55 results on '"Iulian BREZEAN"'
Search Results
2. Pancreatic adenocarcinoma with synchronous liver metastases – is there a role for surgery?
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Alexandru Filipescu, Pharmacy, Bucharest, Romania, Cornel Savu, Carmen Savu, Mihaela Vilcu, Camelia Cristina Diaconu, Gabriel Gorecki, Nicolae Bacalbasa, Irina Balescu, Mihai Dimitriu, Cristian Balalau, Iulian Brezean, Laura Iliescu, Lucian Pop, and Emil Belu
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Medicine (General) ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,Gastroenterology ,R5-920 ,Internal medicine ,pancreatic adenocarcinoma ,medicine ,Medicine ,Adenocarcinoma ,resection ,business ,liver metastases - Abstract
Pancreatic cancer remains one of the most aggressive neoplasms affecting people worldwide, with lower than one year rates of survival, especially if metastatic disease is encountered. In such cases palliative chemotherapy has been proposed, but the overall prognostic remains extremely poor. Meanwhile, in certain cases, spectacular response to chemotherapy has been observed, with significant reduction and even disappearance of the liver lesions. In this respect, attention was focused on establishing whether surgery might improve the outcomes in such cases. This is a literature review of the largest studies conducted on this issue.
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- 2020
3. Etiopathogenesis of inflammatory pseudotumors of the liver
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Mihai Dimitriu, Carmen Savu, Cristian Balalau, Nicolae Bacalbasa, Camelia Cristina Diaconu, Lucian Pop, Pharmacy, Bucharest, Romania, Laura Iliescu, Iulian Brezean, Mihaela Vilcu, Irina Balescu, Alexandru Filipescu, Pharmacy, Bucharest, Roman, Cornel Savu, and Emil Belu
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Medicine (General) ,Pathology ,medicine.medical_specialty ,business.industry ,liver ,stomatognathic diseases ,R5-920 ,Materials Chemistry ,Medicine ,etiopathogenesis ,business ,inflammatory pseudotumors ,Inflammatory pseudotumors - Abstract
Inflammatory pseudotumors of the liver are rare entities, only few cases being reported so far, pathogenesis of these lesions being scarcely understood. However since now multiple mechanisms have been proposed in order to explain the development of these lesions, the knowledge of their pathogenesis being mandatory in order to further orientate the therapeutic strategy. The current paper is a literature review of the largest studies which aimed to discuss the etiopathogenesis of the inflammatory pseudotumors of the liver.
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- 2020
4. Uterine neuroendocrine tumors – literature review
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Iulian Brezean, Nicolae Bacalbasa, Irina Balescu, Mihaela Vilcu, Pharmacy, Bucharest, Romania, and Simona Dima
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Medicine (General) ,Pathology ,medicine.medical_specialty ,business.industry ,Neuroendocrine tumors ,uterine neuroendocrine tumors ,medicine.disease ,surgery ,R5-920 ,Materials Chemistry ,Medicine ,business ,prognostic ,radiotherapy - Abstract
Uterine neuroendocrine tumors are extremely rare malignancies which are usually diagnosed in advanced stages of the disease and are associated with poor prognostic. Due to their rarity a standard therapeutic strategy as well as a standard diagnostic protocol is still missing, these patients being rather diagnosed and treated by extrapolation of the present guidelines for other types of neuroendocrine tumors. This is a literature review of the most relevant studies conducted on the issue of diagnostic and management of uterine neuroendocrine tumors.
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- 2020
5. The correlation between the extent of left upper abdominal resections and perioperative outcomes in advanced stage and relapsed ovarian cancer
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Irina Balescu, Pharmacy, Bucharest, Roman, Iulian Brezean, Dragos Cretoiu, Ioana Halmaciu, Laura Iliescu, Nicolae Bacalbasa, Mihai Dimitriu, Alexandru Filipescu, Pharmacy, Bucharest, Romania, Camelia Cristina Diaconu, Mihaela Vilcu, and Simona Dima
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Medicine (General) ,medicine.medical_specialty ,business.industry ,Advanced stage ,Perioperative ,advanced stage or relapsed ovarian cancer ,medicine.disease ,Surgery ,left upper abdominal resections ,R5-920 ,debulking surgery ,Materials Chemistry ,medicine ,Medicine ,business ,Ovarian cancer - Abstract
The aim of this study is to analyze the feasibility and safety of left upper abdominal resections as part of debulking surgery. Case series presentation. Between January 2015 and August 2019, 32 patients were submitted to left upper abdominal resections. Left upper abdominal resections were performed as part of primary cytoreduction in 22 cases, as part of secondary cytoreduction in eight cases, and respectively as part of tertiary cytoreduction in two cases. The complexity of the resection increased from primary to secondary and tertiary cytoreduction; in the meantime, the rates of postoperative complications also increased with the attempt of cytoreduction. Therefore the postoperative morbidity rate was of 27% at the time of primary cytoreduction, 37.5% at the time of secondary cytoreduction and 50% at the time of tertiary cytoreduction. However, association of left upper abdominal resections leaded to a complete resection rate of 77% at the time of primary cytoreduction, 62.5% at the time of secondary cytoreduction and 50% at the time of tertiary cytoreduction. Conclusions. Left upper abdominal resections might increase the rates of complete debulking in the setting of advanced stage or relapsed ovarian cancer. However the complexity of procedures and the risk of postoperative complications increase with the number of attempts of debulking.
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- 2020
6. Right Upper Abdominal Resections in Advanced Stage Ovarian Cancer
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Nicolae Bacalbasa, Irina Balescu, Iulian Brezean, Cora Pop, Alexandru Filipescu, Mihaela Vilcu, Camelia Cristina Diaconu, Simona Dima, and Laura Iliescu
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Adult ,Cancer Research ,medicine.medical_specialty ,Operative Time ,Blood Loss, Surgical ,General Biochemistry, Genetics and Molecular Biology ,Resection ,Abdomen ,medicine ,Humans ,In patient ,Neoplasm Metastasis ,Aged ,Neoplasm Staging ,Retrospective Studies ,Ovarian Neoplasms ,Pharmacology ,Porta hepatis ,business.industry ,Advanced stage ,Cytoreduction Surgical Procedures ,Perioperative ,Middle Aged ,medicine.disease ,Debulking ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Full thickness ,business ,Ovarian cancer ,Research Article - Abstract
Background/aim The right upper abdominal involvement is frequently encountered in patients with advanced stage ovarian cancer. The aim of this paper is to study the safety and efficacy of extended resections at this level as well as to determine the sites of residual disease. Patients and methods Between January 2016 and December 2019, 26 patients submitted to right upper abdominal resections were identified. Results Peritoneal stripping and full thickness resections were the most commonly performed resections (in 57% and 19% of cases, respectively), followed by capsular liver resection and atypical liver resection (in 30% and 23% of cases, respectively) while the most common sites where resection was incomplete were the liver pedicle and porta hepatis. Exceptionally, one case necessitated performing a pancreatoduodenectomy as part of debulking surgery. Postoperatively, two cases developed serious complications and required reintervention; however, the overall mortality was null. Conclusion Right upper abdominal resections seem to be feasible and effective in order to maximize the debulking effort with acceptable risks arising from perioperative complications.
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- 2020
7. Superior Mesenteric and Portal Vein Reconstruction With Cadaveric Allograft During Pancreatoduodenectomy – A Case Report and Literature Review
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Irinel Popescu, Vladislav Brasoveanu, Mihaela Vilcu, Nicolae Bacalbasa, Simona Dima, Irina Balescu, Laura Iliescu, and Iulian Brezean
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Cancer Research ,medicine.medical_specialty ,Portal vein ,General Biochemistry, Genetics and Molecular Biology ,Mesenteric Vein ,Pancreaticoduodenectomy ,Resection ,Mesenteric Veins ,Pancreatic cancer ,Cadaver ,Humans ,Medicine ,Postoperative outcome ,Neoplasm Invasiveness ,External iliac vein ,Superior mesenteric vein ,Aged ,Neoplasm Staging ,Pharmacology ,Portal Vein ,business.industry ,Plastic Surgery Procedures ,Allografts ,medicine.disease ,Tumor Burden ,Pancreatic Neoplasms ,Treatment Outcome ,Radiology ,business ,Cadaveric spasm ,Vascular Surgical Procedures ,Research Article - Abstract
Background/aim During the last decade it has been widely demonstrated that venous involvement in pancreatic head cancer is not a sign of poor prognostic, while surgery with curative intent is feasible and with encouraging results. However, the location and extent of venous invasion can occasionally pose serious problems in terms of reconstruction. The aim of the paper is to describe a case in which total superior mesenteric and portal vein resection followed by reconstruction were successfully performed. Case report We present the case of a 74-year-old patient submitted to surgery for locally advanced pancreatic cancer invading the portal and superior mesenteric veins. Surgery consisting of pancreatoduodenectomy en bloc with portal vein and superior mesenteric vein resection was performed. The venous axis was reconstructed by using a venous cadaveric allograft originating from the external iliac vein. The postoperative outcome was favorable and the histopathological studies confirmed the local invasion of the resected venous structures. Conclusion The cadaveric venous allograft can be safely used in order to reconstruct the venous axis following extended vascular resections for pancreatic cancer.
