Alexandru Nicodin | University Of Medicine And Pharmacy Timisoara (original) (raw)
Papers by Alexandru Nicodin
Interactive CardioVascular and Thoracic Surgery, 2008
Pleuropulmonary tuberculosis (TB) is a relatively frequent condition (the incidence of (TB) was 1... more Pleuropulmonary tuberculosis (TB) is a relatively frequent condition (the incidence of (TB) was 176y100,000 in our county in 2004) and some of these patients with TB are undergoing surgical interventions. The authors share their experience in surgical treatment of pleuropulmonary tuberculosis, based on minimal invasive techniques such as VATS and filling the residual cavities with muscle or skinmuscle grafts. The authors are retrospectively revising 144 patients between 1 January 2001 and 31 December 2007 who underwent surgical treatment for tuberculosis in this period. Two hundred and thirteen surgical procedures were performed for pleuropulmonary tuberculosis, representing 4% of all the procedures done in the department. For most of the patients the etiological diagnosis was not established until the operations, all the patients were sputum-negative. The diagnoses at the admittance were: pulmonary nodules or tumors (42 patients), pleural collections , pleural thickening and post-tuberculosis syndromes (46), fibrocavitary tuberculosis (6), and tuberculous pericarditis (4). Of all the procedures applied, 14 were pulmonary resections, 50 atypical (wedge) resections, 70 video-assisted thoracic surgery (VATS) procedures, and nine patients needed muscle or skin-musle flap for residual pleural cavities. Eleven patients (7.6%) had to undergo secondary surgery due to complications. No in-hospital mortality was registered. The mean hospitalisation period was 10.1"4.2 (S.D.) days.
Introduction: Tuberculous pleurisy raise a number of issues related to the etiology and the subse... more Introduction: Tuberculous pleurisy raise a number of issues related to the etiology and the subsequent treatment. Therefore, the correct treatment schemes are set late in many cases, from the submission to the family doctor, clinical and imaging diagnosis, presentation to pulmonologist and thoracic surgeon. Unfortunately in our clinic there are still many patients with stage III Light needing pulmonary pleural decortication, a significant proportion of patients suffering complications of this surgery so intricate and far-reaching. Matherial and Method: We conducted a retrospective study over a period of 12 years, with the study group of 131 patients diagnosed with tuberculosis treated in our clinic between 2001 and 2013, aged between 6 and the 81 years. We excluded from our study all patients with tuberculous pulmonary pathology (tuberculomas), TB mediastinal lymph nodes or TB pericarditis. Patients were divided to two groups: A - 71 patients who received minimally invasive surgery,...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2010
We present a case of 48-year-old male with a nine months history of right inferior thoracic (T10-... more We present a case of 48-year-old male with a nine months history of right inferior thoracic (T10-T12) paravertebral mass, which became painful after a back trauma; dyspnea and hemoptysis were associated. The preoperative native and with contrast substance CT revealed a tumor mass extended from the right paravertebral muscles to the diaphragmatic right pillar muscle, invading the postero-basal pleura and the posterior arches of the right XIth and 12th ribs with osteolysis. Fragments of 10 cm large tumor resection specimen (striated muscle, dense connective tissue, adipose tissue, lymph nodes and intercostals nerves) were routinely processed, further immunohistochemical investigations were needed, using Dako antibodies pan-CK clone MNF116, CD34, CD20, vimentin, synaptophysin, melanoma HMB45 clone, with LSAB 2Kits system and further CK AE1÷AE3, CK7, CK20, CEA, S-100 protein, CD31, von Willebrand factor, D2-40÷podoplanin, Ki-67 antigen, with EnVision system and DAB visualization in both...
European Respiratory Journal, Sep 1, 2012
Number: 2350 Publication Number: P2418 Abstract Group: 8.
Pectus excavatum (PE) is the most frequent anterior chest deformity. Despite that since now more ... more Pectus excavatum (PE) is the most frequent anterior chest deformity. Despite that since now more than 50 surgical procedures were performed for the correction of PE, only two were widely accepted by the medical community and each one of them was considered, in its own period of time, the gold standard in the surgical treatment of PE. This study is a retrospective comparison of the outcomes of the two main surgical procedures for the correction of PE, modified Ravitch procedure (MRP) and minimal invasive Nuss procedure (MIRPE) in The Department of Pediatric Surgery and Orthopedics, Emergency Children’s Hospital „Louis Turcanu”, Timisoara, Romania and in The Pediatric Surgery Unit, Pediatrics Clinic, Universitary Hospital Szeged Hungary in the last 10 years. A total of 39 cases of children underwent surgical correction of pectus excavatum, 29 by MRP, mean age 9 years and 10 by MIRPE, mean age 13 years. There were no deaths in any group. Mean hospital stay was 13 days for the MRP group...
