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Article ; Online: Histopathological Characteristics – Immediate Prognostic Factors for Left Colon Cancer

Madi MARINCA / Mircea BEURAN

Modern Medicine, Vol 27, Iss 1, Pp 41-

2020 Volume 46

Abstract: Introduction: Colorectal cancer represents the second leading cause of cancer mortality in our country, the survival rates being determined by the stage of the disease and the presence of metastases, being of 90% for early stages at 5 years, of 70% for ... ...

Abstract	Introduction: Colorectal cancer represents the second leading cause of cancer mortality in our country, the survival rates being determined by the stage of the disease and the presence of metastases, being of 90% for early stages at 5 years, of 70% for the tumors with local invasion and of 10% in case of distal metastases. The aim of our study is to evaluate the prognosis of left colon cancer according to its histopathological characteristics. Material and methods: A number of 171 patients with left colon cancer (splenic flexure, descending colon, sigmoid colon and rectosigmoidian junction) were included in the study. The patients were admitted to the Surgical Unit of the Emergency Clinical Hospital of Bucharest between January 1st 2015 – December 31st 2016. The histopathological analysis followed the norms of the Americal College of Pathologists, and the determination of tumor staging was done based on the TNM classifi cation. Results: Most patients are in the 3rd stage (65.5%) and in the 4th stage (19.3%) of cancer, only 2.3% being diagnosed in the 1st stage. A number of 36 patients present distal metastases, the most frequent location being in the liver (21 patients). 24% of the patients presented postoperative complications, while 2.3% died, without any differences determined by the presence of lymph nodes or distal metastases. Distal metastases are associated with the resistance environment (p=0.048), while the invasion of lymph nodes is significantly higher (p=0.049) in patients with tubulovillous adenoma. The degree of differentiation of tumors differs significantly from a statistical point of view (p=0.002), according to the histopathological type. Conclusions: The incidence of lymphatic metastases differs according to the histopathological type of the tumor, the tubulovillous adenoma being more frequently associated with lymphatic metastases; distal metastases are more frequently seen in patients in the rural areas, based on the low addressability and accessibility to medical services. The frequency of ...
Keywords	left colon cancer ; lymph node metastasis ; distal metastasis ; histopathological characteristics ; prognostic factors ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Media Med Publicis
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The impact of patient-dependent risk factors on morbidity and mortality following gastric surgery for malignancies

Bogdan Dumitriu / Sebastian Valcea / Gabriel Andrei / Mircea Beuran

Journal of Mind and Medical Sciences, Vol 8, Iss 2, Pp 267-

2021 Volume 272

Abstract: Gastric cancer remains a leading cause of mortality worldwide. The treatment for gastric cancer is multimodal, in which gastrectomy remains the only curative approach. However, gastric resection is often associated with increased morbidity and mortality ... ...

Abstract	Gastric cancer remains a leading cause of mortality worldwide. The treatment for gastric cancer is multimodal, in which gastrectomy remains the only curative approach. However, gastric resection is often associated with increased morbidity and mortality rates, depending on several factors. These factors can be attributed to the patient as comorbidities or effects of the disease upon him and, on the other hand, there are risk factors independent of the patient, such as aspects of the tumor (type, staging, location), experience of the surgical and anesthetic team, logistics of the hospital, yield of adjuvant therapies etc. We recognize the fact that patient-related risk factors are often overlooked and not taken into consideration prior to surgery, thus becoming a source of morbidity and mortality. These factors are more susceptible to modulating in order to better select candidates for gastric resection and thus create a better outcome. Therefore, identifying and modulating patient-related risk factors is paramount in order to decrease the incidence of morbidity and mortality following gastric resections.
Keywords	gastric surgery ; malignancies ; risk factors ; morbidity ; mortality ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	Ion Motofei, Carol Davila University
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Evaluation of anemia as a postoperative risk factor in the evolution of patients with gastric resection for malignancies

Bogdan Dumitriu / Sebastian Valcea / Gabriel Andrei / Mircea Beuran

Journal of Clinical and Investigative Surgery, Vol 6, Iss 2, Pp 136-

2021 Volume 140

Abstract: Introduction. Gastric cancer remains among the top three digestive diseases with the highest mortality rates in the world. Treatment of gastric cancer is multidisciplinary, gastric resection being essential for the best result. Anemia is one of the most ... ...

