[Amyand's hernia--case presentation and a discussion about diagnosis problems and surgical treatment].

We present the case of a 62 years old patient, with multiple associated tares, which was operated in emergency for an Amyand's hernia. The appendix was perforated and generated a big pussy collection (aprox. 200 ml) in the hernia sac.

[Transanal endoscopic microsurgery--our initial experience].

Unlabelled: The aim of this study was to describe a single institution's experience with transanal endoscopic microsurgery (TEMS) in patients with benign and malignant rectal tumors.

Material And Method: This was a prospective descriptive survey. Between January 2006 and January 2010, 14 patients underwent transanal endoscopic microsurgery excision of benign (8) or malignant (6) rectal tumors, located 4 to 15 cm from the dentate line.

[Benefits of mechanical suture in our experience].

Unlabelled: The evolution of mechanical suture technology experienced a continuous improvement but the implementation of these devices in current practice of Romanian surgery encountered difficulties related mostly to increased costs.

Purpose: Review of casuistic related to the use of mechanical suture devices.

Methods: We studied the casuistic between 2008 and July 2011.

[Certitudes and controversy regarding neural elements preservation in total mesorectal excision technique (ETM)].

The total excision of the mezorect, as a technique of reference in the surgical solution of rectal cancer, is evaluated today through the view of the oncological and functional outcome. Within the functional outcome, the genito-urinary disorders which follow the damage of the pelvic vegetative nervous structures, still cause discussions and controversy among dedicated specialists in this area. The work plans to share an experience of over ten years of ETM practice, in which the technico-tactical accumulation have been realized progressively, outlining a relatively codificated attitude, centered on the "critical moments" of this intervention.

[Role of early biliary and pancreatic decompression by minimally invasive procedure in acute pancreatitis].

Introduction: Acute pancreatitis is an acute inflammatory process of the pancreas, with variable involvement of other regional tissues or remote organ systems.

Materials And Methods: In an ongoing effort to search for optimal solution in the management of acute pancreatitis, a serious and unpredictable disease, even in the context of therapies that are part of modem therapeutic protocols line, we offer an original pathogenic and mininvasive therapeutic approach. The purpose is to bring attention to this original treatment method and highlight its advantages.

[Videomediastinoscopic transcervical approach of postpneumonectomy left main bronchial fistula].

Bronchopleural fistulas and empyema are the most devastating complications after lung resection. The optimal management remains a major subject of controversy for thoracic surgeons over the wide variety of therapeutic approaches, none suitable for all patients. In 1996 Azorin et al.

[Perioperative immunologic changes in colorectal cancer patients].

The aim of the study was to investigate the perioperative immunological profile in colon cancer patients and possible correlations with disease. To investigate the changes in immune mediators profile induced by tumor resection, we assessed the serum levels of cytokines (IL-6, IL-8, IL-10, IFN-gamma, TNF-alpha), chemokines (MIP-1alpha, MCP-1, ENA-78) and growth factors (VEGF, bFGF) in colon cancer patients before, during and after surgery and compared the results with those measured for a group of healthy controls. We have used XMap profiling technology (Luminex) that allows simultaneous measurement of multiple parameters in small volumes of samples.

[Sleeve resection of right main bronchus for posttraumatic bronchial stenosis].

Introduction: Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. A high index of clinical suspicion and accurate interpretation of radiological findings are necessary for prompt surgical intervention with primary repair of the airway. Delays in treatment increases the risk of partial to complete bronchial stenosis.

[Ascending colon perforation by ingested fruit stones].

Background: Ingested foreign bodies present problems due to the related complications, perforation being the most frequent.

Material And Method: This is a descriptive study of two cases of ascending colon perforation by numerous ingested fruit stones. The main symptoms were abdominal pain with tenderness in the lower right quadrant.

[Immunohistochemical screening of hMLH1 and hMSH2 gene mutations in patients diagnosed with colorectal cancer and microsatellite instability suspicion].

Study Aim: Immunohistochemical screening of hMLH1 and hMSH2 gene mutations in patients diagnosed with colorectal cancers, suspected of having microsatellite instability, as diagnosed between January 2002 and December 2009 in the Surgery Department of the CF Clinical Hospital Cluj-Napoca (prospective non-randomised study).

Methods: Inclusion criteria were adenocarcinoma pathology finding and also minimum one of the revised Bethesda criteria for genetic testing of microsatellite instability in colorectal cancers. 110 eligible patients were divided in 2 study groups according to the number of Bethesda criteria met (group A - 1 criteria; group B - 2 or more criteria).

[Upper digestive hemorrhage appearing after cephalic duodeno-pancreatectomy].

The frequency of upper gastrointestinal hemorrhage as a postoperative complication of cephalic duodenopancreatectomy remained constant for decades despite the overall decrease in the incidence of mortality occuring after cephalic duodeno-pancreatomy. It is the second most common complication after anastomotic fistulas, but more frequently fatal, especially when the pancreas is anastomosed with the stomach. The case presented here is of a patient of 55 years age, diagnosed in our clinic with vaterian ampuloma for which was performed cephalic duodenopancreatectomy and gastrointestinal and hepatobiliary continuity was restored by performing terminolateral pancreato-gastric anastomosis, termino-lateral hepato-jejunal anatomosis and termino-lateral gastro-jejunal anastomosis on a jejunal loop ascended transmezocolic.

