasma vaporization for the endoscopic treatment of benign prostatic hyperplasia (BPH).

Methods: From March 2018 to December 2021, we prospectively evaluated 220 patients with symptomatic BPH who underwent TLP. Patients were assessed based on the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR).

Multimodal Approach Combining Thulium Laser Vaporization, Bipolar Transurethral Resection of the Prostate, and Bipolar Plasma Vaporization versus Bipolar Transurethral Resection of the Prostate: A Matched-Pair Analysis.

The aim of our study is to compare the perioperative and functional outcomes of a multimodal approach combining thulium laser vaporization, bipolar TURP, and bipolar plasma vaporization (TLP) with bipolar TURP in a matched-pair analysis. A nonrandomized, observational, retrospective, and matched-pair analysis was performed on two homogeneous groups of 60 patients who underwent TLP versus bipolar TURP at our center between March 2018 and December 2021. The American Society of Anesthesiologists (ASA) score and prostate volume (PV) were the main parameters used to match patients between the two groups.

Liver Phantoms Cast in 3D-Printed Mold for Image-Guided Procedures.

Introduction: Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold.

Intraoperative Ultrasound guided Palliative Radiofrequency Ablation of Unresectable Nonmetastatic Pancreatic Malignancies: A Pilot Observational Study.

Background And Aims: Radiofrequency ablation of unresectable pancreatic tumors represents a palliative method in selected patients. The lack of standardization of the technique used as well as the non-homogeneous immediate and long-term results from the reports in the literature made us evaluate in a pilot study the application of a standardized technique through a surgical approach, with the evaluation of the immediate and long-term results.

Methods: Ten consecutive patients diagnosed with unresectable nonmetastatic pancreatic adenocarcinoma were referred for radio-frequency ablation by surgical approach.

The Staging of Newly Diagnosed Hepatocellular Carcinoma in Romania. A National Multicentric Study.

Background And Aims: Hepatocellular carcinoma (HCC) is a significant public health issue, with an increasing incidence and prevalence and a high incidence-to-mortality ratio. The prognosis of HCC depends on two competing factors, tumor burden and underlying liver disease severity, encompassed in the Barcelona Clinic Liver Cancer (BCLC) classification. To assess HCC staging and the way staging affects eligibility for treatment at the time of the first diagnosis in Romania in the setting of opportunistic diagnosis, in the absence of a national HCC screening policy.

Gelatin-Based Liver Phantoms for Training Purposes: A Cookbook Approach.

: Patients with liver pathology benefit from image-guided interventions. Training for interventional procedures is recommended to be performed on liver phantoms until a basic proficiency is reached. In the last 40 years, several attempts have been made to develop materials to mimic the imaging characteristics of the human liver in order to create liver phantoms.

Label-free electrochemical aptasensor for the detection of HepG2 hepatocellular carcinoma cells.

Hepatocellular carcinoma (HCC) is the most common liver malignancy and is characterized by increasing incidence and high mortality rates. Current methods for the screening and diagnosis of HCC exhibit inherent limitations, highlighting the ever-growing need for the development of new methods for the early diagnosis of HCC. The aim of this work was to develop a novel electrochemical aptasensor for the detection of HepG2 cells, a type of circulating tumor cells that can be used as biomarkers for the early detection of HCC.

A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by Chelidonium Majus L. : Report of Two Cases of Herb-Induced Liver Injury and Literature Review.

Background: In instances where individuals manifest elevated transaminase levels without a clearly discernible cause, a comprehensive patient history proves invaluable in unveiling latent triggers. In this report, we present 2 cases of herb-induced liver injury (HILI) characterized by severe hypertransaminasemia attributed to the consumption of Chelidonium majus L . (also known as greater celandine [GC]), an agent considered an alternative therapeutic remedy.

HER2 Overexpression in Periampullary Tumors According to Anatomical and Histological Classification-A Systematic Review.

Pancreatic cancer is one of the most aggressive, heterogeneous, and fatal types of human cancer; therefore, more effective therapeutic drugs are urgently needed. Human epidermal growth factor receptor 2 (HER2) overexpression and amplification have been identified as a cornerstone in this pathology. The aim of this review is to identify HER2 membrane overexpression in relation to pancreatic cancer pathways that can be used in order to develop a targeted therapy.

Evaluation of miR-148a-3p and miR-106a-5p as Biomarkers for Prostate Cancer: Pilot Study.

MicroRNAs (miRNAs) are a class of small non-coding RNAs that may function as tumor suppressors or oncogenes. Alteration of their expression levels has been linked to a range of human malignancies, including cancer. The objective of this investigation is to assess the relative expression levels of certain miRNAs to distinguish between prostate cancer (PCa) from benign prostatic hyperplasia (BPH).