Introduction: Transthoracic CT guided fine needle biopsy is extremely valuable in establishing th... more Introduction: Transthoracic CT guided fine needle biopsy is extremely valuable in establishing the diagnosis for mediastino-pulmonary masses, especially when the patient cannot undergo other types of surgical intervention, be it curative or diagnostic. Although minimally invasive, the method is sometimes followed by complications, among which pneumothorax and bleeding have been most frequently reported. These complications are directly linked to various factors, the most important of them being the accuracy with which the target is reached at the first attempt. Objective: In order to reduce the number of these complications, we made a study about a low cost stereotactical device that meets the criteria of accuracy required. Material and methods: The device is a pure mechanical concept. It has a system of columns-racks united by a guiding body, a goniometrical system to properly establish the attack angle for the target, a pusher rod with an ensemble of clamping/release system for th...
The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress... more The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress in the diagnosis and the treatment of the pleural effusions. The advantages of the mini-invasive surgery and its relatively simple technique have allowed the abandon of the traditional thoracotomies performed for diagnostic purposes and, at the same time, the achievement of very good therapeutic results. The authors present their experience of the mini-invasive surgery from January 2001 to December 2005. In that period of time, they performed 282 video-assisted operations (15 in 2001, 37 in 2002, 65 in 2003, 77 in 2004, 88 in 2005). 170 of these procedures were made for pleural pathology: pleural and pleuro-pericardial effusions, pleural empyema, hemothorax, pneumothorax, and pleural tumors. The mini-invasive surgery was used for diagnosis (in the cases with irrelevant paraclinical investigations), as well as for curative and palliative treatment. The authors provide statistical data an...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Idiopathic pulmonary fibrosis is a severe disease, with unpredictable evolution that frequently l... more Idiopathic pulmonary fibrosis is a severe disease, with unpredictable evolution that frequently leads to respiratory failure and death, despite some progresses made in the field of therapy. Basically, the bad prognosis and failure of therapy are the consequence of the lack of data about the molecular events that have as result the extensive fibrosis. Although the basic lesions were defined many years ago, the pathological classification of pulmonary fibrosis is controversial. In the present work, we analyzed the prognostic impact of basic microscopic lesions on a possible new classification that could be related to the patient outcome. For this purpose, we have investigated 20 cases with idiopathic pulmonary fibrosis and samples of lung parenchyma were obtained by video assisted thoracoscopy. The specimens were processed by usual histological technique and sections were stained with Hematoxylin-Eosin, Masson's trichrome and Gordon-Sweet silver staining. There were evaluated the ...
Pneumologia (Bucharest, Romania)
Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an unc... more Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an uncommon feature of intrathoracic tuberculosis in adults. The authors present the case of a 64 year old man who developed prolonged fever and was admitted to Clinical Hospital of Infectious Diseases and Pneumophtisiology Dr. Victor Babeş Timişoara during 06.04-15.04.2009. Diagnosis of mediastinal lymph node tuberculosis was established only after axillary thoracotomy and biopsy of tumoral mass, although the first results obtained after mediastinoscopy were negative. Dynamics of biological features, diagnostic pitfalls, differential diagnosis difficulties and peculiar aspects of evolution are presented. Mediastinal tuberculous adenopathy, without associated pulmonary involvement is a rare form of presentation among adults, generally evolving with sustained fever. Diagnosis of mediastinal tuberculosis is difficult due to non-specific clinical aspects and lack of characteristic radiographic fe...
