[Surgical procedures in penis cancer].

In the period of 1980-1999 (20 years) in Colentina Surgical Clinic were admitted and operated 16 patients with the diagnosis of pennial cancer (histopathology--squamocellular carcinoma), 13 of whom being from Colentina Dermatological Clinic. The mean age was about 64 years old, 10 cases presenting phimosis. Surgical procedures undergone were represented by partial pennial amputation with bilateral superficial inguinal lymphadenectomy (10 cases), total pennial amputation with superficial inguinal lymphadenectomy (4 cases), respectively emasculation with bilateral inguinal-iliopelvic lymphadenectomy (2 cases).

[Pancreatic insulinomas].

In the period of 1980-1999 (20 years) were operated 18 patients (8 males and 10 females) in "Colentina" Surgical Clinic, the average age being of 45 years, with hystopathologically confirmed insulinomas. The topography of these lesions was in the head of the pancreas (4), in the isthmus (5), in the body and tail (9). The classical clinical and biochemical signs were presented in 13 cases, the rest of the patients presenting atypical signs of disease.

[Late results after the Mark Belsey IV antireflux procedure in achalasia].

Cardial achalasia (cardiospasm, megaesophagus) represents the failure or lack of relaxation capacity of the inferior esophageal sphincter; it is the second esophageal disease and is considered a premalignant lesion. Treatment of achalasia is surgical but palliative, considering the lack of an etiopathogenic therapy for this moment. We present a retrospective study done on 19 patients (10 males and 9 females, with a mean age of 49 years) operated in "Colentina" Surgical Clinic in the period of 1996-1999 for achalasia (presenting symptoms-dysphagia, regurgitation, weight loss) by extramucosal esocardiomyotomy practiced on a length of 5-10 cm, by thoracic approach, followed by the Mark Belsey IV antireflux procedure.

[The therapeutic options in biliary ileus].

Unlabelled: Gallstone ileus is a rare, serious condition, requiring emergency surgery. Although most data in the literature confirm the need for a conservative surgical approach, several authors report the one-stage repair of the cholecystoduodenal fistula. The present study deals with seven cases of gallstone ileus operated upon in a 20-year period.

[Complicated postbulbar duodenal ulcers: the characteristics of the diagnosis and of the surgical procedure and management].

The paper reports on the authors' experience used on 164 patients with complicated postbulbar ulcers (12% of the duodenal ulcers) with hemorrhage (52 cases), perforation (9 cases), duodenal stenosis (13 cases), stenosis and penetration (36 cases) and pancreatic-biliary penetrations (36 cases). The frequency of hemorrhagic complication was of 31%. As the hemorrhage due to postbulbar ulcer is favoured by vascular fistula, the severe character of the hemorrhage and the frequency of the recurrence, mainly the cataclysmic one, impose the radical surgery as early as possible.

Chronic pancreatitis. Anatomo-clinical and surgical treatment characteristics.

Chronic pancreatitis of biliary origin, often localized in the cephalic region of the gland and etiopathogenetically related to biliary lithiasis whose anatomoclinical evolution is thus complicated, has a good prognosis. Chronic pancreatitis proper, persistent, recurrent calcifying with pancreatic lithiasis and with pseudocysts, more rare in Romania, raises difficulties of diagnosis and of surgical treatment, the prognosis being doubtful. In a group of 321 patients (33.

[Chronic pancreatitis: anatomico-clinical and surgical therapy characteristics. Our experience with 321 cases].

Chronic pancreatitis of biliary origin, frequently located in the cephalic portion of the organ, etiopathogenically dependent on biliary lithiasis, the anatomoclinical evolution of which is complicated by their presence, have a better prognosis, and are usually reversible following therapy of the biliary affections. Persistent chronic pancreatitis proper, usually of the recurrent type, associated with calcification and the development of pancreatic stones, and with pseudocysts, although rare in our country, raise diagnostic difficulties from the standpoint of surgery, and have a reserved prognosis. The authors have evaluated a total of 321 cases hospitalized between 1960 and 1987 with chronic pancreatitis of biliary origin (252 cases--78.

