Acest material poate ajuta specialistul sa informeze pacientul, simplu si corect!
Ce este hernia inghinala?
Hernia inghinala este cel mai frecvent tip de hernie, apare atunci când conținutul abdominal se exteriorizează printr-un defect al peretelui muscular situat in santul dintre coapsa si abdomen (regiune inghinala).
Factori de risc nemodificabili:
Factori de risc ce pot fi modificati prin stilul de viata :
Simptomele obișnuite sunt reprezentate de durere sau presiune in regiunea inghinala (la locul herniei) mai ales la efort fizic, tuse sau dupa o perioada mai lunga de stat in picioare, și apariția unei umflături.
Evoluție – netratată crește în volum și evoluează spre complicații (incarcerare, strangulare) ce pot pune în pericol viața.
Tratament – este doar chirurgical.
Obiectivele operației:
Cum se face operația?
Cât durează operația – între 30-90 de minute
Cât durează spitalizarea – între 1-7 zile
Cât trebuie să mă abțin de la efort fizic – în funcție de procedeul chirurgical între 1-4 săptămâni
Complicații – reapariția herniei, infecții postoperatorii, sângerare
Laparoscopia în tratamentul herniei inghinale are urmatoarele aventaje:
comanadina June 28th, 2018
Posted In: Doctor
Acest material poate ajuta specialistul sa informeze pacientul, simplu si corect!
Ce este cancerul rectal?
Cancerul rectal reprezintă apariția unei tumori la nivelul segmentului terminal al tubului digestiv.
Simptomele obișnuite sunt reprezentate de sângerare si anemie, diaree sau constipatie, modificari ale calibrului si formei scaunului (scaun in creion), scădere ponderală, durere abdominala colicativa, balonări.
Evoluție – netrat se răspândește în organism și duce la deces. De asemenea mai poate provoca stări grave ce necesită tratament chirurgical de urgență – ocluzia intestinală (încurcătură de mațe popular), sângerări grave, invazia organelor vecine (ex. vezica urinara).
Factori de risc: dieta bogata in carne rosie sau vanat, alcoolul, fumatul, acizi biliari, factori ereditari, bolile intestinale inflamatorii ( boala Crohn, recto-colita ulcero-hemoragica).
Tratament – este chirurgical și oncologic (radioterapie si chimioterapie).
Obiectivele operației:
Cum se face operația
Cât durează operația – între 60-240 de minute, depinzand de complexitatea cazului.
Cât durează spitalizarea – între 3-10 zile
Cât trebuie să mă abțin de la efort fizic – în funcție de procedeul chirurgical între 2-6 săptămâni
Complicații – reapariția tumorii, infecții postoperatorii, sângerare
Laparoscopia în tratamentul cancerului colorectal
comanadina June 28th, 2018
Posted In: Doctor
Karen Chang • Mathew Fakhoury •
Moshe Barnajian • Cristi Tarta • Roberto Bergamaschi
Abstract
Background This study was performed to evaluate shortterm clinical outcomes of laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon.
Methods This was a retrospective study of selected patients who underwent laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon for tumors or Crohn’s disease by a single surgeon from July 2002 through June 2012. Data were retrieved from an Institutional Review Board-approved database. Study end point was postoperative adverse events, including mortality, complications, reoperations, and readmissions at 30 days. Antiperistaltic side-to-side anastomoses were fashioned laparoscopically with a 60-mm-long stapler cartridge and enterocolotomy was hand-sewn intracorporeally in two layers. Values were expressed as medians (ranges) for continuous variables.
Results There were 243 patients (143 females) aged 61 (range = 19–96) years, with body mass index of 29 (18–43) kg/m2 and ASA 1:2:3:4 of 52:110:77:4; 30 % had previous abdominal surgery and 38 % had a preexisting comorbidity. There were 84 ileocolic resections with ileo ascending anastomosis and 159 right colectomies with ileotransverse anastomosis. Operating time was 135 (60–220) min. Estimated blood loss was 50 (10–600) ml. Specimen extraction site incision length was 4.1 (3–4.4) cm. Conversion rate was 3 % and there was no mortality at 30 days, 15 complications (6.2 %), and 8 reoperations (3.3 %). Readmission rate was 8.7 %. Length of stay was 4 (2–32) days. Pathology confirmed Crohn’s disease in 84 patients, adenocarcinoma in 152, and other tumors in 7 patients.
Conclusion Laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon resulted in a favorable outcome in selected patients with Crohn’s disease or tumors of the right colon.
Keywords Laparoscopy Right colon resection Intracorporeal ileocolic anastomosis Crohn’s disease Tumor
Full paper: Laparoscopic right colon resection with intracorporeal anastomosis
Tarta Cristi June 8th, 2018
Posted In: Doctor
Adina Coman
Ce este cancerul rectal?
