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Article: Anastomotic Leakage after Colorectal Surgery: Risk Factors, Diagnosis and Therapeutic Options.

Denicu, Maria Mădălina / Cârțu, Dan / Râmboiu, Sandu / Ciorbagiu, Mihai / Șurlin, Valeriu / Nemeș, Răducu / Chiuțu, Luminița Cristina

Current health sciences journal

2023 Volume 49, Issue 3, Page(s) 333–342

Abstract: Anastomotic leakage (AL) is the most severe and devastating complication of colorectal surgery. The objectives of this study were to identify the risk factors involved in the development of AL, evaluate diagnostic methods and explore therapeutic options ... ...

Abstract	Anastomotic leakage (AL) is the most severe and devastating complication of colorectal surgery. The objectives of this study were to identify the risk factors involved in the development of AL, evaluate diagnostic methods and explore therapeutic options in case of colorectal cancer surgery. Material and methods: we conducted a retrospective study on 28 AL recorded after 315 elective colorectal cancer surgeries performed in 1st Surgery Clinic of Craiova over an 8-year period (2014-2022). Results: The overall incidence of AL was 8.88%. The identified risk factors were rectal cancer (22.38%), low anterior rectal resection (50%), open approach, advanced age (82.15% over 60 years old), male sex (3:1), and the presence of two or more co-morbidities. Medical conservative treatment was the primary line of treatment in all cases. Leakage closure was achieved in 22 cases (78.56%), with exclusive conservative treatment in 15 cases (46.42%) and combined conservative and surgical treatment in 7 cases (25.0%). Overall morbidity was recorded at 64.28%, with 8 cases of general evolving complications and 10 cases of local complications. General mortality was reported at 6 (21.42%), with 3 (16.66%) occurring after conservative treatment and 3 after re-interventions (30%). Conclusions: our study identified advanced age, the presence of two or more co-morbidities, male sex, rectal surgery, and neoadjuvant chemoradiation as the most important risk factors for AL. Medical conservative treatment was the primary treatment modality, while reoperation was necessary in cases of uncontrollable sepsis and MODS. Mortality after re-intervention was nearly double compared to conservative treatment.
Language	English
Publishing date	2023-09-30
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.49.03.05
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Article: Intestinal Stomas in Abdominal Surgery: Etiological Circumstances, Indications, High Gravity Factors and Complications.

Albulescu, Elena Luminița / Râmboiu, Sandu / Șurlin, Marin Valeriu / Grigorean, Valentin Titus / Bârsan, Ionuț Cristinel / Nemeș, Răducu Nicolae / Chiuțu, Luminița Cristina

Current health sciences journal

2023 Volume 49, Issue 3, Page(s) 371–380

Abstract: This is a retrospective study of 264 intestinal stomas performed in the surgical unit of the Emergency Clinical Hospital "Bagdasar Arseni", Bucharest, within a 7-year period (2015-2021) aiming to evaluate their evolutive complications, risk factors, ... ...

Abstract	This is a retrospective study of 264 intestinal stomas performed in the surgical unit of the Emergency Clinical Hospital "Bagdasar Arseni", Bucharest, within a 7-year period (2015-2021) aiming to evaluate their evolutive complications, risk factors, management and prevention strategies. Material and method. Colostomies: 218 (82.57%) cases, ileostomies 46 (17.43%) cases. Temporary stomas (103 cases or 39.02%) were isolated stomas of discharge in 45 cases and associated with other colorectal procedures in 58 cases. Postoperative complications included general systemic complications in 60 (22.72%) cases and local complications specific to stomas in 84 (31.81%) cases and common to abdominal surgery in 94 (35.60%) cases, which were solved by reoperation in 51 cases, with a reintervention rate of 19.31%. Stoma closures were performed in 34 (33.0%) of the 103 patients with temporary stomas. Of these, 26 (25.24%) patients died in the early postoperative period (< 30 days), the remaining 60 patients refused reintervention or were lost to follow-up. Conclusions. Faecal diversion still represents a therapeutic option for a wide range of benign or malignant digestive or extra-digestive abdominal diseases performed in emergency or scheduled surgeries, mostly for colorectal cancer and its complications.
Language	English
Publishing date	2023-09-30
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.49.03.09
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Article: Ventral Hernia Repair and Drainage - A Prospective, Observational, and Comparative Study of Outcomes.