[Microvascularization of the liver in vagotomy].

Sub-diaphragmatic truncal vagotomy produces early and late changes in the microvascular network of the liver. Bilateral sub-diaphragmatic truncal vagotomy was performed experimentally in the dog. After 7 days, 60 days and 2 years, the animals were subjected to laparotomy under general anaesthetic and China ink was injected into the aorta above the coeliac trunk.

[Details of diagnosis and surgical treatment in terminal choledochal lithiasis].

Lithiasis of the terminal choledocus raises problems of pre- and intraoperative diagnosis, especially when the evolution is complicated by sclero-inflammatory of the Oddi, chronic pancreatitis, or acute pancreatitis, or with angiocholitis and hepato-renal failure. The high frequency of the lithiasis of the terminal choledocus (37.72% of all cases of biliary lithiasis) makes necessary an improvement of the methods used for the exploration, and evacuation of this type of lithiasis, and for the recovery of the biliary flow.

[Hepatic tuberculosis; difficulties of diagnosis and therapeutic management].

Micro, and/or macro-nodular lesions are frequently encountered in the liver in the course of the tuberculous disease, especially during primary dissemination, as well as during the secondary one. In some cases the evolution of liver tuberculous lesions will determine hepato-biliary symptomatology (hepatomegaly, icteric cholangitis) which makes necessary exploratory laparotomy. The authors present their experience in connection with 2 patients presenting liver tuberculous localizations during the primary dissemination.

[Difficulties of diagnosis and surgical treatment in gallbladder cancer].

After a review of the etiopathogenic data, as well as of anatomo-pathologic aspects of the cancers of the gall-bladder the authors stress the difficulties of diagnosis encountered in the pre-surgery stage, and during the surgical intervention. In view of an early detection of neoplastic lesions the authors suggest extemporaneous histo-pathogenic examination of the lithiasic gall-bladder. They prefer the transparietal-hepatic cholangiography, and the intraoperative transhepatic cholangiography for an exact assessment of the convergence point of hepatic canals, with a view to perform peripheral hepato-digestive derivations.

[Acute biliary pancreatitis. Anatomoclinical and therapeutic aspects].

After an introduction on the role of the biliary factors in the etiopathogeny of acute pancreatitis the authors present an analysis of their personal experience in this field. A total of 46 cases are discussed, with acute biliary pancreatitis, which were diagnosed during surgical interventions. Of the 46 patients 13 had an oedematous form of acute biliary pancreatitis, 22 had necrotizing pancreatitis with associated haemorrhage, 3 had suppurated pancreatitis and 6 had a pancreatic abscess.

[Lithiasic cholecysto-choledochal fistulas. Peculiarities of diagnosis and surgical treatment].

On the basis of a study of 16 cases the authors discuss the etiopathogenic, anatomo-pathologic and therapeutic aspects of biliobiliary fistulae. The age of the patients ranged between 27 and 75 years and all had biliary lithiasis for a long time. The authors stress the difficulties of the pre- and intraoperatory diagnosis, as well as the surgical methods of treatment.

[Anatomoclinical and therapeutic aspects of nodular goiter].

Based on the experience acquired in the treatment of 500 patients with thyroid affections, of which 229 had benign nodular goiters and 12 had degenerated nodular goiters, the authors stress the necessity of very detailed preoperative exploration, that are capable to provide a series of essential elements for establishing the indication for surgery. Clinical exploration is also a significant contribution, as well as the peroperative exploration, including the histologic one. The trend is noted, as a result of exploration capabilities, and of improved pre- and postoperative treatment possibilities, to perform extensive, and even total resections.

[Postbulbar hemorrhagic ulcer].

Although it is relatively rare (only 10,4% of the cases), post-bulbar ulcers have a rather complicated evolution. The authors have recorded 26 observations with digestive haemorrhage, 3 cases with perforations, 32 stenoses, and pancreatic penetration. These give raise to problems of surgical tactic and surgical technique.