Pneumologia (Bucharest, Romania)
In our clinic we have gathered more than 750 cases of CT-guided transthoracic fine needle aspirat... more In our clinic we have gathered more than 750 cases of CT-guided transthoracic fine needle aspiration (FNA). This procedure is very useful for the diagnosis of mediastinal/pulmonary tumor masses. Because of the relatively high cost of this procedure, we tried to find out a less expensive but still reliable way to get the diagnosis for these tumors, and for this reason we figure out an original approach. The study population consisted of 160 patients divided in two groups. To first group we applied the classic method using the conventional needles and the Papanicolaou stain. For the second group we used the spinal anesthetic needle and an original stain (blue--polychrome--tanine--Dragan). The chi2 test was used to match the results and complications between the two groups. This study prove that this original method is as reliable as the classic one but with a ten-fold reduction of costs: 1,198 euro versus 128 euro per 100 smears. Choosing of this original method for the diagnosis of m...
Pleural tuberculosis (TB) is most often treated by a pneumologist. Some cases require operative i... more Pleural tuberculosis (TB) is most often treated by a pneumologist. Some cases require operative interventions and may represent a challenge for the thoracic surgeon. There are two specific problems regarding TB pleural effusions: 15-25% of them remain undiagnosed using the conventional methods of diagnosis (imaging, thoracentesis, percutaneous pleural biopsies) and have a tendency for the rapid production of dense adherences and loculations. The authors present their experience in the diagnosis and the treatment of tuberculous pleurisy by means of mini-invasive surgical techniques. The period of study was January 2001-December 2006. In that period, the authors performed 400 video-assisted surgical operations, representing 9% of all the operations carried out in the clinic (3833). The surgical indications were for diagnosis (pleural, pericardial, lung or lymph node biopsy) and for treatment (pleurisy, pleuro-pericarditis, empyema). The contraindications for VATS were the usual ones. ...
Thoracic trauma often bears difficult problems of diagnosis and treatment. This paper reports 87 ... more Thoracic trauma often bears difficult problems of diagnosis and treatment. This paper reports 87 procedures on 20 severe thoracic injured patients, who have also suffered multiple injuries, to whom was performed bronchoscopy. These cases were regarding gender, age, traumatic cause, associated injuries and dynamic endo-bronchial aspect. There are detailed technique used in bronchoscopy and bronchoscopic suction, additional diagnostic procedures, technical tips, incidents and are also reported close and follow up results in these cases. We discuss indications of bronchoscopy and broncho-aspiration in thoracic trauma from diagnostic and treatment point of view. Conclusions underline major role of bronchoscopy in the management of severe thoracic trauma.
Pneumoftiziologia : revista Societătii Române de Pneumoftiziologie / [Societatea Română de Pneumoftiziologie]
37 patients with certified diagnosis, operated for lung cancer (LC) in The Central Military Hospi... more 37 patients with certified diagnosis, operated for lung cancer (LC) in The Central Military Hospital Bucharest, during six months period (October 1st 1996-June 1st 1997). It was a retrospective study on the patients medical files. Sex distribution, postsurgical staging and histological type were studied. We calculated the following delays: 1. Between the first medical examination and the first suspicion (chest X-ray): 6 +/- 3 days; 2. Between the first medical examination and first hospital admission: 14 +/- 11 days; 3. Between the first hospital admission and the first admission in surgical units: 43 +/- 23 days; 4. Between the first admission in surgical units and surgery: 59 +/- 26 days; 5. The delay until bronchoscopy: 23 +/- 16 days; 6. The delay until the CT examination: 26 +/- 16 days; 7. Between the first medical examination and the surgery: 78 +/- 30 days. These delays were correlated with the specialty profile of the services which referred the patients: pulmonology, inter...
Chirurgia (Bucharest, Romania : 1990)
Pectus excavatum (PE) is the most frequent anterior chest deformity and occurs in approximately 1... more Pectus excavatum (PE) is the most frequent anterior chest deformity and occurs in approximately 1 in 1000 live births. In 1998 Donald Nuss introduced a new minimal invasive operative technique for PE which avoids any cartilage resection or sternum osteotomy. The purpose of this study is to assess the short and medium time results after minimal invasive correction of pectus excavatum and to present our improvements to the original Nuss technique. During a two years period seven PE patients were treated by us using Nuss technique. The intervention represents a premiere because it was the first Nuss operation performed by a team composed exclusively by Romanian surgeons. We present you the seven cases, our operative technique and the short and medium term outcomes. No itraoperative incidences were recorded. Postoperative course was good for all patients. Complication occurred in three cases: two pleural effusions and a wound dehiscence. They have been all successfully resolved with no ...