Soare, Ana-Maria Stan / Preda, Silviu-Daniel / Râmboiu, Sandu / Cârţu, Dan / Pătraşcu, Ștefan / Cazacu, Sergiu / Biciuşcă, Viorel / Știolică, Adina Turcu / Andronic, Octavian / Păduraru, Dan Nicolae / Daniel, Ion / Mitroi, George / Marinescu, Daniela / Șurlin, Valeriu

Chirurgia (Bucharest, Romania : 1990)

2023 Volume 118, Issue 4, Page(s) 426–434

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Prospective Studies ; Treatment Outcome ; Drainage ; Postoperative Complications/epidemiology ; Hernia, Ventral/surgery
Language	English
Publishing date	2023-09-12
Publishing country	Romania
Document type	Observational Study ; Journal Article
ZDB-ID	419244-8
ISSN	1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
ISSN (online)	1842-368X
ISSN	1221-9118 ; 0009-4730 ; 0377-5003
DOI	10.21614/chirurgia.2023.v.118.i.4.p.426
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Article: Postoperative Pain after Inguinal Hernia Repair Using the Tension-Free Lichtenstein Procedure: A Retrospective Study.

Răcăreanu, Marian / Preda, Silviu-Daniel / Predoi, Anamaria / Konstantinos, Sapalidis / Bratiloveanu, Tudor / Mogoș, Gabriel Florin Răzvan / Dobrinescu, Adrian / Râmboiu, Sandu / Mărgăritescu, Dragoș / Cârțu, Dan / Șurlin, Valeriu

Current health sciences journal

2023 Volume 49, Issue 4, Page(s) 524–529

Abstract: Inguinal hernia surgery is a constantly evolving field, with ongoing research efforts aimed at enhancing surgical techniques and outcomes for patients. This retrospective study conducted between 2015 and 2020 in the First Surgical Clinic of Craiova ... ...

Abstract	Inguinal hernia surgery is a constantly evolving field, with ongoing research efforts aimed at enhancing surgical techniques and outcomes for patients. This retrospective study conducted between 2015 and 2020 in the First Surgical Clinic of Craiova Emergency Clinical Hospital focused on the occurrence and characteristics of postoperative pain following inguinal hernia repair using the tension-free Lichtenstein procedure. A total of 178 patients were included in the study, with 16.85% reporting postoperative pain. The average pain intensity was 6.4 on a scale of 1 to 10. Patients described the pain as numbness, burning sensation, stinging, pressure, and tingling sensations. Notably, 50% of patients reported pain related to weather changes. While the study explored potential relationships between patient demographics, hernia type, and postoperative pain, no statistically significant associations were found. Approximately 20% of patients with postoperative pain reported adverse effects on their work, and 10% used analgesics for pain management. This study highlights the multifaceted nature of postoperative pain following inguinal hernia repair, emphasizing the need for further research to identify individual risk factors and adherence to international guidelines for hernia management. The findings also underscore the importance of effective pain management strategies to improve patient comfort and quality of life post-surgery.
Language	English
Publishing date	2023-12-29
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.49.04.7
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Article: Schwannoma: A Rare Case of Submucosal Gastric Tumor.

Fugărețu, Cosmina / Mișarca, Cătalin / Petcu, Lucian / Șoană, Raluca / Cîrnațiu, Andrada / Surlin, Marin Valeriu / Patrascu, Stefan / Ramboiu, Sandu

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 12

Abstract: ... is very rarely preoperative. The immunohistochemical identification of S-100 on the surgical specimen ...