Cancerul rectal reprezintă apariția unei tumori la nivelul segmentului terminal al tubului digestiv.
Simptomele obișnuite sunt reprezentate de sângerare si anemie, diaree sau constipatie, modificari ale calibrului si formei scaunului (scaun in creion), scădere ponderală, durere abdominala colicativa, balonări.
Evoluție – netrat se răspândește în organism și duce la deces. De asemenea mai poate provoca stări grave ce necesită tratament chirurgical de urgență – ocluzia intestinală (încurcătură de mațe popular), sângerări grave, invazia organelor vecine (ex. vezica urinara).
Factori de risc: dieta bogata in carne rosie sau vanat, alcoolul, fumatul, acizi biliari, factori ereditari, bolile intestinale inflamatorii ( boala Crohn, recto-colita ulcero-hemoragica).
Tratament – este chirurgical și oncologic (radioterapie si chimioterapie).
Obiectivele operației:
Cum se face operația
Cât durează operația – între 60-240 de minute, depinzand de complexitatea cazului.
Cât durează spitalizarea – între 3-10 zile
Cât trebuie să mă abțin de la efort fizic – în funcție de procedeul chirurgical între 2-6 săptămâni
Complicații – reapariția tumorii, infecții postoperatorii, sângerare
Laparoscopia în tratamentul cancerului colorectal
comanadina May 7th, 2018
Posted In: Doctor
C. Tarta • M. Bishawi • R. Bergamaschi
This study is a narrative review of the current literature regarding intracorporeal ileocolic anastomosis in laparoscopic right colon resection for benign or malignant diseases of the right colon and terminal ileum.
The search strategy included Medline, Embase, CINAHL, ACP Journal Club, and Cochrane databases with laparoscopic right colectomy and intracorporeal anastomosis as keywords. All retrieved references were screened by two independent blinded reviewers. Thirteen papers including 611 patients undergoing laparoscopic right colon resection with intracorporeal ileocolic anastomosis
for benign or malignant diseases of the right colon and terminal ileum were identified. There were eight case series and five case control studies. Anastomoses were fashioned as antiperistaltic or isoperistaltic, totally stapled or stapled/handsewn. The mesenteric defect was mostly left open. Overall operating time ranged from 53 to 360 min. The most common specimen extraction site locations were periumbilical, suprapubic, or transvaginal with a median incision length ranging from 3 to 6 cm. The overall rate of surgical site infection was 2.7 %. The anastomotic leak rates varied from 0 to 8.5 %. Postoperative mortality was 0.12 %. Intracorporeal ileocolic anastomosis following laparoscopic resection of the right colon is not commonly performed, but offers potential benefits if carried out by experienced surgeons in selected patients.
Keywords Review Laparoscopic intracorporeal anastomosis Laparoscopic right colon resection Benign disease Malignant disease Right colon Terminal ileum
Full paper: Intracorporeal ileocolic anastomosis_ a review
Tarta Cristi May 7th, 2018
Posted In: Doctor
Ciprian Duta, MD, PhD, Stelian Pantea, MD, PhD, Caius Lazar, MD, Abdullah Salim, MD, Daniela Barjica, MD
ABSTRACT
Background and Objectives: Open surgery has been the mainstay treatment for liver hydatidosis in the past.
Today, for treatment of simple and uncomplicated cysts, we have a variety of choices: antihelmintic therapy, the PAIR (puncture, aspiration, injection, and respiration) technique, and the laparoscopic approach. We reviewed our series of 267 cases of hepatic hydatidosis submitted to surgery over a period of 20 years, from 1995 through 2014, comparing the results of these minimally invasive treatments.
Methods: In 92 patients (25.7% of cases) who presented with complicated liver hydatid cysts, we performed open surgery. In 16.4% of cases (59 patients), we used a laparoscopic approach, and in 208 patients (57.9% of cases), we used the PAIR technique. All patients were monitored after surgery for a mean of 61.7 months (range, 16–127). Postoperative follow-up consisted of clinical examination, laboratory investigation, abdominal ultrasound, and magnetic resonance imaging.
Results: Almost all patients (198, 95.2%) treated with the PAIR technique and 55 patients (93.2%) treated with the laparoscopic approach were cured. Six patients (2.8%) from the echo-guided puncture group had to undergo a repeat of the procedure because the cavity did not disappear after 2 years. In 4 patients (2%), we performed open surgery for 2 biliary fistulas and 2 hepatic abscesses. Four patients from the laparoscopic group needed additional procedures. Open surgery was necessary in 2 patients for a recurrence after 2 years; 1 patient had developed a liver
abscess and the other had a biliary fistula.
Conclusions: In conclusion, open surgery remains the viable option for complicated cysts, with biliary communication, with multiple daughter vesicles, or with calcified walls. For simple, uncomplicated hydatid cysts, both methods (the PAIR technique and laparoscopic procedure) are safe and efficient, with very good results and low morbidity rates.