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- 2020
8. Extended Pelvic Resections as Part of Secondary Cytoreduction for Relapsed Ovarian Adenocarcinoma
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Nicolae Bacalbasa, Irina Balescu, Simona Dima, Iulian Brezean, and Mihaela Vilcu
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Adult ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Disease ,General Biochemistry, Genetics and Molecular Biology ,Cystectomy ,Recurrent disease ,medicine ,Humans ,Ovarian adenocarcinoma ,Aged ,Pelvic Neoplasms ,Retrospective Studies ,Ovarian Neoplasms ,Pharmacology ,Tumor biology ,business.industry ,Mortality rate ,Cytoreduction Surgical Procedures ,Middle Aged ,Prognosis ,medicine.disease ,Debulking ,Adenocarcinoma, Mucinous ,Cystadenocarcinoma, Serous ,Endometrial Neoplasms ,Surgery ,Female ,Neoplasm Recurrence, Local ,Ovarian cancer ,business ,Adenocarcinoma, Clear Cell ,Follow-Up Studies ,Research Article - Abstract
Background/aim Ovarian cancer presents an aggressive tumor biology, a significant number of patients experiencing recurrent disease. The aim of this study was to examine the feasibility and effectiveness of secondary debulking surgery for relapsed ovarian cancer. Patients and methods Between 2014 and 2018, debulking surgery for relapsed ovarian cancer was performed in 40 cases. Results Debulking surgery to no residual disease was achieved in 31 cases; among the remaining cases, an R1 resection was feasible in six cases, while in the remaining three cases an R2 resection was performed. The most commonly performed visceral resections were represented by rectosigmoidian resection, right colon resection, total or partial cystectomy and unilateral or bilateral ureteral resection. The early postoperative morbidity rate was 32.5% while the postoperative mortality rate was 2.5%. Conclusion Extended pelvic resections are feasible in patients with relapsed ovarian cancer and might be performed with acceptable rates of postoperative complications.
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- 2019
9. Laparoscopic management of ureteral endometriosis
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Irina Balescu, Nicolae Bacalbasa, Iulian Brezean, and Mihaela Vilcu
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lcsh:R5-920 ,medicine.medical_specialty ,Ureteral endometriosis ,business.industry ,lcsh:R ,laparoscopy ,Urology ,lcsh:Medicine ,General Medicine ,medicine ,resection ,lcsh:Medicine (General) ,business ,ureteral endometriosis - Abstract
Ureteral endometriosis is characterized by the development of deep infiltrating islets of endometrial tissue affecting the ureter, the optimal management in such cases being still poorly defined. Once the techniques of laparoscopic surgery improved, this minimally invasive approach has been proposed with encouraging results in treating such cases. When it comes to the types of surgical procedure which are needed in such cases, they are chosen accordingly to the degree, extent and localization of the endometrial tissue. This is a literature review of the largest studies which were conducted on the theme of the laparoscopic management of ureteral endometriosis; the main analyzed parameters refer to the efficacy and safety of the procedure.
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- 2019
10. Laparoscopic management of deep infiltrating colorectal endometriosis
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Irina Balescu, Iulian Brezean, Nicolae Bacalbasa, and Mihaela Vilcu
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endometriosis ,Colorectal endometriosis ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,lcsh:R ,lcsh:Medicine ,General Medicine ,shaving ,full thickness resection ,Gastroenterology ,Internal medicine ,Medicine ,lcsh:Medicine (General) ,business ,colorectal resection - Abstract
Deep infiltrating endometriosis is a debilitating disease which usually affects young women and significantly impacts on the quality of life. Due to the fact that it remains a benign condition which usually affects patients at the reproductive age, an aggressive, radical surgical procedure might be considered as a too mutilating one by certain cases. In consequence, attention was focused on treating these patients in a less invasive manner, procedures like rectal shaving or full thickness local excision being proposed. In the meantime, once the minimally invasive techniques evolved, laparoscopic surgery has been widely proposed in the last decade in order to treat this pathology. The current paper is a literature review of the largest studies which investigated and compared the outcomes after minimally invasive approach for deep infiltrating colorectal endometriosis.
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- 2019
11. Intraductal papillary mucinous neoplasm of the pancreas – when and how to operate?
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Emil Belu, Cristian Balalau, Camelia Cristina Diaconu, Gabriel Gorecki, Pharmacy, Bucharest, Romania, Alexandru Filipescu, Nicolae Bacalbasa, Mihaela Vilcu, Lucian Pop, Irina Balescu, Iulian Brezean, Mihai Dimitriu, Laura Iliescu, Carmen Savu, and Cornel Savu
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Medicine (General) ,Pathology ,medicine.medical_specialty ,Intraductal papillary mucinous neoplasm ,business.industry ,General Medicine ,medicine.disease ,branch duct ,R5-920 ,medicine.anatomical_structure ,medicine ,Medicine ,resection ,Pancreas ,business ,main duct ,ntraductal papillary mucinous neoplasm - Abstract
Described for the first time in 1982, intraductal papillary mucinous neoplasms have been widely studied so far. According to the site of origin and location, it seems that these tumors have a specific risk of malignisation and therefore their type of treatment as well as the moment in which it should be applied should be carefully tailored. In this respect, multiple therapeutic strategies have been proposed, ranging from follow up and limited excision to total pancreatectomy. The current paper is a literature review of the largest studies conducted on the theme of the therapeutic strategies in intraductal papillary mucinous neoplasms.
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- 2020
12. Indocyanine green guided surgery for pancreatic surgery
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Mihaela Vilcu, Emil Belu, Cornel Savu, Carmen Savu, Pharmacy, Bucharest, Romania, Mihai Dimitriu, Nicolae Bacalbasa, Camelia Cristina Diaconu, Laura Iliescu, Lucian Pop, Alexandru Filipescu, Iulian Brezean, Cristian Balalau, and Irina Balescu
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Medicine (General) ,medicine.medical_specialty ,indocyanine green ,business.industry ,pancreatic tumors ,infrared guided surgery ,Pancreatic surgery ,Surgery ,chemistry.chemical_compound ,R5-920 ,chemistry ,Materials Chemistry ,medicine ,Medicine ,business ,Indocyanine green - Abstract
Indocyanine green guided surgery has gained significant popularity in the last decade in different areas including colorectal, gynecological or even hepatic surgery. Moreover, recently published papers came to demonstrate the utility of the method in pancreatic surgery, providing a better identification of pancreatic lesions and bringing significant information regarding the local anatomy. The current paper represents a literature review of the most relevant studies published so far on this issue.
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- 2020
13. Indocyanine green guided liver resection for hepatocellular carcinoma – literature review
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Laura Iliescu, Mihai Dimitriu, Pharmacy, Bucharest, Romania, Cornel Savu, Iulian Brezean, Carmen Savu, Nicolae Bacalbasa, Mihaela Vilcu, Emil Belu, Camelia Cristina Diaconu, Lucian Pop, Cristian Balalau, Irina Balescu, and Alexandru Filipescu
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Medicine (General) ,medicine.medical_specialty ,indocyanine green ,business.industry ,anatomical liver resection ,General Medicine ,medicine.disease ,Resection ,chemistry.chemical_compound ,R5-920 ,chemistry ,Hepatocellular carcinoma ,infrared ,medicine ,Medicine ,Radiology ,business ,Indocyanine green - Abstract
Anatomical liver resection guided by segmental portal inflow compression proved to be an efficient tool in order to maximize the curative surgical treatment in hepatocellular carcinoma. In this respect, in the last decades, once the concept of indocyanine guided surgery gained more field, the method has been also implemented in hepatic surgery. Therefore it seems that intravenous injection followed by portal pedicle clamping and liver inspection in infrared light inspection might delimitate the segments of the liver and might successfully guide the gesture of anatomical liver resection. The current paper is a literature review of the studies which analyzed the efficacy and safety of indocyanine green guided liver surgery.