Abstract	Schwannoma is a tumor that originates from the Schwann cells that surround a neuron's axon. This tumor is very rare in the gastrointestinal tract and develops submucosally from intestinal nerve plexuses. The most common location for gastrointestinal schwannomas is the stomach, where they account for only 0.2% of gastric tumors. We present the case of a 56-year-old asymptomatic patient who was diagnosed, following a routine ultrasound examination, with an abdominal tumor. An abdominal MRI confirmed the gastric origin of the tumor. Although a subsequent upper-digestive endoscopic ultrasound was performed, a definitive diagnosis could not be established. Thus, a laparoscopic wedge resection of the stomach was performed. The immunohistochemical examination of the tumor established the diagnosis of benign schwannoma. Despite the availability of advanced endoscopy and imaging techniques, the diagnosis of gastric schwannoma is very rarely preoperative. The immunohistochemical identification of S-100 on the surgical specimen confirmed the diagnosis.
Language	English
Publishing date	2023-06-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13122073
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Article: Ventral Hernia Repair and Diabetes Mellitus - A Prospective, Observational and Comparative Study of Outcomes.

Soare, Ana-Maria Stan / Preda, Silviu-Daniel / Râmboiu, Sandu / Cârțu, Dan / Pătrașcu, Ștefan / Cazacu, Sergiu / Biciușcă, Viorel / Turcu-Știolică, Adina / Andronic, Octavian / Păduraru, Dan Nicolae / Daniel, Ion / Bințințan, Vasile / Oprea, Valentin / Marinescu, Daniela / Șurlin, Valeriu

Current health sciences journal

2023 Volume 49, Issue 2, Page(s) 263–272

Abstract: Diabetes mellitus (DM) and obesity are known to influence postoperative outcomes in surgical patients. This study aimed to analyze the divergence in outcomes between patients with and without DM who underwent ventral hernia repair, while also assessing ... ...

Abstract	Diabetes mellitus (DM) and obesity are known to influence postoperative outcomes in surgical patients. This study aimed to analyze the divergence in outcomes between patients with and without DM who underwent ventral hernia repair, while also assessing the additional impact of obesity on postoperative complications, hospitalization, and costs. A prospective, non-interventional, observational study was conducted over five years (2018-2022) at the First Surgical Clinic of Craiova Emergency Clinical Hospital. The study included 216 patients, with 42 (19.44%) having DM, half of whom were also obese. There were no significant differences in age between patients with or without DM. However, diabetes and obesity were more prevalent in female patients. The mean duration of hospitalization was 10.7±8.6 days, with no significant differences observed between patients with or without DM or obesity. Statistical analysis revealed that patients with DM had a higher incidence of seroma formation, wound infection, and hematoma formation compared to patients without DM. However, there were no significant differences in mesh infection, hospitalization days, or costs between the two groups. Similarly, no significant differences were found between obese and non-obese patients in terms of complications, hospitalization days, or costs. In conclusion, this study highlights that DM is associated with an increased risk of specific complications in ventral hernia repair, including seroma formation, wound infection, and hematoma formation. However, the impact of obesity on these outcomes appears to be limited. Individualized preoperative optimization and targeted interventions are necessary to mitigate the risk of complications in patients with DM or obesity.
Language	English
Publishing date	2023-06-30
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2708703-7
ISSN	2069-4032 ; 2067-0656
ISSN (online)	2069-4032
ISSN	2067-0656
DOI	10.12865/CHSJ.49.02.263
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Article: Could there be an interplay between periodontal changes and pancreatic malignancies?

Ungureanu, Bogdan Silviu / Gheorghe, Dorin Nicolae / Nicolae, Flavia Mirela / Râmboiu, Sandu / Radu, Petru Adrian / Șurlin, Valeriu Marin / Strâmbu, Victor Dan Eugen / Gheonea, Dan Ionut / Roman, Alexandra / Șurlin, Petra

World journal of clinical cases

2022 Volume 11, Issue 3, Page(s) 545–555

Abstract: The term "periodontal disease" refers to a group of chronic inflammatory illnesses caused by specific microorganisms from subgingival biofilm, that affect the tooth-supporting tissues. Recent research has also shown that periodontal infection plays a ... ...