Key Words: Laparoscopic approach, Liver hydatidosis, Percutaneous echo-guided puncture.
Full paper: Minimally Invasive Treatment of Liver Hydatidosis
Duta Ciprian May 7th, 2018
Posted In: Doctor
CIPRIAN DUŢĂ1), SORINA TĂBAN2), DIANA AL-JOBORY1), ADELINA-ROXANA GHEJU2), ROMULUS-BOGDAN TIMAR3), SORIN DEMA4), POMPILIU HORAŢIU PETRESCU5)
Worldwide, colorectal cancer is one of the most prevalent malignancies. Due to oncological safety concerns, data regarding the laparoscopic surgical treatment of rectal cancer is scarce. Our study’s main aim was investigate the oncological adequacy of laparoscopic surgery in the treatment of rectal cancer by comparing its oncological reliability with the oncological results obtained after open surgery for rectal cancer.
In this retrospective study, 80 patients who underwent surgery for rectal cancer, admitted in our Clinic between January 1, 2014–November 31, 2015 were enrolled. The studied group was stratified according to the way of approach chosen: classic surgery (59 cases) and laparoscopic surgery (21 cases), respectively. Based on the histopathological examination, we analyzed the histological grading of rectal neoplasms, TNM staging, resection margins, lymphovascular and perineural invasion and the number of regional lymph nodes identified in the perirectal
adipose tissue. The average number of isolated lymph nodes demonstrated non-significant differences between the two types of approaches: 20 lymph nodes in the classical approach versus 18 lymph nodes in the laparoscopic approach (p=0.109). Lymph nodes affected by metastases were associated in the majority of cases with stage IIIB and stage IIIC rectal cancers (100% and 83.3%, respectively). The laparoscopic approach proved to be efficient in terms of reaching oncological resection limits. On the resection specimens extracted by laparoscopic surgery, the residual tumor (R1) was encountered in 5% of the cases versus in 6.7% of the cases after classic surgery. The laparoscopic approach is oncologically feasible in the rectal cancer surgical treatment.
Keywords: rectal cancer, laparoscopy, classic approach, lymph nodes, resection limits, tumor grade.
Duta Ciprian May 7th, 2018
Posted In: Doctor
Flore Varcus1, Ciprian Duta1, Amadeus Dobrescu1, Fuger Lazar1, Marius Papurica2, Cristi Tarta1
1Surgical Clinic 2, Victor Babes University of Medicine and Pharmacy, Timişoara, Romania
2Intensive Care and Anesthesia Unit, Victor Babes University of Medicine and Pharmacy, Timişoara, Romania
Full paper: Laparoscopic Repair of Inguinal Hernia TEP versus TAPP
Varcus Flore May 3rd, 2018
Posted In: Doctor
Abstract
Backgrounds The incidence of patients presenting with perforated peptic ulcers (PPU) has decreased during the last decades. At the same time, a laparoscopic approach to this condition has been adopted by increased number of surgeons. The aim of this study was to evaluate the early postoperative results of the laparoscopic treatment of perforated peptic ulcer performed in eight Romanian surgical centers with extensive experience in laparoscopic surgery.
Methods Between 2009 and 2013, 297 patients with perforated peptic ulcer were operated in the eight centers participating in this retrospective study. The patients’ charts were reviewed for demographics, surgical procedure, complications and short-term outcomes.
Results Boey score of 0 was found in 122 patients (41.1%), Boey 1 in 169 (56.9%), Boey 3 in 6 (2.0%). For 145 (48.8%) patients, primary suture repair was performed, in 146 (49.2%) primary suture repair with omentopexy. There were 6 (2.0%) conversions to open surgery. The operative time was between 25 and 120 min, with a mean of 68 min.
Two (0.7%) deaths were noted. Mean hospital stay was 5.5 days, ranges 3–25 days. Postoperative complications included: 7 (2.4%) superficial surgical site infections, 5 (1.6%) cardiovascular, 3 (1.0%) pulmonary, 2 (0.7%) duodenal leakages, 3 (1.0%) deep space infections and 1 (0.3%) upper digestive hemorrhage.
Conclusions This study shows that the laparoscopic approach for PPU is feasible; the procedure is safe, with no increased risk of duodenal fistulae or residual intraperitoneal abscesses. We now consider the laparoscopic approach for PPU as the ‘‘gold standard’’ in patients with Boey score 0 or 1.
Full paper: Laparoscopic Repair for Perforated Peptic Ulcer:_A Retrospective
Varcus Flore May 3rd, 2018
Posted In: Doctor
Varcus, C. Tarta, A. Dobrescu, D. Brebu, Adina Coman, G. Noditi, C. Duta
Full document: Minim invasive aproach of inguinal hernia: the experience of Surgical Clinic 2 Timisoara
comanadina March 30th, 2018
Posted In: Doctor
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