Impact on Long-term Survival of a Standardized Histopathological Protocol on the R1 Incidence in Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma.

Pancreatic Ductal Adenocarcinoma (PDAC) is a pathology with a very poor prognostic, the only curative treatment option being surgery, in association with chemotherapy. This study aims to assess the influence that the use of a standardized pathology report after a pancreaticoduodenectomy (PD) has on the R1 margins rate and the impact that this has on long term survival. Material and We included 116 patients admitted to the Regional Institute of Gastroenterology and Hepatology Prof.

Prognostic Indicators of Overall Survival in Hepatocellular Carcinoma Patients Undergoing Liver Resection.

Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer and the third contributor to malignancy-related deaths worldwide. The hepatic venous pressure gradient (HVPG), transient elastography-liver stiffness measurement (TE-LSM), and the association between TBS (tumor burden score), alpha-fetoprotein levels, and the Child-Pugh classification (TAC score) can serve as valuable prognostic indicators for these patients. Therefore, the main objective of our research was to analyze the prognostic value of the HVPG, TE-LSM, TBS, and TAC scores.

Metabolic Signatures: Pioneering the Frontier of Rectal Cancer Diagnosis and Response to Neoadjuvant Treatment with Biomarkers-A Systematic Review.

Colorectal cancer (CRC) is one of the most aggressive, heterogenous, and fatal types of human cancer for which screening, and more effective therapeutic drugs are urgently needed. Early-stage detection and treatment greatly improve the 5-year survival rate. In the era of targeted therapies for all types of cancer, a complete metabolomic profile is mandatory before neoadjuvant therapy to assign the correct drugs and check the response to the treatment given.

Emergency liver resection for non-traumatic lesions. A systematic review.

Aim: Primary liver tumors have an incidence of 20% regarding benign tumors respectively 5.7% of the overall incident cases of cancer. In any major hepatic injury, the surgical treatment has two main goals: hemostasis and excision of the affected liver segments.

Role of Metabolomics in Pathogenesis and Prompt Diagnosis of Gastric Cancer Metastasis-A Systematic Review.

Introduction: Gastric cancer is the fourth most frequently diagnosed form of cancer and the third leading cause of cancer-related mortality worldwide. The aim of this review is to identify individual metabolic biomarkers and their association with accurate diagnostic values, which can predict gastric cancer metastasis.

Materials And Methods: After searching the keywords, 83 articles were found over a period of 13 years.

Perineal Hernia Mesh Repair Using Only the Perineal Approach: How We Do It.

Perineal hernia is a rare complication of rectal surgery. Different types of surgical approach have been described, but none of them have proven their superiority. Although there are many methods of closing the defect, we selected two cases to present from a series of five cases, in which the perineal hernia was successfully resolved surgically using only the perineal approach.

Safety Issues in the Development of an Innovative Medical Parallel Robot Used in Renal Single-Incision Laparoscopic Surgery.

Robotic-assisted single-incision laparoscopic surgery (SILS) is becoming an increasingly widespread field worldwide due to the benefits it brings to both the patient and the surgeon. The goal of this study is to develop a secure robotic solution for SILS, focusing specifically on urology, by identifying and addressing various safety concerns from an early design stage. Starting with the medical tasks and protocols, the technical specifications of the robotic system as well as potential; hazards have been identified.

Robot-Guided Ultrasonography in Surgical Interventions.

Introduction: The introduction of robotic-guided procedures in surgical techniques has brought an increase in the accuracy and control of resections. Surgery has evolved as a technique since the development of laparoscopy, which has added to the visualisation of the peritoneal cavity from a different perspective. Multi-armed robot associated with real-time intraoperative imaging devices brings important manoeuvrability and dexterity improvements in certain surgical fields.

Distinct Morphological and Molecular Profiles of NAFLD and NAFLD-associated HCC Revealed by Immunohistochemistry and MicroRNA Analysis.

Background And Aims: Non-alcoholic fatty liver disease (NAFLD) is a common hepatic condition that can progress to hepatocellular carcinoma (HCC) in non-cirrhotic livers. To better understand the development of NAFLD-associated HCC, we performed an integrated morphological and molecular analysis to identify new insights that can improve the follow-up of NAFLD patients.

Methods: Our study included a cohort of 14 NAFLD-associated HCC and 41 NAFLD patients.

Overlap syndrome of autoimmune hepatitis and primary biliary cholangitis complicated with atypical hepatocellular carcinoma: a case report.

Background: Hepatocellular carcinoma (HCC) is a primary tumor of the liver. The majority of HCCs are associated most frequently with chronic B or C viral hepatitis, alcohol intake or aflatoxin exposure. Cirrhosis is a strong risk factor associated with HCC.