Abstract	The term "periodontal disease" refers to a group of chronic inflammatory illnesses caused by specific microorganisms from subgingival biofilm, that affect the tooth-supporting tissues. Recent research has also shown that periodontal infection plays a role in aggravating systemic disease states at distal sites, reinforcing the significance of the oral cavity for general health. Additionally, it has been suggested that gastroenterological malignancies may be promoted by hematogenous, enteral or lymphatic translocation of periopathogens. In the past 25 years, the global burden of pancreatic cancer (PC) has more than doubled, making it one of the major causes of cancer-related mortality. Periodontitis has been linked to at least 50% increased risk of PC and it could be considered a risk factor for this malignancy. A recent study performed on 59000 African American women with a follow up of 21 years showed that participants who had poor dental health had higher chances of PC. The findings, according to researchers, might be related to the inflammation that some oral bacteria trigger. Regarding the mortality of PC, periodontitis considerably raises the chance of dying from PC. Microbiome alterations in the gut, oral cavity and pancreatic tissues of PC patients occur when compared to healthy flora, demonstrating a link between PC and microecology. Inflammation may also contribute to PC development, although the underlying pathway is not yet known. The function of the microbiome in PC risk has drawn more focus over the last decade. Future risk of PC has been linked to the oral microbiome, specifically increased levels of
Language	English
Publishing date	2022-12-31
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2307-8960
ISSN	2307-8960
DOI	10.12998/wjcc.v11.i3.545
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Article ; Online: The Impact of Cancer Stem Cells in Colorectal Cancer.

Radu, Petru / Zurzu, Mihai / Tigora, Anca / Paic, Vlad / Bratucu, Mircea / Garofil, Dragos / Surlin, Valeriu / Munteanu, Alexandru Claudiu / Coman, Ionut Simion / Popa, Florian / Strambu, Victor / Ramboiu, Sandu

International journal of molecular sciences

2024 Volume 25, Issue 8

Abstract: Despite incessant research, colorectal cancer (CRC) is still one of the most common causes of fatality in both men and women worldwide. Over time, advancements in medical treatments have notably enhanced the survival rates of patients with colorectal ... ...

Abstract	Despite incessant research, colorectal cancer (CRC) is still one of the most common causes of fatality in both men and women worldwide. Over time, advancements in medical treatments have notably enhanced the survival rates of patients with colorectal cancer. Managing metastatic CRC involves a complex tradeoff between the potential benefits and adverse effects of treatment, considering factors like disease progression, treatment toxicity, drug resistance, and the overall impact on the patient's quality of life. An increasing body of evidence highlights the significance of the cancer stem cell (CSC) concept, proposing that CSCs occupy a central role in triggering cancer. CSCs have been a focal point of extensive research in a variety of cancer types, including CRC. Colorectal cancer stem cells (CCSCs) play a crucial role in tumor initiation, metastasis, and therapy resistance, making them potential treatment targets. Various methods exist for isolating CCSCs, and understanding the mechanisms of drug resistance associated with them is crucial. This paper offers an overview of the current body of research pertaining to the comprehension of CSCs in colorectal cancer.
MeSH term(s)	Humans ; Colorectal Neoplasms/pathology ; Neoplastic Stem Cells/pathology ; Neoplastic Stem Cells/metabolism ; Drug Resistance, Neoplasm ; Animals
Language	English
Publishing date	2024-04-09
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25084140
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Article ; Online: Therapeutic Options in Postoperative Enterocutaneous Fistula-A Retrospective Case Series.

Denicu, Maria Mădălina / Cartu, Dan / Ciorbagiu, Mihai / Nemes, Raducu Nicolae / Surlin, Valeriu / Ramboiu, Sandu / Chiuțu, Luminița Cristina

Medicina (Kaunas, Lithuania)

2022 Volume 58, Issue 7

Abstract: Objectives: The aim of the study was to present the results obtained in our experiment regarding the management of postoperative enterocutaneous fistulas (PECF).: Materials and methods: We conducted a retrospective study on 64 PECF registered after ... ...