[Lower limb revascularization--a continuous challenge].

Revascularization of the lower extremity in patients with diabetes or chronic obstructive arterial disease is a challenging, still unsolved problem. Modern day technique (stem cell therapy, hyperbaric therapy) has yet to deliver satisfactory results. Homogenous (safenous vein) or heterogeneous (terom, dacron, PTFE-teflon) by-pass surgery is limited because of technical difficulty and positive outcomes have a short duration.

[Current methods for wound debridement].

Wound management experienced significant changes in the last half century, while acknowledging the concept of "moist wound healing" and the strategy of "wound bed preparation". New solutions in this area have brought by developing new methods of debridement, exudates management and decrease of bacterial load. Debridement is the most widespread used method for conditioning wound and involves the application of interventions that accelerate the healing process.

[The transpleurodiaphragmatic laparoscopic approach of rear dome liver cysts].

The localizations of liver cysts in the posterior hepatic dome (segment VII) and the hydatid cysts in particular, difficult to approach in "conventional" open or laparoscopic surgery, with significant parietal sacrifices and "demolition", requires a secure atypical laparoscopic approaching way, with positive results for both patient and surgeon, with minimal impact, with social and professional reintegration and faster healing. Transpleurodiaphragmatic laparoscopic approach using "Device for aspiration of liver hydatid cyst or ovarian cyst (OSIM 120809/30.04.

[Surgical management of malignant large bowel obstructions].

Introduction: Despite significant progress, the management of acute colonic obstruction still remains a challenging problem. The purpose of this study was represented by the evaluation of the clinical results of different techniques of resection for malignant colorectal (primary or staged) obstruction.

Methods: We performed a non-randomized clinical study.

[Emergency pancreatoduodenectomy for severe iatrogenic duodenal injury--case report].

We present the case of a male patient admitted for high flow biliary fistula (> 2000 ml/24h) as a consequence of a prior right nephrectomy by lumbar approach. The patient was operated after the failure of the medical conservative treatment and continous declining medical status. We noted the complete absence of the gastric antrum, duodenum I and II with the intraperitomeal direct display and opening of the Vater papilla, witch was difficult to identify unless common bile duct (CBD) was catheterized by supraduodenal choledocotomy.

[Gastric metastasis of clear cell renal carcinoma].

We report the case of a patient operated in 2003 for renal clear cell carcinoma (CCRC), when left nephrectomy was performed. In the years following occur: lung (2004) and brain (2006) metastasis, pathological bone fracture in right femur (2007), which needed a complex treatment: polichimiotherapy, cobaltotherapy, right temporal metastasectomy, right femoral fixation with metal rod. In our clinic was hospitalised for serious upper gastrointestinal bleeding, severe anaemia (haemoglobin 5.

[Improvement in the quality of life for patients with adjustable gastric banding: initial results].

Unlabelled: The aim of the study was to evaluate the improvement in quality of life for patients that have undergone the laparoscopic gastric banding, using the BAROS and Moorehead-Ardelt II questionnaires.

Methods: We selected a 20 patient group (65% women) that underwent this surgical procedure in our clinic. The initial average weight was 123.

[Results and prognostic factors in rectal cancer surgically treated with curative intent--experience of a single tertiary center].

Background: Rectal cancer has a paradoxal prognosis in about 25% of patients, although intraoperative parameters and tumor stage are known as major determinants of prognosis.

Aim: This study assessed the prognostic factors in patients with rectal cancer treated without total mesorectal excision in long-term follow-up.

Material And Methods: A single center tertiary population included retrospectively 87 patients with rectal cancer operated between 1992 and 2002 using conventional resection.

[Particular aspects of endoprosthesis in malignant advanced pharingeal-esophageal stenosis].

Introduction: The esophageal neoplasm is currently the seventh cause of death through cancer worlwide. In the developing countries it is situated on the fifth place and has one of the worst prognostics for a neoplasm. Due to the specifical intratoracical topography, clinically inaccesible and without symptoms, the disease is rather incurable when the disphagia appears.

[Non-ulcerous duodenal perforations: a clinical analysis of 23 cases].

Non-ulcerous duodenal perforations are a rare and seldom studied pathology. The present retrospective study analyses a group of 23 patients, over a 10 year period (Jan 1st 2000 - Dec 31st 2009) with this pathology. The most frequent etiology was iatrogenic (52.

[Jejunal ischemic ulcer with perforation: a case report].

Ulcerative ischemic lesions of the small bowel represents a rare abdominal pathology. We present the case of a 68-year-old male who was admitted to our hospital for abdominal pain, nausea and vomiting. Ultrasound examination followed by upper endoscopy raised up the suspicion of a jejunal ulcerative perforated lesion.