Chirurgia (Bucharest, Romania : 1990)
Esophageal atresia (EA) is the most common malformation of the esophagus. Primary anastomosis is ... more Esophageal atresia (EA) is the most common malformation of the esophagus. Primary anastomosis is achievable in more than 90% of the cases and the milestone of the surgical intervention is achieving a watertight, low-tension anastomosis of the esophageal pouches. The purpose of this paper is to present a new method for releasing tension in the anastomosis and also to provide a safe way for enteral feeding in children with primarily repaired EA. From 2000 to 2012 twenty-one patients underwent primary esophageal anastomosis for EA in our department. During the surgical intervention, a 12-french Foley catheter is inserted through one of the nostrils, through the esophagus down to the site of the anastomosis and passed by into the stomach. After surgery, continuous gentile traction is maintained on the catheter for several days. We had no postoperative disruption of the anastomosis and anastomotic leaks occurred in 1 of the 21 cases. Overall survival rate was 67%. Using the Foley cathete...
The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress... more The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress in the diagnosis and the treatment of the pleural effusions. The advantages of the mini-invasive surgery and its relatively simple technique have allowed the abandon of the traditional thoracotomies performed for diagnostic purposes and, at the same time, the achievement of very good therapeutic results. The authors present their experience of the mini-invasive surgery from January 2001 to December 2005. In that period of time, they performed 282 video-assisted operations (15 in 2001, 37 in 2002, 65 in 2003, 77 in 2004, 88 in 2005). 170 of these procedures were made for pleural pathology: pleural and pleuropericardial effusions, pleural empyema, hemothorax, pneumothorax, and pleural tumors. The mini-invasive surgery was used for diagnosis (in the cases with irrelevant paraclinical investigations), as well as for curative and palliative treatment. The authors provide statistical data and classifications according to the pre-and postoperative diagnosis, the patients' age, their sex, pathological results. At the same time, the paper presents the possibilities and limitations of the thoracoscopic surgery, as well as the cases when the conversion to the videoassisted surgery (VATS) was necessary. There were situations in which VATS was directly adopted, as imposed by certain technical problems and/or by the performance of some supplementary surgical procedures.
Journal of Cardiothoracic Surgery, 2013
Journal of Cardiothoracic Surgery, 2013
Interactive CardioVascular and Thoracic Surgery, 2008
Pleuropulmonary tuberculosis (TB) is a relatively frequent condition (the incidence of (TB) was 1... more Pleuropulmonary tuberculosis (TB) is a relatively frequent condition (the incidence of (TB) was 176y100,000 in our county in 2004) and some of these patients with TB are undergoing surgical interventions. The authors share their experience in surgical treatment of pleuropulmonary tuberculosis, based on minimal invasive techniques such as VATS and filling the residual cavities with muscle or skinmuscle grafts. The authors are retrospectively revising 144 patients between 1 January 2001 and 31 December 2007 who underwent surgical treatment for tuberculosis in this period. Two hundred and thirteen surgical procedures were performed for pleuropulmonary tuberculosis, representing 4% of all the procedures done in the department. For most of the patients the etiological diagnosis was not established until the operations, all the patients were sputum-negative. The diagnoses at the admittance were: pulmonary nodules or tumors (42 patients), pleural collections , pleural thickening and post-tuberculosis syndromes (46), fibrocavitary tuberculosis (6), and tuberculous pericarditis (4). Of all the procedures applied, 14 were pulmonary resections, 50 atypical (wedge) resections, 70 video-assisted thoracic surgery (VATS) procedures, and nine patients needed muscle or skin-musle flap for residual pleural cavities. Eleven patients (7.6%) had to undergo secondary surgery due to complications. No in-hospital mortality was registered. The mean hospitalisation period was 10.1"4.2 (S.D.) days.