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- 2020
14. The correlation between endometriosis and metabolic syndrome
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Simona Dima, Irina Balescu, Pharmacy, Bucharest, Romania, Nicolae Bacalbasa, Iulian Brezean, and Mihaela Vilcu
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endometriosis ,obesity ,Medicine (General) ,medicine.medical_specialty ,business.industry ,Endometriosis ,General Medicine ,medicine.disease ,Gastroenterology ,metabolic syndrome ,Correlation ,R5-920 ,Internal medicine ,estrogen ,medicine ,Medicine ,Metabolic syndrome ,business - Abstract
Although it represents a benign condition, endometriosis is an important and sometimes debilitating health problem affecting women worldwide, associated with a high capacity of relapse. While the correlation between different endometrial pathologies, obesity and metabolic syndrome has been clearly demonstrated lately, the relationship between endometriosis and metabolic syndrome is far to be understood. The aim of this paper is to review the most relevant studies conducted on this issue.
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- 2020
15. Indocyanine green utility in sentinel node detection for cervical cancer patients
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Iulian Brezean, Cristian Balalau, Mihaela Vilcu, Nicolae Bacalbașa, and Irina Balescu
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sentinel lymph node detection ,Cervical cancer ,lcsh:R5-920 ,medicine.medical_specialty ,indocyanine green ,cervical cancer ,business.industry ,Sentinel node ,medicine.disease ,chemistry.chemical_compound ,chemistry ,medicine ,Radiology ,lcsh:Medicine (General) ,business ,Indocyanine green - Abstract
With wide implementation of screening tests for the Human Papilloma Virus, the number of diagnosed cases of premalignant or early stages of cervical cancer has increased considerably. As a consequence, surgeons’ attention has focused on determining how best to limit the surgical procedure so the benefits of the procedure will not be surpassed by postoperative morbidity. In this respect, extended lymph node dissection, routinely associated so far with cervical cancer patients, has in the last decades been replaced with sentinel node detection and biopsy. Initially performed through radiocolloid injection, this method has undergone permanent changes in order to maximize its efficacy and safety. Although the laparoscopic approach had been widely used in the past, a new method has been proposed, i.e., the use of indocyanine green injection, which has yielded promising results for sentinel node detection in the early stages of cervical carcinoma. This paper reviews the literature of the most relevant studies conducted on this topic.
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- 2019
16. Benefits and ethical issues in domino liver transplant
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Irina Balescu, Mihaela Vilcu, Adina Croitoru, Iulian Brezean, Nicolae Bacalbasa, Pharmacy, Bucharest, Romania, and Simona Dima
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Medicine (General) ,Ethical issues ,General Medicine ,survival ,Domino ,surgical procedures, operative ,R5-920 ,Political science ,metabolic disorders ,Medicine ,ethical issues ,Engineering ethics ,domino liver transplant - Abstract
Due to the permanent discordance between the number of available liver grafts and the number of cases on the waiting lists, attention was focused on developing different solutions in order to increase the number of grafts. Once the technique of living donor has been proposed, the number of grafts increased but the gap between the number of available grafts and the cases on the waiting list is still significant. Therefore attention was focused on finding out other solutions such as splitting the graft or performing a domino liver transplant. The procedure of domino transplant consists of harvesting a graft from a young patient with metabolic disorders in which a healthy graft will be used and implants it to a marginal receiver. The method seems to associate minimal risks for the marginal donor to develop the metabolic disorder especially if the donor suffers from familial amyloid polyneuropathy; however, ethical issues in such cases are obvious. The aim of this paper is to analyse both the benefits of domino liver transplant and the ethical issues of the procedure.
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- 2019
17. Value of sentinel node biopsy in anal cancer patients
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Nicolae Bacalbasa, Iulian Brezean, Pharmacy, Bucharest, Romania, Mihaela Vilcu, Irina Balescu, and Cristian Balalau
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Biopsy ,medicine ,Anal cancer ,General Medicine ,Radiology ,Sentinel node ,medicine.disease ,business ,Value (mathematics) - Published
- 2019
18. The role of sentinel lymph node detection in early gastric cancer – literature review
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Cristian Balalau, Iulian Brezean, Nicolae Bacalbasa, Pharmacy, Bucharest, Romania, Mihaela Vilcu, and Irina Balescu
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Oncology ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,gastric cancer ,lcsh:R ,Sentinel lymph node ,lcsh:Medicine ,sentinel lymph node dissection ,General Medicine ,Early Gastric Cancer ,Internal medicine ,lymphadenectomy ,medicine ,lcsh:Medicine (General) ,business - Abstract
Gastric cancer has been for a long period of time one of the most aggressive malignancies due to the fact that it was usually diagnosed in advanced stages of the disease. However, in the last decades, introduction of upper digestive endoscopy on a wider scale led to a higher detection of this malignancy in earlier stages. Therefore, surgery with curative intent and, in consequence, better long-term outcomes, has been reported. In order to maximize the effect of surgery and to minimize the postoperative complication rates, in the Eastern studies the concept of sentinel lymph node biopsy has been implemented with satisfactory results. This is a literature review of the studies conducted so far on the theme of sentinel lymph node detection in gastric cancer patients.
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- 2019
19. Does sentinel node biopsy play a role in pancreatic adenocarcinoma?
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Nicolae Bacalbasa, Iulian Brezean, Mihaela Vilcu, Pharmacy, Bucharest, Romania, Irina Balescu, and Cristian Balalau
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lcsh:R5-920 ,Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,lcsh:R ,lcsh:Medicine ,General Medicine ,Sentinel node ,medicine.disease ,sentinel node biopsy ,Biopsy ,pancreatic adenocarcinoma ,Medicine ,Adenocarcinoma ,lcsh:Medicine (General) ,business ,lymph node metastases - Abstract
Pancreatic adenocarcinoma remains one of the most aggressive malignancies worldwide which is unfortunately associated with very poor long-term survival. However, it seems that the only option in order to improve the outcomes of these patients remains radical surgery consisting of in block resection of the tumor and the surrounding tissues. When it comes to the extent of the lymph node dissection, a permanent debate still exists between the eastern and the western countries; while the Western countries consider that an extended lymph node dissection increases the postoperative complication worthwhile, the Eastern countries consider that this should be the treatment of choice as long as these tumors usually disseminate on the lymphatic route. In order to establish what patients could benefit most from an extended lymph node dissection, certain authors proposed performing the sentinel lymph node biopsy technique. This is a literature review of the largest studies conducted on this theme.
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- 2019
20. Gracilis myocutaneous flap for perineal defect reconstruction after left hemivulvectomy for locally invasive vulvar cancer – A case report and a literature review
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Adriana Ghelmene, Andreea Mereuta, Nicolae Bacalbasa, Iulian Brezean, Irina Balescu, Mihaela Vilcu, and Alina Tanase
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perineal defect ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,Defect reconstruction ,radical total vulvectomy ,Vulvar cancer ,medicine.disease ,Surgery ,Gracilis myocutaneous flap ,gracilis myocutaneous flap ,medicine ,Hemivulvectomy ,lcsh:Medicine (General) ,business - Abstract
Performing radical surgery for locally advanced vulvar cancer is usually associated with the occurrence of large perineal defects. In order to provide a better healing process of the perineal wound, different reconstructive techniques have been proposed. We present the case of a 63-year-old female patient diagnosed with locally advanced vulvar cancer for which a left hemivulvectomy with bilateral inguinal lymph node dissection was performed. After completion of the resection phase, the reconstruction with gracilis myocutaneous flap was performed. The patient developed a non-union of the flap. However, it slowly healed without any surgical re-intervention. Gracilis myocutaneous flap seems to be an effective and feasible method of perineal reconstruction after extended perineal resection for gynecological malignancies, including vulvar cancer. The method appears effective even in pre-irradiated patients with larger perineal wounds resulting after total pelvic exenteration for locally advanced gynecological malignancies.