Abstract	Objectives: The aim of the study was to present the results obtained in our experiment regarding the management of postoperative enterocutaneous fistulas (PECF). Materials and methods: We conducted a retrospective study on 64 PECF registered after 2030 abdominal surgeries (1525 digestive tract surgeries and 505 extra-digestive ones) over a period of 7 years (1st of January 2014-31th of December 2020) in the 1st and 2nd Surgery Clinics, Clinical County Emergency Hospital of Craiova, Romania. The group included 41 men (64.06%) and 23 women (35.34%), aged between 21-94 years. Of the cases, 71.85% occurred in elderly patients over 65 years old. Spontaneous fistulas in Crohn's disease, intestinal diverticulosis, or specific inflammatory bowel disease were excluded. Results: The overall incidence of 3.15% varied according to the surgery type: 6.22% after gastroduodenal surgery, 1.78% after enterectomies, 4.30% after colorectal surgery, 4.28% after bilio-digestive anastomoses, and 0.39% after extra-digestive surgery. We recorded a 70.31% fistula closure rate, 78.94% after exclusive conservative treatment and 57.61% after surgery; morbidity was 79.68%, mortality was 29.68%. Conclusion: PECF management requires a multidisciplinary approach and is carried out according to an algorithm underlying well-established objectives and priorities. Conservative treatment including resuscitation, sepsis control, output control, skin protection, and nutritional support is the first line treatment; surgery is reserved for complications or permanent repair of fistulas that do not close under conservative treatment. The therapeutic strategy is adapted to topography, morphological characteristics and fistula output, age, general condition, and response to therapy.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical/adverse effects ; Digestive System Surgical Procedures/adverse effects ; Female ; Humans ; Intestinal Fistula/etiology ; Intestinal Fistula/surgery ; Male ; Middle Aged ; Postoperative Complications/surgery ; Postoperative Complications/therapy ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2022-06-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina58070880
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Article: The Need for Oral Hygiene Care and Periodontal Status among Hospitalized Gastric Cancer Patients.

Nicolae, Flavia Mirela / Bennardo, Francesco / Barone, Selene / Șurlin, Petra / Gheorghe, Dorin Nicolae / Burtea, Daniela / Pătrascu, Ștefan / Râmboiu, Sandu / Radu, Adrian Petru / Ungureanu, Bogdan Silviu / Turcu-Știolica, Adina / Didilescu, Andreea Cristiana / Strâmbu, Victor Dan Eugen / Șurlin, Valeriu Marin / Gheonea, Dan Ionuț

Journal of personalized medicine

2022 Volume 12, Issue 5

Abstract: Poor oral hygiene leads to the accumulation of dental plaque, thus contributing to the initiation of periodontal disease (PD). Local infections can lead to systemic inflammatory responses, which are essential mediators for the evolution of systemic ... ...

Abstract	Poor oral hygiene leads to the accumulation of dental plaque, thus contributing to the initiation of periodontal disease (PD). Local infections can lead to systemic inflammatory responses, which are essential mediators for the evolution of systemic conditions or cancer tumorigenesis. Often, patients hospitalized with life-threatening and incapacitating disorders such as gastric cancer (GC) might lose interest in keeping their mouth healthy. This study evaluates oral hygiene, periodontal status, and the need for oral care and medical personnel to assist in achieving it in patients hospitalized with GC. This study was carried out on 25 patients with a diagnosis of GC, divided into two groups (GP-14 patients from the Gastroenterology Department, and SP-11 patients from the 1st Department of Surgery). Patients were examined on the day of admission (T0), the day of the medical procedure of endoscopy or surgery (T1), and the day of discharge (T2), recording the number of absent teeth, dental plaque (PI), bleeding on probing (BOP), probing depths (PPD), frequency of toothbrushing, and if the oral hygiene had been self-performed or assisted. Data were subjected to statistical analysis. Our results showed that, in both the GP and the SP group, there were strong and statistically significant correlations between PI and BOP measured on the last day of hospitalization and the period of hospitalization after the medical procedure. Longer hospital stays and the presence of surgery were risk factors for changing toothbrushing frequency. Results also highlight the need for a dentist to diagnose and eventually treat periodontal disease before and after hospitalization, and for a trained nurse who should help take care of the patient's oral hygiene during hospitalization.
Language	English
Publishing date	2022-04-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12050684
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