Introduction: Tuberculous pleurisy raise a number of issues related to the etiology and the subse... more Introduction: Tuberculous pleurisy raise a number of issues related to the etiology and the subsequent treatment. Therefore, the correct treatment schemes are set late in many cases, from the submission to the family doctor, clinical and imaging diagnosis, presentation to pulmonologist and thoracic surgeon. Unfortunately in our clinic there are still many patients with stage III Light needing pulmonary pleural decortication, a significant proportion of patients suffering complications of this surgery so intricate and far-reaching. Matherial and Method: We conducted a retrospective study over a period of 12 years, with the study group of 131 patients diagnosed with tuberculosis treated in our clinic between 2001 and 2013, aged between 6 and the 81 years. We excluded from our study all patients with tuberculous pulmonary pathology (tuberculomas), TB mediastinal lymph nodes or TB pericarditis. Patients were divided to two groups: A - 71 patients who received minimally invasive surgery,...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2010
We present a case of 48-year-old male with a nine months history of right inferior thoracic (T10-... more We present a case of 48-year-old male with a nine months history of right inferior thoracic (T10-T12) paravertebral mass, which became painful after a back trauma; dyspnea and hemoptysis were associated. The preoperative native and with contrast substance CT revealed a tumor mass extended from the right paravertebral muscles to the diaphragmatic right pillar muscle, invading the postero-basal pleura and the posterior arches of the right XIth and 12th ribs with osteolysis. Fragments of 10 cm large tumor resection specimen (striated muscle, dense connective tissue, adipose tissue, lymph nodes and intercostals nerves) were routinely processed, further immunohistochemical investigations were needed, using Dako antibodies pan-CK clone MNF116, CD34, CD20, vimentin, synaptophysin, melanoma HMB45 clone, with LSAB 2Kits system and further CK AE1÷AE3, CK7, CK20, CEA, S-100 protein, CD31, von Willebrand factor, D2-40÷podoplanin, Ki-67 antigen, with EnVision system and DAB visualization in both...
European Respiratory Journal, Sep 1, 2012
Number: 2350 Publication Number: P2418 Abstract Group: 8.
Pectus excavatum (PE) is the most frequent anterior chest deformity. Despite that since now more ... more Pectus excavatum (PE) is the most frequent anterior chest deformity. Despite that since now more than 50 surgical procedures were performed for the correction of PE, only two were widely accepted by the medical community and each one of them was considered, in its own period of time, the gold standard in the surgical treatment of PE. This study is a retrospective comparison of the outcomes of the two main surgical procedures for the correction of PE, modified Ravitch procedure (MRP) and minimal invasive Nuss procedure (MIRPE) in The Department of Pediatric Surgery and Orthopedics, Emergency Children’s Hospital „Louis Turcanu”, Timisoara, Romania and in The Pediatric Surgery Unit, Pediatrics Clinic, Universitary Hospital Szeged Hungary in the last 10 years. A total of 39 cases of children underwent surgical correction of pectus excavatum, 29 by MRP, mean age 9 years and 10 by MIRPE, mean age 13 years. There were no deaths in any group. Mean hospital stay was 13 days for the MRP group...
Introduction: Transthoracic CT guided fine needle biopsy is extremely valuable in establishing th... more Introduction: Transthoracic CT guided fine needle biopsy is extremely valuable in establishing the diagnosis for mediastino-pulmonary masses, especially when the patient cannot undergo other types of surgical intervention, be it curative or diagnostic. Although minimally invasive, the method is sometimes followed by complications, among which pneumothorax and bleeding have been most frequently reported. These complications are directly linked to various factors, the most important of them being the accuracy with which the target is reached at the first attempt. Objective: In order to reduce the number of these complications, we made a study about a low cost stereotactical device that meets the criteria of accuracy required. Material and methods: The device is a pure mechanical concept. It has a system of columns-racks united by a guiding body, a goniometrical system to properly establish the attack angle for the target, a pusher rod with an ensemble of clamping/release system for th...
The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress... more The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress in the diagnosis and the treatment of the pleural effusions. The advantages of the mini-invasive surgery and its relatively simple technique have allowed the abandon of the traditional thoracotomies performed for diagnostic purposes and, at the same time, the achievement of very good therapeutic results. The authors present their experience of the mini-invasive surgery from January 2001 to December 2005. In that period of time, they performed 282 video-assisted operations (15 in 2001, 37 in 2002, 65 in 2003, 77 in 2004, 88 in 2005). 170 of these procedures were made for pleural pathology: pleural and pleuro-pericardial effusions, pleural empyema, hemothorax, pneumothorax, and pleural tumors. The mini-invasive surgery was used for diagnosis (in the cases with irrelevant paraclinical investigations), as well as for curative and palliative treatment. The authors provide statistical data an...