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- 2019
21. The influence of lymph node status on the overall survival in surgically treated hilar cholangiocarcinoma
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Mihaela Vilcu, Iulian Brezean, Nicolae Bacalbasa, Irina Balescu, and Pharmacy, Bucharest, Romania
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Medicine (General) ,medicine.medical_specialty ,business.industry ,lymph node dissection ,R5-920 ,medicine.anatomical_structure ,Materials Chemistry ,Overall survival ,Medicine ,hilar cholangiocarcinoma ,resection ,Radiology ,business ,Lymph node - Abstract
Cholangiocarcinoma represents an extremely aggressive digestive malignancy associated with very poor survival rates in the absence of a treatment with curative intent. Moreover, an important per cent of patients are diagnosed in advanced stages of the disease, when resection with curative intent is no longer feasible. When it comes to cases which can be submitted to surgery, radical resection, including lymph node dissection, seems to be one of the most important therapeutic strategies in order to improve survival. This is a literature review of the most relevant studies which were focused on analyzing the impact of lymph node status on the overall survival of surgically treated hilar cholangiocarcinomas
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- 2019
22. Merkel cell carcinoma – pro and cons aspects for sentinel lymph node biopsy
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Mihaela Vilcu, Irina Balescu, Iulian Brezean, Nicolae Bacalbasa, Mihai Dimitriu, and Pharmacy, Bucharest, Romania
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Medicine (General) ,Pathology ,medicine.medical_specialty ,integumentary system ,medicine.diagnostic_test ,business.industry ,Merkel cell carcinoma ,Sentinel lymph node ,cons ,General Medicine ,medicine.disease ,sentinel node biopsy ,merkel cell carcinoma ,R5-920 ,Biopsy ,Medicine ,business ,prognostic - Abstract
Merkel cell carcinoma represents an aggressive histopathological subtype of skin cancer with a high propensity to spread via lymphatic route. Once the benefits of the sentinel lymph node detection have been proven in malignant melanoma, the effectiveness of the method was investigated further on in Merkel cell carcinoma, as long as the two tumoral subtypes seem to have a common embryological origin. Surprisingly, the results reported so far in Merkel cell carcinoma are rather confusing, the method not being so far associated as part of the standard therapeutic protocol. However, it seems that the method plays a certain role in identifying the high risk patients and further tailoring the therapeutic strategy. This is a literature review of the most eloquent studies conducted on this theme.
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- 2019
23. Sentinel lymph node biopsy in thyroid cancer – literature review
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Pharmacy, Bucharest, Romania, Mihaela Vilcu, Nicolae Bacalbasa, Irina Balescu, and Iulian Brezean
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Medicine (General) ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Sentinel lymph node ,medicine.disease ,sentinel node biopsy ,R5-920 ,cervical lymph node dissection ,Biopsy ,thyroid cancer ,Materials Chemistry ,medicine ,Medicine ,Radiology ,business ,Thyroid cancer - Abstract
Thyroid cancer has been usually treated by total or near total thyroidectomy in association with cervical lymph node dissection and followed by adjuvant oncological and endocrinological treatment. In order to maximize the effect of the surgical approach and to minimize the perioperative rates of complications, certain authors proposed the introduction of the sentinel node detection; however, the method has certain particularities due to the complex lymphatic anatomy of the cervical region. This is a literature review of the more significant studies conducted so far on this theme.
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- 2019
24. Anterior Pelvic Exenteration for Chemo-irradiated Non-diethylstilbestrol Exposed Clear Cell Vaginal Cancer
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Nicolae Bacalbasa, Iulian Brezean, Simona Dima, Mihaela Vilcu, and Irina Balescu
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Adult ,Cancer Research ,medicine.medical_specialty ,Vaginal Neoplasms ,medicine.medical_treatment ,Locally advanced ,Diethylstilbestrol ,General Biochemistry, Genetics and Molecular Biology ,Lesion ,medicine ,Humans ,Stage (cooking) ,Pharmacology ,Vaginal cancer ,Pelvic exenteration ,business.industry ,Chemoradiotherapy ,medicine.disease ,Pelvic Exenteration ,Surgery ,Anterior pelvic exenteration ,Treatment Outcome ,Carcinogens ,Female ,medicine.symptom ,business ,Clear cell ,Adenocarcinoma, Clear Cell ,Research Article ,medicine.drug - Abstract
Background/Aim: Clear cell vaginal adenocarcinomas are rare tumors occurring in women which are usually treated by chemo radiotherapy with good outcomes. However, in certain cases, this treatment is not associated with complete response and a further surgery is needed. Case Report: We present the case of a 38-year-old patient diagnosed with stage IVA clear cell vaginal cancer who had been previously submitted to radio chemotherapy and in whom the lesion persisted after the oncological treatment; therefore, the patient was proposed for surgery with curative intent. The tumor was resected by performing an anterior pelvic exenteration with good outcomes, the patient being discharged in the seventh postoperative day. At one-year follow-up the patient remains free of recurrent disease. Conclusion: Pelvic exenteration with curative intent might be the option of choice for persistent locally advanced clear cell vaginal cancer.
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- 2019
25. Pelvic Exenteration for Locally Advanced and Relapsed Pelvic Malignancies – An Analysis of 100 Cases
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Iulian Brezean, Simona Dima, Adrian Neacsu, Nicolae Bacalbasa, Irina Balescu, Adina Croitoru, and Mihaela Vilcu
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Aged ,Neoplasm Staging ,Pelvic Neoplasms ,Pharmacology ,Cervical cancer ,Pelvic exenteration ,business.industry ,Endometrial cancer ,Mortality rate ,Disease Management ,Cancer ,Middle Aged ,Prognosis ,medicine.disease ,Primary tumor ,Pelvic Exenteration ,Tumor Burden ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Ovarian cancer ,business ,Research Article - Abstract
Background/aim Although pelvic exenteration is an aggressive surgical procedure, it remains almost the only curative solution for patients diagnosed with large pelvic malignancies. Patients and methods We present a series of 100 patients submitted to pelvic exenteration with curative intent. Results The origin of the primary tumor was most commonly represented by cervical cancer, followed by, endometrial cancer, rectal cancer, ovarian cancer and vulvo-vaginal cancer. An R0 resection was confirmed in 68 cases, while the remaining 32 cases presented lateral positive resection margins or perineal positive margins. The postoperative morbidity rate was 37% while the mortality rate was 3%. As for the-long term outcomes, the median overall survival time was 38.7 months, being most significantly influenced by the origin of the primary tumor. Conclusion Although pelvic exenteration is still associated with an increased morbidity, an important improvement in the long-term survival can be achieved, especially if radical resection is feasible.
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- 2019
26. Pancreatoduodenectomy En Bloc With Vascular Resections in Borderline Resectable Pancreatic Cancer
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Irina Balescu, Mihaela Vilcu, Adina Croitoru, Iulian Brezean, Vladislav Brasoveanu, Nicolae Bacalbasa, and Simona Dima
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Asymptomatic ,General Biochemistry, Genetics and Molecular Biology ,Pancreaticoduodenectomy ,Resection ,Postoperative Complications ,Borderline resectable ,Long period ,medicine.artery ,Pancreatic cancer ,medicine ,Humans ,Superior mesenteric artery ,Vascular resection ,Neoplasm Staging ,Pharmacology ,Chemotherapy ,Portal Vein ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,Treatment Outcome ,Female ,Neoplasm Grading ,medicine.symptom ,business ,Vascular Surgical Procedures ,Research Article - Abstract
Background/aim Pancreatic cancer remains asymptomatic for a long period of time, being frequently diagnosed when vascular invasion is already present. Such cases are widely known as borderline lesions. The aim of this study was to identify the effectiveness of vascular resection in this subgroup of patients. Patients and methods Fifteen such cases were submitted to surgery with curative intent. Results Eight cases were diagnosed with borderline resectable lesions with portal vein invasion and were submitted to per primam resection and seven cases were initially diagnosed with arterial invasion and had been initially submitted to neoadjuvant chemotherapy followed by resection. In all cases portal vein resection was needed while in other four cases association of superior mesenteric artery resection was performed. Postoperatively, five patients developed complications requiring reoperation, three of whom died at the end of the first postoperative month. The histopathological studies confirmed the completeness of resection in all cases. Conclusion Vascular resections in pancreatic cancer resections remain demanding procedures, and are reserved for cases in which a radical resection is feasible.
