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Aim: The aim of the present study is to investigate the incidence of accidental parathyroidectomy and the connection between the type of surgery, or the resected piece sent for histopathological examination and the number of accidentally excised parathyroid glands., Material and Methods: Patients who had thyroid surgery between January 2005 and December 2014 and were admitted to a surgery clinic from Targu Mures, Romania, were enrolled in this study. For statistical analysis we used Chi-squared test, Student's t-test and ANOVA test, with a p value < 0.05 considered statistically significant., Results: A total of 3065 patients (315 males, 2750 females) were included in our study, with a mean age of 49.66±13.73. The frequence of incidental parathyroidectomy was 15.36%, most patients with IPT (88.95%) had only one parathyroid gland removed and we found a statistically significant association (p = 0.01) between the incidence of IPT and the type of surgery., Discussion: Iatrogenic injury of the parathyroid glands cause hypoparathyroidism which can be transient in majority and permanent in 1.5% of the patients. The most frequent cases with accidental removal of the parathyroid glands were total and subtotal thyroidectomies (79.6%), respectively reinterventions or completion thyroidectomies (10.62%)., Conclusions: Incidental parathyroidectomy is not uncommon following thyroid surgery, even in the hands of experienced surgeons and it is more often seen in female patients with polynodular goiter according to our study. Total thyroidectomies and reinterventions on the thyroid gland increase the risk of incidental parathyroidectomy., Key Words: Incidental parathyroidectomy, Hypoparathyroidism, Parathyroid glands.

Aim: Breast cancer is known as the most frequent cancer type among women. In several developing countries advanced stage cases present an increase trend, despite the global provisions of screening for early detection. The aim was to investigate patients with locally advanced breast cancers, in a developing country from eastern Europe., Material and Methods: A retrospective study was performed, including patients diagnosed with breast cancer who underwent surgical intervention, during 2007-2017. Besides demographic data, surgical techniques were investigated. Within histopathological data tumor size, type and grade were examined. We also investigated lymph node status and patient's hormonal parameters., Results: We examined 1008 patients diagnosed with benign and malignant mammary gland tumors over 11 years. After excluding benign tumors, inflammatory cancers, biopsies, recurrent breast cancers and initial stages, 125 patients remained eligible. Exulceration and hemorrhage were observed in 64 (51.2%) locally advanced cases. Resection of the pectoralis major muscle was realized in 12.8% due to tumoral infiltration., Discussion: Locally advanced breast cancer represents approximately 5% in developed countries. Within our results, this rate was 27.9%. This discrepancy is given by the regular national mammary screening programs within several developed countries., Conclusions: In the developing countries locally advanced breast cancer presents a continuous increase and hemorrhagic exulcerated types are not uncommon. Due to the poor health education and sometimes inadequate health care in eastern Europe, just a few patients have benefited of neoadjuvant therapy and preoperative mammography was performed in a small number of patients., Key Words: Brest Cancer, Locally Advanced.

Background: Inguinal hernia repair is one of the most common surgical procedures in man. Immediate postoperative pain is an important issue that can delay hospital discharge. Besides, the presence of chronic pain after herniorrhaphy, which can affect up to 50% of patients, is a growing concern. However information regarding the precise etiological factors of this chronic postoperative pain is lacking. One factor thought to contribute to post herniorrhaphy chronic pain is the surgical procedure for inguinal hernia repair used by the surgeon., Materials and Method: The study was conducted over a period of 5 years and included 1000 consecutive patients operated with inguinal hernia. Each patients completed a questionnaire about the presence or absence of pain or sensory disorders. After completed only 365 of patients remains in the study. From this patients, a total of 38 had different intensity of pain. From those, 13% were operated through an tissular procedure, whereas the laparoscopic procedure was responsible only for 7% of the patients with chronic postoperative pain. Most of the patients had mild or moderate pain and only one patient experienced severe pain. According to the type of procedure performed, in 25 patients were used the tissular procedure and only 12 patients with laparoscopic hernia repair had chronic pain., Conclusion: The etiology of chronic groin pain post hernia repair is related in part to nerve injury. This is supported by the high frequency of sensory symptoms and numbness in these patients. However other factors including the role of tissue injury and inflammatory postoperative changes need to be considered., Key Words: Chronic postoperative pain, Inguinal hernia repair, Open surgery, Laparoscopic surgery.

Background: Acute cholecystitis is still frequent in emergency surgical departments. As surgical technique, nowadays laparoscopy is widely used and with low complications and with low postoperative morbidity., Material and Methods: We perform an analytical study about the safety of laparoscopic surgery in patients with acute cholecystitis in a single Surgical Department with an experience of over 20 years in laparoscopic surgery. We included 193 patient admitted in our department during 2014 and 2015., Results: Of the 193 patients, 43% were diagnosed with acute lithiasic cholecystitis (ALC) whereas 56% had chronic lithiasic cholecystitis (CLC). We assessed the comorbidities of the patient via Pearson's Chi-Square test and we found out that there is a significant relationship between acute cholecystitis and high blood tension, obesity and diabetes. Surgical techniques performed were in 95% of cases laparoscopic cholecystectomy and only in 5% we performed open surgery., Discussions: Experienced surgeons have a lower conversion rate as compared to less experienced surgeons. For this reason, postoperative assessment criteria have been proposed, with a view to identify the risk of conversion CONCLUSION: In our study laparoscopic surgery for acute cholecystitis is a safe procedure with low intraoperative complication rate and with a reduced hospital stay., Key Words: Acute cholecystitis, Intraoperative adhesion, Intraoperative bleeding, Laparoscopic cholecystectomy.

Background: Data from the literature regarding the prognostic role of DNA mismatch repair system (MMR) in colorectal cancer are still controversial., Aim: The aim of the study was to identify the prognostic role of different phenotypic, clinical and pathological characteristics in microsatellite unstable vs. microsatellite stable colorectal cancer in terms of survival and disease free interval., Methods: We conducted a retrospective study that included a total of 103 patients who underwent curative surgery for colorectal cancer. Immunohistochemistry testing revealed MLH1, MLH2, MLH6, PMS2 genes and mutations of the BRAF gene. We identified three groups of patients: patients with colorectal tumors with MSI produced by hypermethylation, (MLH1/BRAF+) group, patients with microsatellite instable tumours produced by genetic mutations MSI groupb(MLH1, MLH2, MLH6, PMS2) and patients with microsatellite stable tumours (MSS)., Results: The study shows that: MSI tumours (MLH1/BRAF+) group occur more frequently in women (p=0.05), on the right side of the colon (p=0.001). The 5-year survival rate was higher in patients with MSI tumours (MLH1/BRAF+) group than in those with microsatellite stable tumours, the differences were not statistically significant ; relapse rate was higher in patients with MSI tumors than in those with MSI tumours (MLH1/BRAF+) group (p=0.03) or with MSS tumors (p=0.004)., Conclusions: The identification of microsatellite unstable colorectal tumours is an important molecular marker with role in recognition subgroups of patients with different phenotypic characteristics, survival and relapse rates., Key Words: Colorectal cancer, Mismatch repair genes, Prognostic role.