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2013
Idiopathic pulmonary fibrosis is a severe disease, with unpredictable evolution that frequently l... more Idiopathic pulmonary fibrosis is a severe disease, with unpredictable evolution that frequently leads to respiratory failure and death, despite some progresses made in the field of therapy. Basically, the bad prognosis and failure of therapy are the consequence of the lack of data about the molecular events that have as result the extensive fibrosis. Although the basic lesions were defined many years ago, the pathological classification of pulmonary fibrosis is controversial. In the present work, we analyzed the prognostic impact of basic microscopic lesions on a possible new classification that could be related to the patient outcome. For this purpose, we have investigated 20 cases with idiopathic pulmonary fibrosis and samples of lung parenchyma were obtained by video assisted thoracoscopy. The specimens were processed by usual histological technique and sections were stained with Hematoxylin-Eosin, Masson's trichrome and Gordon-Sweet silver staining. There were evaluated the ...
Pneumologia (Bucharest, Romania)
Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an unc... more Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an uncommon feature of intrathoracic tuberculosis in adults. The authors present the case of a 64 year old man who developed prolonged fever and was admitted to Clinical Hospital of Infectious Diseases and Pneumophtisiology Dr. Victor Babeş Timişoara during 06.04-15.04.2009. Diagnosis of mediastinal lymph node tuberculosis was established only after axillary thoracotomy and biopsy of tumoral mass, although the first results obtained after mediastinoscopy were negative. Dynamics of biological features, diagnostic pitfalls, differential diagnosis difficulties and peculiar aspects of evolution are presented. Mediastinal tuberculous adenopathy, without associated pulmonary involvement is a rare form of presentation among adults, generally evolving with sustained fever. Diagnosis of mediastinal tuberculosis is difficult due to non-specific clinical aspects and lack of characteristic radiographic fe...
Pneumologia (Bucharest, Romania)
In our clinic we have gathered more than 750 cases of CT-guided transthoracic fine needle aspirat... more In our clinic we have gathered more than 750 cases of CT-guided transthoracic fine needle aspiration (FNA). This procedure is very useful for the diagnosis of mediastinal/pulmonary tumor masses. Because of the relatively high cost of this procedure, we tried to find out a less expensive but still reliable way to get the diagnosis for these tumors, and for this reason we figure out an original approach. The study population consisted of 160 patients divided in two groups. To first group we applied the classic method using the conventional needles and the Papanicolaou stain. For the second group we used the spinal anesthetic needle and an original stain (blue--polychrome--tanine--Dragan). The chi2 test was used to match the results and complications between the two groups. This study prove that this original method is as reliable as the classic one but with a ten-fold reduction of costs: 1,198 euro versus 128 euro per 100 smears. Choosing of this original method for the diagnosis of m...
Pleural tuberculosis (TB) is most often treated by a pneumologist. Some cases require operative i... more Pleural tuberculosis (TB) is most often treated by a pneumologist. Some cases require operative interventions and may represent a challenge for the thoracic surgeon. There are two specific problems regarding TB pleural effusions: 15-25% of them remain undiagnosed using the conventional methods of diagnosis (imaging, thoracentesis, percutaneous pleural biopsies) and have a tendency for the rapid production of dense adherences and loculations. The authors present their experience in the diagnosis and the treatment of tuberculous pleurisy by means of mini-invasive surgical techniques. The period of study was January 2001-December 2006. In that period, the authors performed 400 video-assisted surgical operations, representing 9% of all the operations carried out in the clinic (3833). The surgical indications were for diagnosis (pleural, pericardial, lung or lymph node biopsy) and for treatment (pleurisy, pleuro-pericarditis, empyema). The contraindications for VATS were the usual ones. ...
Thoracic trauma often bears difficult problems of diagnosis and treatment. This paper reports 87 ... more Thoracic trauma often bears difficult problems of diagnosis and treatment. This paper reports 87 procedures on 20 severe thoracic injured patients, who have also suffered multiple injuries, to whom was performed bronchoscopy. These cases were regarding gender, age, traumatic cause, associated injuries and dynamic endo-bronchial aspect. There are detailed technique used in bronchoscopy and bronchoscopic suction, additional diagnostic procedures, technical tips, incidents and are also reported close and follow up results in these cases. We discuss indications of bronchoscopy and broncho-aspiration in thoracic trauma from diagnostic and treatment point of view. Conclusions underline major role of bronchoscopy in the management of severe thoracic trauma.