- Published
- 2019
27. Management of cervical cancer during pregnancy– literature review
- Author
-
Pharmacy, Bucharest, Romania, Alin Bodog, Iulian Brezean, Nicolae Bacalbasa, Mihaela Vilcu, Ioan Dumitru Suciu, and Irina Balescu
- Subjects
Cervical cancer ,Pregnancy ,medicine.medical_specialty ,business.industry ,Obstetrics ,medicine ,General Medicine ,medicine.disease ,business - Published
- 2018
28. Diagnostic and therapeutic strategies in peritoneal carcinomatosis from breast cancer – literature minireview
- Author
-
Irina Balescu, Pharmacy, Bucharest, Romania, Ioan Dumitru Suciu, Mihaela Vilcu, Nicolae Bacalbasa, Iulian Brezean, and Alin Bodog
- Subjects
Oncology ,medicine.medical_specialty ,Breast cancer ,business.industry ,Internal medicine ,Medicine ,General Medicine ,business ,medicine.disease ,Peritoneal carcinomatosis - Published
- 2018
29. Sentinel lymph node biopsy in vulvar cancer – literature minireview
- Author
-
Mihaela Vilcu, Nicolae Bacalbasa, Pharmacy, Bucharest, Romania, Ioan Dumitru Suciu, Iulian Brezean, Irina Balescu, and Alin Bodog
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Biopsy ,Sentinel lymph node ,medicine ,General Medicine ,Radiology ,Vulvar cancer ,medicine.disease ,business - Published
- 2018
30. Is there a place for liver transplantation in cases with unresectable central cholangiocarcinoma?
- Author
-
Irina Balescu, Iulian Brezean, Alin Bodog, Nicolae Bacalbașa, and Mihaela Vilcu
- Subjects
medicine.medical_specialty ,liver transplantation ,business.industry , unresectable ,medicine.medical_treatment ,lcsh:R ,central cholangiocarcinoma ,medicine ,lcsh:Medicine ,Liver transplantation ,business ,Surgery - Abstract
Central cholangiocarcinoma represents a very aggressive malignancy associated with poor survival rats especially due to the fact that most patients are diagnosed in advanced stages of the disease when curative resection is no longer feasible. In order to try improving the long-term outcomes of these patients, especially in unresectable cases liver transplantation has been proposed with promising results. This is a literature review of the largest studies focused on this subject. Cholangiocarcinomas remain aggressive tumors with poor outcomes whenever surgery with curative intent is not feasible. Currently, the largest experience accumulated consists of neoadjuvant external beam radiotherapy in association with beam radiation, 5 fluorouracil and capecitabine followed by orthotopic liver transplantation. Following this therapeutic protocol excellent long-term outcomes have been reported even if vascular involvement is present.
- Published
- 2018
31. A SPECIFIC CASE OF APPENDICITIS IN THE ELDERLY – AN EXPERIENCE FOR THE YOUNG CLINICIAN
- Author
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Iulian Brezean, Mihaela Vâlcu, I. R. Toader, C. A. Vișan, and S.A. A. Shadaloey
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,General surgery ,Medicine ,030208 emergency & critical care medicine ,030211 gastroenterology & hepatology ,business ,medicine.disease ,Appendicitis - Abstract
Appendicitis is an inflammatory disease caused by obstruction of the appendiceal lumen. It represents one of the most common abdominal pathologies in clinical practice. Appendicitis has a well-defined range of signs and symptoms but is harder to diagnose in elderly patients because of less specific symptomatology, a wide differential diagnosis, and communication problems. The perforation rate in the elderly is 50–70%, rising with age (particularly above age 80), compared with a perforation rate of 20–30% in the general population, suggesting that symptoms may appear mild while the case may actually be severe. With rising life expectancy and thus an increase in elderly patients presenting with appendicitis symptoms, and to further the experience of the young clinician, we report the case of an 88-year old woman who was admitted to the hospital’s emergency ward, with acute hypogastric pain that radiated to the back and to the entire abdomen. Appendicitis was diagnosed, followed by surgical procedure and the patient recovered well.
- Published
- 2018
32. Hepatic artery reconstruction after extended resection for borderline resectable pancreatic head cancer: A case report
- Author
-
Emil Belu, Cornel Savu, Carmen Savu, Vladislav Brasoveanu, Nicolae Bacalbasa, Lucian Pop, Gabriel Gorecki, Ovidiu Stiru, Laura Iliescu, Ovidiu Gabriel Bratu, Camelia Cristina Diaconu, Iulian Brezean, Irina Balescu, and Dragos Romanescu
- Subjects
0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Left gastric artery ,business.industry ,Cancer ,General Medicine ,Articles ,Splenic artery ,Vascular surgery ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Immunology and Microbiology (miscellaneous) ,030220 oncology & carcinogenesis ,Pancreatic cancer ,medicine.artery ,medicine ,Medical history ,Radiology ,Radical surgery ,business ,Artery - Abstract
Pancreatic head cancer is frequently associated with invasion of the surrounding vascular structures, such cases being considered for a long period of time as unresectable. Improvement of the vascular surgery techniques allowed association of extended vascular resections and reconstructions, increasing in this way the percentage of patients benefiting from radical surgery. We present the case of a 47-year-old male patient with no significant medical history diagnosed with a large pancreatic head tumor invading the common and proper hepatic artery as well as the portal vein. The venous reconstruction was performed using a synthetic prosthesis while the left hepatic artery was sutured to the left gastric artery; meanwhile the right hepatic artery was reconstructed using the splenic artery. In conclusion, extended hepatic artery resection followed by arterial reconstruction in association with portal vein resection and prosthetic replacement might be needed in cases presenting large pancreatic head tumors with vascular invasion.
- Published
- 2020
33. Utility of indocyanine green injection in patients with cervical cancer besides the identification of sentinel lymph node (Review)
- Author
-
Emil Belu, Dragos Cretoiu, Irina Balescu, Camelia Cristina Diaconu, Mihaela Vilcu, Cristian Balalau, Adrian Neacsu, Iulian Brezean, Carmen Savu, Ovidiu Gabriel Bratu, Alexandru Filipescu, Nicolae Bacalbasa, Laura Iliescu, Cornel Savu, and Ioana Halmaciu
- Subjects
0301 basic medicine ,Cervical cancer ,Cancer Research ,medicine.medical_specialty ,business.industry ,Sentinel lymph node ,Cancer ,Trachelectomy ,Review ,General Medicine ,Disease ,medicine.disease ,03 medical and health sciences ,Dissection ,chemistry.chemical_compound ,030104 developmental biology ,0302 clinical medicine ,Lower limb lymphedema ,Immunology and Microbiology (miscellaneous) ,chemistry ,030220 oncology & carcinogenesis ,Medicine ,Radiology ,business ,Indocyanine green - Abstract
Due to the wide introduction of screening tests, patients with neoplastic diseases of the uterine cervix trend to be diagnosed in early stages of the disease, and less invasive surgical procedures are needed in certain cases. In this respect, the technique of sentinel lymph node dissection has been widely implemented as part of the therapeutic strategy, indocyanine green (ICG) being one of the most reliable markers for sentinel lymph node detection. However, it seems that this agent is extremely useful in order to achieve better short-term and long-term results after cervical cancer surgery, due to its capacity to determine the uterine vascular perfusion in cases in which conservative treatment, such as trachelectomy, is performed, as well as to prevent and treat lower limb lymphedema. A literature review was conducted of the studies which focused on the role of ICG utility in cervical cancer patients besides sentinel lymph node detection, special focus was given to vascularization preservation and lower limb lymphedema prevention and treatment.