Abstract	Introduction. Gastric cancer remains among the top three digestive diseases with the highest mortality rates in the world. Treatment of gastric cancer is multidisciplinary, gastric resection being essential for the best result. Anemia is one of the most common comorbidities present in patients diagnosed with gastric cancer. Materials and Methods. This is a retrospective analytical study over a period of 6 years (2014-2019). It is based on 114 consecutive gastric resections for cancer performed by a single team using exclusively resection and reconstruction stapling methods. The study aims to investigate a correlation between the presence of preoperative anemia and the incidence of postoperative morbidity and mortality. Results. Preoperative anemia was found in 70% of patients, with about half of these patients presenting with mild anemia. Most postoperative complications were grade I and II according to the Clavien Dindo scale. Anemia was correlated with an increase in infectious complications, anastomotic leaks and secondary peritoneal abscesses, pancreatic complications after multivisceral resection and length of hospital stay. Conclusions. Preoperative anemia is a risk factor that exposes the cancer patient to an increased incidence of life-threatening postoperative complications. In addition, it also extends the length of hospital stay and costs. Therefore, special attention should be paid to the identification and reduction of anemia before extensive gastric surgery in order to obtain the best possible therapeutic result.
Keywords	anemia ; postoperative risk factors ; gastric resection ; gastric cancer ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Digital ProScholar Media
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: MODERN TRENDS IN THE DIAGNOSIS AND TREATMENT OF HEMORRHOIDAL DISEASE

Romică Mehic / Alexandru Laurenţiu Chiotoroiu / Mircea Beuran

Romanian Journal of Medical Practice, Vol 13, Iss 1, Pp 47-

2018 Volume 53

Abstract: Introduction. Hemorrhoidal disease (HD) is one of the most common anorectal disorders with a prevalence of 4.4% and with multiple social, medical and economic implications. Hence the interest and permanent tendencies of change of approach and treatment ... ...

Abstract	Introduction. Hemorrhoidal disease (HD) is one of the most common anorectal disorders with a prevalence of 4.4% and with multiple social, medical and economic implications. Hence the interest and permanent tendencies of change of approach and treatment of this disease. Material and methods. We studied medical books and articles starting from classical techniques of treatment of HD and trying to identify the tendencies of its evolution as well as the appearance of new therapeutic techniques and technologies and the degree of their implementation. Conclusions. There is a tendency of promotion of ambulatory techniques in the treatment of HD, rising in some countries to 90%. Ambulatory medicine has multiple advantages: the increasing efficiency of hospital bads use, increasing of patient degree of satisfaction, lower costs for every resolved case. The modern office procedures (rubber band ligation, injection sclerotherapy, infrared coagulation) or he new miniinvasive techniques (DG-HAL, PPH) meet the anesthetic and surgical conditions of an ambulatory surgery. The ideal operation should have as low as possible recurrences, not have major complications, allow as quickly as possible resumption of social activities, can be done ambulatory and have as small as possible costs. The problem of good medical guidelines of medical practice became more and more actual, with increasing of practical application of evidence-based medicine, with increasing quantity of medical informations, with involvement of medical conflicts in pacient-physician relationship. Starting from these guidelines every medical facility should have his own protocols and procedures.
Keywords	hemorrhoids ; techniques ; technologies ; tendencies ; guidelines ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2018-03-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prognostic impact of Lymph node resection in stage II colon cancer

Diana Chetroiu / Mircea Beuran / Petruta Violeta Filip / Sorina Diaconu / Carmen Orban / Corina Silvia Pop / Alexandru Laurentiu Chiotoroiu

Romanian Medical Journal, Vol 69, Iss 2, Pp 57-

a prospective study from a tertiary hospital center

2022 Volume 61

Abstract: Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of ...