Pneumoftiziologia : revista Societătii Române de Pneumoftiziologie / [Societatea Română de Pneumoftiziologie]
37 patients with certified diagnosis, operated for lung cancer (LC) in The Central Military Hospi... more 37 patients with certified diagnosis, operated for lung cancer (LC) in The Central Military Hospital Bucharest, during six months period (October 1st 1996-June 1st 1997). It was a retrospective study on the patients medical files. Sex distribution, postsurgical staging and histological type were studied. We calculated the following delays: 1. Between the first medical examination and the first suspicion (chest X-ray): 6 +/- 3 days; 2. Between the first medical examination and first hospital admission: 14 +/- 11 days; 3. Between the first hospital admission and the first admission in surgical units: 43 +/- 23 days; 4. Between the first admission in surgical units and surgery: 59 +/- 26 days; 5. The delay until bronchoscopy: 23 +/- 16 days; 6. The delay until the CT examination: 26 +/- 16 days; 7. Between the first medical examination and the surgery: 78 +/- 30 days. These delays were correlated with the specialty profile of the services which referred the patients: pulmonology, inter...
Chirurgia (Bucharest, Romania : 1990)
Pectus excavatum (PE) is the most frequent anterior chest deformity and occurs in approximately 1... more Pectus excavatum (PE) is the most frequent anterior chest deformity and occurs in approximately 1 in 1000 live births. In 1998 Donald Nuss introduced a new minimal invasive operative technique for PE which avoids any cartilage resection or sternum osteotomy. The purpose of this study is to assess the short and medium time results after minimal invasive correction of pectus excavatum and to present our improvements to the original Nuss technique. During a two years period seven PE patients were treated by us using Nuss technique. The intervention represents a premiere because it was the first Nuss operation performed by a team composed exclusively by Romanian surgeons. We present you the seven cases, our operative technique and the short and medium term outcomes. No itraoperative incidences were recorded. Postoperative course was good for all patients. Complication occurred in three cases: two pleural effusions and a wound dehiscence. They have been all successfully resolved with no ...
Chirurgia (Bucharest, Romania : 1990)
Esophageal atresia (EA) is the most common malformation of the esophagus. Primary anastomosis is ... more Esophageal atresia (EA) is the most common malformation of the esophagus. Primary anastomosis is achievable in more than 90% of the cases and the milestone of the surgical intervention is achieving a watertight, low-tension anastomosis of the esophageal pouches. The purpose of this paper is to present a new method for releasing tension in the anastomosis and also to provide a safe way for enteral feeding in children with primarily repaired EA. From 2000 to 2012 twenty-one patients underwent primary esophageal anastomosis for EA in our department. During the surgical intervention, a 12-french Foley catheter is inserted through one of the nostrils, through the esophagus down to the site of the anastomosis and passed by into the stomach. After surgery, continuous gentile traction is maintained on the catheter for several days. We had no postoperative disruption of the anastomosis and anastomotic leaks occurred in 1 of the 21 cases. Overall survival rate was 67%. Using the Foley cathete...
The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress... more The thoracoscopic surgery and the video-assisted thoracic surgery have made a remarkable progress in the diagnosis and the treatment of the pleural effusions. The advantages of the mini-invasive surgery and its relatively simple technique have allowed the abandon of the traditional thoracotomies performed for diagnostic purposes and, at the same time, the achievement of very good therapeutic results. The authors present their experience of the mini-invasive surgery from January 2001 to December 2005. In that period of time, they performed 282 video-assisted operations (15 in 2001, 37 in 2002, 65 in 2003, 77 in 2004, 88 in 2005). 170 of these procedures were made for pleural pathology: pleural and pleuropericardial effusions, pleural empyema, hemothorax, pneumothorax, and pleural tumors. The mini-invasive surgery was used for diagnosis (in the cases with irrelevant paraclinical investigations), as well as for curative and palliative treatment. The authors provide statistical data and classifications according to the pre-and postoperative diagnosis, the patients' age, their sex, pathological results. At the same time, the paper presents the possibilities and limitations of the thoracoscopic surgery, as well as the cases when the conversion to the videoassisted surgery (VATS) was necessary. There were situations in which VATS was directly adopted, as imposed by certain technical problems and/or by the performance of some supplementary surgical procedures.
Journal of Cardiothoracic Surgery, 2013
Journal of Cardiothoracic Surgery, 2013