- Published
- 2020
34. Cytoreductive surgery for advanced stage ovarian cancer in the second trimester of pregnancy-a case report and literature review
- Author
-
Iulian Brezean, Irina Balescu, Nicolae Bacalbasa, Laura Iliescu, Simona Dima, and Mihaela Vilcu
- Subjects
Adult ,medicine.medical_specialty ,endocrine system diseases ,medicine.medical_treatment ,Ovariectomy ,Hysterectomy ,advanced stage ovarian cancer ,cytoreduction ,03 medical and health sciences ,0302 clinical medicine ,Peritonectomy ,Pregnancy ,medicine ,Humans ,030212 general & internal medicine ,Clinical Case Report ,Lymph node ,Ovarian Neoplasms ,Chemotherapy ,business.industry ,Romania ,General surgery ,Ovary ,General Medicine ,Cytoreduction Surgical Procedures ,medicine.disease ,Dissection ,Omentectomy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pregnancy Trimester, Second ,Female ,Lymph Nodes ,Ovarian cancer ,business ,Research Article - Abstract
Rationale: Advanced stage ovarian cancer is rarely encountered in pregnant women, due to the high number of ultrasound imagistic studies performed during this period. The clinical course of patients diagnosed with advanced stage ovarian cancer is similar in pregnant and nonpregnant women. Patient concerns: We present the case of a 27-year-old woman initially submitted to emergency surgery for ovarian cyst torsion in the ninth week of gestation, at that moment ovarian cystectomy being performed. Diagnoses: The histopathological studies demonstrated the presence of a moderately differentiated epithelial ovarian cancer. Interventions: Although the interdisciplinary team decided for staging surgery followed by platinum-based chemotherapy beginning from the second trimester of pregnancy, both the patient and her family refused this strategy and opined for total hysterectomy en bloc with bilateral adnexectomy. Surprisingly, intraoperatively both ovaries had a tumoral aspect, whereas peritoneal carcinomatosis nodules were found in the Douglas pouch. Therefore, the neoplastic process was staged as a IIIC epithelial ovarian cancer, a total hysterectomy with bilateral adnexectomy, Douglas pouch peritonectomy, omentectomy, pelvic and para-aortic lymph node dissection being performed. Outcomes: The patient was discharged in the sixth postoperative day and was confined to the oncology service in order to be submitted to the standard taxanes and platinum based chemotherapy. Lessons: Although ovarian cancer has been rarely reported during pregnancy, this diagnostic should be taken in consideration whenever persistent adnexal masses are encountered.
- Published
- 2020
35. The Influence of the Preoperative Status on the Risk of Postoperative Complications After Cytoreductive Surgery for Advanced-stage Ovarian Cancer
- Author
-
Mihai Dimitriu, Nicolae Bacalbasa, Camelia Cristina Diaconu, Laura Iliescu, Mihaela Vilcu, Simona Dima, Iulian Brezean, and Irina Balescu
- Subjects
Adult ,Cancer Research ,medicine.medical_specialty ,Preoperative risk ,Comorbidity ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Serum albumin level ,Postoperative Complications ,medicine ,Humans ,Aged ,Neoplasm Staging ,Pharmacology ,Aged, 80 and over ,Ovarian Neoplasms ,business.industry ,Advanced stage ,Nutritional status ,Cytoreduction Surgical Procedures ,Middle Aged ,medicine.disease ,Debulking ,Prognosis ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Preoperative Period ,Female ,Neoplasm Grading ,Ovarian cancer ,business ,Cytoreductive surgery ,Elderly age ,Research Article - Abstract
Background/aim The aim of this study was to analyze the influence of preoperative status on the risk of developing further postoperative complications after debulking surgery for advanced-stage ovarian cancer. Patients and methods A total of 80 consecutive patients submitted to surgery between 2014 and 2019 for advanced-stage ovarian cancer were retrospectively reviewed. Results Among the 80 cases there were seven patients who developed serious postoperative complications requiring reintervention. Among these cases it seems that association of obesity, poor nutritional status (defined as a lower than 3.5 g/dl serum albumin level) and elderly age were significantly associated with the risk of developing further complications. Conclusion When selecting the candidates for debulking surgery for advanced-stage ovarian cancer attention should be focused on excluding cases presenting such preoperative risk factors in order to decrease the postoperative morbidity.
- Published
- 2019
36. Urinary Tract Resections as Part of Debulking Surgery for Locally Advanced Endometrial Stromal Sarcomas
- Author
-
Laura Iliescu, Iulian Brezean, Camelia Cristina Diaconu, Simona Dima, Mihaela Vilcu, Nicolae Bacalbasa, and Irina Balescu
- Subjects
Cancer Research ,medicine.medical_specialty ,Stromal cell ,Ureterectomy ,medicine.medical_treatment ,Urinary system ,Biopsy ,Sarcoma, Endometrial Stromal ,Locally advanced ,Cystectomy ,General Biochemistry, Genetics and Molecular Biology ,medicine ,Humans ,In patient ,Neoplasm Invasiveness ,Urinary Tract ,Neoplasm Staging ,Pharmacology ,Hysterectomy ,business.industry ,Cytoreduction Surgical Procedures ,Middle Aged ,Debulking ,Surgery ,Treatment Outcome ,Female ,business ,Research Article - Abstract
Background/aim Although very rare tumors, uterine sarcomas are extremely aggressive gynecologic malignancies being responsible for a significant number of gynecological cancer-related deaths. However, in such cases, it seems that cytoreductive surgery might increase the lifespan if debulking to no residual disease is achieved. Patients and methods We present a case series of three patients diagnosed with endometrial stromal sarcomas in which urinary tract resections were needed in order to maximize the debulking effort. Results In all cases total hysterectomy with bilateral adnexectomy was performed; in the meantime, urinary tract resection was needed due to the local extension of the neoplastic disease and consisted of unilateral ureteral resection followed by reimplantation through ureteroneocystostomy in one case, bilateral ureteral resection en bloc with partial cystectomy and ureteral reimplantation in one case and total cystectomy with bilateral ureterectomy followed by cutaneous ostomy in the third case. Moreover, one case also necessitated rectosigmoidian resection followed by colorectal anastomosis. In all cases no residual disease was encountered at the end of the debulking surgery. Conclusion Urinary tract resections might be needed in order to maximize the debulking effort in patients presenting endometrial stromal sarcomas.
- Published
- 2019
37. Iodized Salt Between Myth and Reality: Assessment of Iodine Content in Table Salt Commercially Available in Romania
- Author
-
Iulian Brezean, Mihaela Vilcu, Ileana Pantea, Gabriela Elena Lupusoru, Adrian Barbilian, Mircea Lupusoru, Marius Moga, and Dumitru Ferechide
- Subjects
Waste management ,Process equipment ,Materials Science (miscellaneous) ,Process Chemistry and Technology ,General Engineering ,chemistry.chemical_element ,General Chemistry ,General Medicine ,Iodine ,General Biochemistry, Genetics and Molecular Biology ,Iodised salt ,chemistry ,Materials Chemistry ,General Pharmacology, Toxicology and Pharmaceutics - Abstract
About 1/3 of the world population lives in areas where iodine is scarce. The easiest solution to provide an organism with adequate iodine doses is the iodization of table salt, a process implemented in about 120 countries. Romanian laws require the iodization of salt used for human consumption. The purpose of our study is to assess the iodine concentration of various table salt brands commercially available in Romania, from different countries � Ukraine, Belarus, Greece, Italy, Turkey, Austria, to see if they comply with accepted standards and compare them with those in our country. An iodometric titration method was used for analyzing the iodine content of the salt samples. The analysis of the samples indicate that a great proportion do not meet accepted standards regarding iodine concentration.
- Published
- 2018
38. Successful Resection of a Non-functional Paraganglioma with Celiac Trunk Invasion Followed by Common Hepatic Artery Reimplantation – A Case Report and Literature Review
- Author
-
Vladislav Brasoveanu, Iulian Brezean, Irina Balescu, Mihaela Vilcu, Nicolae Bacalbasa, and Alina Tanase
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Non functional ,Case Study Article ,General Biochemistry, Genetics and Molecular Biology ,Resection ,Paraganglioma ,03 medical and health sciences ,Retroperitoneal tumor ,Hepatic Artery ,0302 clinical medicine ,medicine.artery ,medicine ,Humans ,Neoplasm Invasiveness ,Pelvis ,Pharmacology ,Common hepatic artery ,business.industry ,Middle Aged ,medicine.disease ,Trunk ,Abdominal Pain ,medicine.anatomical_structure ,Postprandial ,Replantation ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Paragangliomas, as well as phaeochromocytomas, are vascular neuroendocrine lesions that might be encountered between neck and pelvis. In certain cases, a preoperative diagnosis is difficult to be established, so resection might be needed whenever a suspect mass is discovered at the imaging studies. Moreover, there are cases in which resection and reconstruction of an important vascular structure might be imposed. In this case report a 59-year-old patient was investigated for upper abdominal pain with postprandial features and was diagnosed with a retroperitoneal tumor of 4/6/7cm invading the celiac trunk. The tumor was successfully resected and the common hepatic artery was reinserted in the celiac stump.