Abstract	Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of suboptimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were monitored between October 2014 and October 2016. The relation between patients’ tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 patients received flourouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for survival without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon cancer and the role of chemotherapy for patients with suboptimal lymph node resection
Keywords	colon cancer ; lymph nodes ; resection ; treatment ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610 ; 616
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correlations between clinico-pathological and prognostic parameters in patients with rectal cancer

Teodor Florin Georgescu / Claudiu Ştefan Turculeţ / Dragoş Eugen Georgescu / Mircea Beuran

Romanian Medical Journal, Vol 67, Iss 2, Pp 158-

2020 Volume 162

Abstract: The objective of this paper was to find correlations between clinico-pathological parameters and survival and tumor recurrence indices with the purpose of improving treatment results and asses better the prognosis of the patients with rectal cancer. The ... ...

Abstract	The objective of this paper was to find correlations between clinico-pathological parameters and survival and tumor recurrence indices with the purpose of improving treatment results and asses better the prognosis of the patients with rectal cancer. The study included 69 patients with rectal cancer in stages I-III according to the AJCC classification (8th edition), who didn’t undergo neoadjuvant treatment and were operated (curative surgery) in the General Department of the Emergency Clinical Hospital Bucharest in a period of 2 years, 01.01.2016 – 31.12.2017. Our statistical analysis showed significant correlations between the quality of the mesorectum and tumor localization, type of surgery or overall survival. Also, we registered important associations between the N stage from TNM classification and tumor grading or lymphovascular invasion. In conclusion, we can say that these correlations observed in our study between clinico-pathological and prognostic parameters in patients with rectal cancer are useful in the treatment and for determining the outcome of these patients.
Keywords	rectal cancer ; mesorectum ; grading ; lymphovascular invasion ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Modern evolutions in interventional radiology

D.P. Venter / Mircea Beuran / C. Oprescu / Mircea Venter / Alexandru Chiotoroiu

Romanian Medical Journal, Vol 67, Iss 4, Pp 353-

2020 Volume 360

Abstract: The spleen is one of the most vulnerable organs in abdominal injuries by contusive mechanism. The treatment of post-traumatic splenic lesions has constantly evolved from surgery to nonoperative treatment in order to preserve the functions of this organ ... ...

Abstract	The spleen is one of the most vulnerable organs in abdominal injuries by contusive mechanism. The treatment of post-traumatic splenic lesions has constantly evolved from surgery to nonoperative treatment in order to preserve the functions of this organ and especially the immunological one. The development of modern technology has supported the nonoperative approach to spleen trauma with main reference to interventional radiology and its role in the patient with transient hemodynamic instability. The article presents the modern, innovative concepts in traumatology, concepts that allow the ideal treatment of the polytraumatized.
Keywords	polytrauma ; interventional radiology ; hybrid room ; spleen ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Special conditions in the treatment of hemorrhoidal disease. The advantages of THD-RAR in the treatment of hemorrhoidal disease in these situations

Romica Mehic / Veronica Indreica / Vasilica Marcu / Mircea Beuran / Alexandru Laurentiu Chiotoroiu

Romanian Medical Journal, Vol 67, Iss 3, Pp 259-

2020 Volume 267

Abstract: Introduction. The prevalence of hemorrhoids in the general population ranks first among benign anorectal diseases. In the last 20 years, however, the number of cases operated for hemorrhoidal disease has decreased and consequently the experience of ... ...

Abstract	Introduction. The prevalence of hemorrhoids in the general population ranks first among benign anorectal diseases. In the last 20 years, however, the number of cases operated for hemorrhoidal disease has decreased and consequently the experience of surgeons in treating this condition has diminished and even less those cases associated with other complex pathologies that sometimes pose special treatment problems. Material and methods. We have studied the articles published in the period 1990-2020, which referred to special condition in patients with hemorrhoidal disease (young, elderly, pregnant woman, coagulation disorders, immunosuppressive states, colon inflammatory diseases, cirrhosis, renal failure, neurological diseases, associated perianal diseases). The recommendations we made were based on summing and updating the data found, conducting a critical review of the results of these studies, to which was added our personal experience, making special reference to the transanal hemorrhoidal dearterialisation (THD) technique. Conclusions. The physiological features of the various stages of human evolution as well as the association with hemorrhoidal disease of other diseases that influence their symptoms and evolution require understanding in their close interdependence. Although hemorrhoidal disease is not a severe condition, it can affect the patient's social life or it can lead to unwanted complications or reinterventions if the therapeutic attitude is not adapted to the patient's associated conditions. The minimal damage of the anal anatomical structures in the THD technique makes the postoperative risks to be minimal even if a series of additional factors specific to the disease associated with hemorrhoids overlap. This makes THD a feasible therapeutic option for these at-risk patients.
Keywords	hemorrhoids ; special conditions ; treatment ; thd ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2020-09-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: THE USE OF CYANOACRYLATE FOR MESH FIXATION IN INGUINAL HERNIA REPAIR – LITERATURE REVIEW