- Published
- 2018
39. Association Between Secondary Peritoneal Hydatidosis and Peritoneal Carcinomatosis from Ovarian Cancer – A Case Report
- Author
-
Mihaela Vilcu, Brasoveanu, Iulian Brezean, Nicolae Bacalbasa, and Irina Balescu
- Subjects
Cancer Research ,medicine.medical_specialty ,Disease ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,Peritoneum ,Echinococcosis ,Internal medicine ,medicine ,Humans ,In patient ,Medical history ,Pathological ,Peritoneal Neoplasms ,Ovarian Neoplasms ,Pharmacology ,business.industry ,Middle Aged ,medicine.disease ,Debulking ,Peritoneal carcinomatosis ,medicine.anatomical_structure ,Female ,Research-Article ,Ovarian cancer ,business - Abstract
Peritoneal carcinomatosis from ovarian cancer is unfortunately a very common finding, especially in patients diagnosed in very late stages of the disease. Nonetheless, it is not the only pathological condition inducing a diffuse involvement of the peritoneum; other entities can have an infectious or miscellaneous origin. However, the association of peritoneal carcinomatosis and parasitic infection has never been reported so far. We present the case of a 50-year-old patient who had been submitted to surgery for a hepatic hydatid cyst. Four years later, the patient was diagnosed with disseminated peritoneal lesions, which proved to have both parasite and neoplastic origin. The patient was re-submitted to surgery, and debulking resection of all pathological lesions was achieved. Although it is very rare, the association of peritoneal carcinomatosis and peritoneal hydatidosis should be taken into consideration whenever the patient reports a suggestive medical history for those two pathological findings.
- Published
- 2018
40. Spleno-pancreatectomy En Bloc with Parcelar Gastrectomy for Splenic Artery Aneurysm – A Case Report and Literature Review
- Author
-
Iulian Brezean, Vladislav Brasoveanu, Nicolae Bacalbasa, Mihaela Vilcu, Mihai Pautov, Alina Tanase, and Irina Balescu
- Subjects
Pharmacology ,Cancer Research ,medicine.medical_specialty ,Splenic artery aneurysm ,business.industry ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Splenic artery ,Asymptomatic ,General Biochemistry, Genetics and Molecular Biology ,Resection ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine.artery ,Long period ,Pancreatectomy ,cardiovascular system ,medicine ,Gastrectomy ,cardiovascular diseases ,medicine.symptom ,business ,Therapeutic strategy - Abstract
Splenic artery aneurysms are common arterial lesions which might remain asymptomatic for a long period of time. In certain cases, these lesions might encounter a significant growth and might become symptomatic. Once diagnosed, a therapeutic strategy should be taken in consideration in order to avoid the apparition of life-threatening complications such as aneurysmal rupture. This is a case report of a 45-year-old patient diagnosed with a splenic artery aneurysm who was successfully submitted to an aneurysmal resection en bloc with distal spleno-pancreatectomy and parcelar gastrectomy.
- Published
- 2018
41. Human anatomic variations: common, external iliac, origin of the obturator, inferior epigastric and medial circumflex femoral arteries, and deep femoral artery course on the medial side of the femoral vessels
- Author
-
Iulian Brezean, Adrian Cosmin Ilie, and Mugurel Constantin Rusu
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Femoral vein ,Contrast Media ,Femoral artery ,Iliac Artery ,Pathology and Forensic Medicine ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Medial circumflex femoral artery ,medicine.artery ,Deep Femoral Artery ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Circumflex ,business.industry ,Anatomic Variation ,Arteries ,Anatomy ,Middle Aged ,Epigastric Arteries ,Surgery ,Femoral Artery ,Orthopedic surgery ,Obturator artery ,030101 anatomy & morphology ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery - Abstract
Probably, the most variable anatomic pattern relates to the iliac arteries system. There are reported here multiple rare anatomic variants found in a single case, at CT evaluation: (a) the unilaterally present common trunk of origin of the obturator, inferior epigastric, and medial circumflex femoral arteries and (b) the medial insertion of the deep femoral artery (DFA) onto the femoral artery, which placed the DFA initially on the medial side of the femoral vein. Such rare, but possible, anatomic variations should recommend surgeons to plan the procedures on a case-by-case basis.
- Published
- 2017
42. Insertion of foreign bodies in penis in the convict settlements environment
- Author
-
Dumitru Ferechide, Iulian Brezean, Mircea Ovidiu Denis Lupușoru, and S Petrea
- Subjects
medicine.anatomical_structure ,History ,Human settlement ,medicine ,Convict ,Anatomy ,Ancient history ,Foreign Bodies ,Penis ,Pathology and Forensic Medicine - Published
- 2017
43. Risk Factors for Postoperative Complications After Vulvar Surgery
- Author
-
Mihaela Vilcu, Iulian Brezean, Simona Dima, Irina Balescu, and Nicolae Bacalbasa
- Subjects
Cancer Research ,medicine.medical_specialty ,Locally advanced ,Disease ,General Biochemistry, Genetics and Molecular Biology ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Gynecologic Surgical Procedures ,Postoperative Complications ,Risk Factors ,medicine ,Humans ,Stage (cooking) ,Surgical treatment ,Aged ,Retrospective Studies ,Pharmacology ,High rate ,Vulvar Neoplasms ,business.industry ,Advanced stage ,Vulvar cancer ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,030220 oncology & carcinogenesis ,Female ,business ,Follow-Up Studies ,Research Article - Abstract
Background/Aim: Although the trends of surgical treatment in vulvar cancer patients are towards less extended resections, a significant number of cases are still diagnosed with locally advanced diseases imposing performing extended resections. The aim of this paper is to identify the prognostic factors for the development of early postoperative complications following vulvar surgery. Patients and Methods: Between 2017 and 2019, 145 patients with vulvar cancer were submitted to surgery with a curative intent. Results: Among these cases there were 93 cases diagnosed with early stages of the disease and 52 cases diagnosed with advanced stages. The risk of postoperative complications was significantly influenced by: i) the stage of the disease, ii) the preoperative levels of serum albumin, iii) the status of the resection margins, iv) previous history of irradiation, v) length of hospital stay and vi) association of comorbidities. Conclusion: Vulvar cancer surgery for locally advanced disease is still associated with high rates of postoperative complications, and an attentive selection of cases submitted to surgery is mandatory.
- Published
- 2019
44. The Impact of the Preoperative Status on the Short-term Outcomes After Exenteration and Pelvic Reconstruction
- Author
-
Iulian Brezean, Mihaela Vilcu, Irina Balescu, Nicolae Bacalbasa, and Simona Dima
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Reconstructive surgery ,medicine.medical_treatment ,Serum albumin ,General Biochemistry, Genetics and Molecular Biology ,Pelvis ,Postoperative Complications ,Risk Factors ,medicine ,Humans ,Aged ,Pharmacology ,Pelvic exenteration ,biology ,business.industry ,Nutritional status ,Perioperative ,Middle Aged ,Plastic Surgery Procedures ,Prognosis ,Surgery ,Pelvic Exenteration ,Treatment Outcome ,biology.protein ,Female ,business ,Biomarkers ,Research Article - Abstract
Background/Aim: The aim of this study was to analyse the influence of the preoperative status on the perioperative outcomes of patients submitted to pelvic reconstructions after exenteration. Materials and Methods: Between January 2017 and December 2018, pelvic exenteration was performed in 86 cases; patients were classified according to their age, nutritional status and association of reconstructive surgery. Results: The median age was 56 years, while the median level of serum albumin was 3.6 g/dl. Reconstructive surgery was more frequently performed in younger patients, while the rate of postoperative complications was similar between the two groups, while the rate of postoperative complications was significantly higher among cases with lower serum albumin levels. Conclusion: Reconstructive surgery should be performed in selected patients. Elderly cases as well as those presenting a poorer nutritional status are at higher risk of developing postoperative complications.
- Published
- 2019
45. Self-harm in the prison system
- Author
-
Mihaela Vilcu, Dumitru Ferechide, S Petrea, Horațiu Moldovan, and Iulian Brezean
- Subjects
Harm ,media_common.quotation_subject ,Prison ,Criminology ,Psychology ,Pathology and Forensic Medicine ,media_common - Published
- 2016
46. Krukenberg Tumors From Breast Cancer – Literature Review
- Author
-
Nicolae Bacalbasa, Irina Balescu, Mihaela Vilcu, Iulian Brezean, Ioana Halmaciu, Pharmacy, Bucharest, Romania, Camelia Cristina Diaconu, and Simona Dima
- Subjects
Oncology ,medicine.medical_specialty ,Breast cancer ,business.industry ,Internal medicine ,medicine ,General Medicine ,business ,medicine.disease - Published
- 2020
47. Synchronous Cervical Adenocarcinoma and Ovarian Serous Adenocarcinoma—A Case Report and Literature Review
- Author
-
Ioana Halmaciu, Iulian Brezean, Camelia Cristina Diaconu, Simona Dima, Alexandru Filipescu, Irina Balescu, Nicolae Bacalbasa, Mihaela Vilcu, Dragos Cretoiu, and Laura Iliescu
- Subjects
Medicine (General) ,medicine.medical_specialty ,Case Report ,Ovarian Serous Adenocarcinoma ,Adenocarcinoma ,Malignancy ,R5-920 ,medicine ,Humans ,Vaginal bleeding ,Radical Hysterectomy ,Lymph node ,business.industry ,Endometrial cancer ,cervical adenocarcinoma ,Middle Aged ,medicine.disease ,Dissection ,medicine.anatomical_structure ,synchronous malignancies ,Uterine Neoplasms ,Automotive Engineering ,serous ovarian adenocarcinoma ,Female ,Radiology ,medicine.symptom ,Ovarian cancer ,business - Abstract
Background/Aim: Synchronous gynecological malignancies are rarely encountered, and most often these cases are represented by synchronous ovarian and endometrial cancer. The aim of this paper is to present the case of a 53-year-old patient who was diagnosed with synchronous cervical and ovarian cancer. Case presentation: The patient had been initially investigated for vaginal bleeding and was submitted to a biopsy confirming the presence of a cervical adenocarcinoma. Once the diagnostic of malignancy was confirmed, the patient was submitted to a computed tomography which revealed the presence of large abdominal tumoral nodules of peritoneal carcinomatosis and was submitted to palliative chemotherapy with poor response. Eighteen months later she developed intestinal obstruction and was submitted to surgery. At that moment, synchronous ovarian and cervical tumors were diagnosed. Total radical hysterectomy with bilateral adnexectomy, pelvic and para-aortic lymph node dissection, omentectomy, and pelvic peritonectomy was performed; in the meantime, the histopathological studies confirmed the presence of two synchronous malignancies. Conclusion: Although synchronous lesions are rarely encountered, this eventuality should not be omitted. In such cases, surgery should be taken in consideration and the intent of radicality should regard both lesions.
- Published
- 2020
48. Expand+In Vivoiv.iiarjournals.orgIn Vivo September-October 2017 vol. 31 no. 5 983-989 Management of a Fulminant Upper Gastrointestinal Bleeding Exteriorized Through Hemobilia Due to Arteriobiliary Fistula Between the Common Bile Duct and a Right Hepatic Artery Aneurysm – A Case Report
- Author
-
Iulian Brezean, Nicolae Bacalbasa, Ion Barbu, Vladislav Brasoveanu, Claudiu Anghel, Mihai Pautov, and Irina Balescu
- Subjects
Pharmacology ,Cancer Research ,medicine.medical_specialty ,Abdominal pain ,Common bile duct ,business.industry ,Fistula ,Arterial Embolization ,030230 surgery ,Jaundice ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Hematochezia ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,cardiovascular system ,medicine ,Radiology ,Upper gastrointestinal bleeding ,medicine.symptom ,business - Abstract
Right hepatic artery aneurysms are rare events that might remain asymptomatic for a long period of time. However, in cases presenting large lesions, symptoms might develop especially due to the association of compression of the surrounding elements. Most often these symptoms and signs include diffuse abdominal pain, jaundice or portal vein compression signs. In rare cases life-threatening complications might develop due to the aneurysmal erosion of the biliary duct, portal vein or due to the aneurysmal rupture in the peritoneal cavity. In all these cases emergency surgery is imposed. We present the case of a 66-year-old patient diagnosed with a partially thrombosed right hepatic artery aneurysm compressing the common bile duct who was initially submitted to a percutaneous arterial embolization of the aneurysm in association with an external biliary drainage; three weeks later the patient presented a fulminant upper gastrointestinal bleeding exteriorized through the external biliary drainage, hematemesis and hematochezia. The patient was successfully submitted to surgery, intraoperatively a synchronous rupture of the portal vein being revealed. The right hepatic artery aneurysm was resected en bloc with common bile duct resection and segmental portal vein resection. The continuity of the portal vein was re-established through the interposition of a cadaveric allograft, the common bile duct was anastomosed with en Roux en Y limb while the right hepatic artery aneurysm was ligated and resected, the arterial vascularization of the liver being provided by the left hepatic artery.
- Published
- 2018
49. Expand+In Vivoiv.iiarjournals.orgIn Vivo September-October 2017 vol. 31 no. 5 979-982 Successful Resection and Vascular Ligation of a Large Hepatic Artery Aneurysm – A Case Report and Literature Review
- Author
-
Irina Balescu, Vladislav Brasoveanu, Nicolae Bacalbasa, Mihai Pautov, Iulian Brezean, Claudiu Anghel, and Ion Barbu
- Subjects
Pharmacology ,Cancer Research ,medicine.medical_specialty ,Percutaneous ,Common hepatic artery ,medicine.diagnostic_test ,Left gastric artery ,business.industry ,medicine.medical_treatment ,030230 surgery ,General Biochemistry, Genetics and Molecular Biology ,Surgery ,Gastroduodenal artery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.artery ,Angiography ,medicine ,Radiology ,Embolization ,Hepatectomy ,business ,Artery - Abstract
The occurrence of hepatic artery aneurysms is rare and might be incidentally diagnosed, as the patient remains asymptomatic for a long period of time. However, due to the fact that these lesions are associated with a high risk of developing life threatening complications, such as intraperitoneal rupture, it has been stated that all cases should be submitted to treatment by endovascular or surgical approach. We present the case of a 68-year-old patient, who presented with recurrent upper digestive tract bleedings and was diagnosed with a large aneurysm of the common and the proper hepatic artery, and the gastroduodenal artery. The preoperative angiography revealed an anatomic variation consisting of the common hepatic artery originating from the celiac trunk, and the left hepatic artery originating from the left gastric artery. A percutaneous right portal vein embolization was performed in order to induce hypertrophy of the left lobe and prepare the patient for a right hepatectomy and aneurysmal resection. However, at the time of surgery, after performing the aneurysmal resection and arterial ligation, the vascular supply of the entire liver was efficiently provided by the left hepatic artery and its collaterals. Concluding, hepatic resection was no longer necessary.
- Published
- 2018
50. Spleno-pancreatectomy
- Author
-
Nicolae, Bacalbasa, Irina, Balescu, Alina, Tanase, Mihai, Pautov, Iulian, Brezean, Mihaela, Vilcu, and Vladislav, Brasoveanu
- Subjects
Male ,Gastrectomy ,cardiovascular system ,Splenectomy ,Humans ,Research-Article ,cardiovascular diseases ,Aneurysm ,Splenic Artery ,Spleen - Abstract
Splenic artery aneurysms are common arterial lesions which might remain asymptomatic for a long period of time. In certain cases, these lesions might encounter a significant growth and might become symptomatic. Once diagnosed, a therapeutic strategy should be taken in consideration in order to avoid the apparition of life-threatening complications such as aneurysmal rupture. This is a case report of a 45-year-old patient diagnosed with a splenic artery aneurysm who was successfully submitted to an aneurysmal resection en bloc with distal spleno-pancreatectomy and parcelar gastrectomy.
- Published
- 2018
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