Mircea Lica / Victor Gheorghe Radu / Alexandru Chiotoroiu / Mircea Beuran

Romanian Journal of Medical Practice, Vol 13, Iss 1, Pp 29-

2018 Volume 35

Abstract: Introduction. Surgical mesh procedures addressed to inguinal hernia leads to better results in term of recurrence, but the problems of postoperative pain still remains, and mesh fixation is considered to be one of the factors. Our objective is to ... ...

Abstract	Introduction. Surgical mesh procedures addressed to inguinal hernia leads to better results in term of recurrence, but the problems of postoperative pain still remains, and mesh fixation is considered to be one of the factors. Our objective is to determine the impact of cyanoacrylate glues for mesh fixation in clinical results considering postoperative acute and chronic pain, complications and recurrence. Material and methods. We performed a systematic review of literature, searching for "cyanoacrylates" (MeSH Terms) AND "hernia" (MeSH Terms) AND "herniorrhaphy" (MeSH Terms) in order to find papers that discuss the use of cyanoacrylate glues in mesh fixation for hernia repair. Results. We found 27 articles: 17 randomized trials (RT), 8 case series, 1 review and 1 meta-analysis. The authors of these papers come from only two regions: Europe and Asia. 4 surgical procedures were used in combinations with cyanoacrylate mesh fixation: Lichtenstein, plug and patch technique, TAPP and TEP. No studies showed the inferiority of glue over the other methods of fixation considering all four postoperative outcomes (acute pain, complication, chronic pain and recurrence). The synthetic glue fixation achieves better results in terms of acute and chronic pain for both open and minimally-invasive surgical procedures for inguinal hernia repair. Conclusions. Although synthetic glue mesh fixation for inguinal hernia is not widely used over the world, it is a safe and effective way for mesh fixation both in open and minimally-invasive inguinal hernia repair and significantly decreases postoperative acute and chronic pain.
Keywords	inguinal hernia ; mesh ; cyanoacrylate ; review ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	306
Language	English
Publishing date	2018-03-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ACUTE PANCREATITIS IN PREGNANCY – A CASE REPORT AND LITERATURE REVIEW

Anca Ricu / Alexandru Laurentiu Chiotoroiu / Ioan Tanase / Liana Ples / Sorin Paun / Mircea Beuran

Romanian Journal of Medical Practice, Vol 14, Iss 3, Pp 331-

2019 Volume 335

Abstract: Introduction. Acute pancreatitis in pregnancy is a rare condition with an approximate incidence of 1 over 1,000–12,000 pregnant women, but it is associated with increased incidence of maternal and fetal mortality. Can occur during any trimester but over ... ...

Abstract	Introduction. Acute pancreatitis in pregnancy is a rare condition with an approximate incidence of 1 over 1,000–12,000 pregnant women, but it is associated with increased incidence of maternal and fetal mortality. Can occur during any trimester but over half (52%) occur during the third trimester and rarely during post-partum period. Difficulty in diagnosis and treatment put significantly in danger the maternal and fetal health. The treatment of pancreatitis in pregnancy should be conservative as far as possible with delaying the definitive treatment until after delivery. Case report. We report a case of a 20-year-old woman, at 32 week of gestation who presented with severe pain confined to the upper abdomen and radiating to the back to the upper abdomen. Investigation undertaken led to the diagnosis of acute pancreatitis which was managed conservatively. She recovered within several days and then delivered a healthy baby. Conclusions. Acute pancreatitis is rare in pregnancy, occurring most commonly in the third trimester. Pancreatitis in pregnancy remains a challenging clinical problem to manage, but if treated early, preterm labor can be avoided.
Keywords	acute pancreatitis ; pregnancy ; gallstones ; prognosis ; treatment ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2019-09-01T00:00:00Z
Publisher	Amaltea Medical Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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