[Our experience in the surgical treatment of the arterial hypertension due to endocrine disturbances]. / Experienta noastra în tratamentul chirurgical al hipertensiunii arteriale secundare de origine endocrina.

This study is trying to expose our experience in the surgical treatment for adrenal tumors which produce arterial hypertension, experience gained over a period of 25 years. There were 93 adrenalcctomies carried out for these kinds of lesions, out of a total of 125 surgical procedures on the adrenal glands. Best results were obtained for phaeochromocytomas and also for tumors that produce primary hyperaldosteronism. Real advances have been done in the field of adrenal glands diseases by diagnosis and treatment but minimal invasive surgery is best used for all adrenal lesions but phaeochromocytomas in which this approach has to be very well judged.

[Multimodality treatment outcome of invasive thymomas]. / Rezultatele tratamentului multimodal în timoame.

UNLABELLED: The aim of the study was to analyze the progression of invasive thymomas associated with myasthenia gravis, after the resection and the progression of unresectable invasive thymomas with a combined chemoradiotherapy. The study was performed on two groups of patients: 8 patients with invasive thymomas and myasthenia gravis operated at the 3rd Surgical Clinic between 1986-1999; 4 patients with unresectable invasive thymomas treated at the Radiology-Oncology Clinic by combined chemoradiotherapy, between 1993-1998. The results are presented for each group of patients, separately. CONCLUSION: The best treatment of invasive thymomas is the multimodal one. The timing of each method was established based on the collaboration between surgeons, medical oncologists, radiotherapists and neurologists, depending on the characteristics of each patient.

Familial adenomatous polyposis--which operation?

Familial adenomatous polyposis (FAP) syndromes are well recognized entities that benefit from surgical treatment which should not be delayed. Screening of first degree relatives is important. The aim of removing the colorectal mucosa with significant potential of malignant transformation can be achieved by means of three distinct procedures: pan-proctocolectomy and ileostomy, subtotal colectomy with ileorectal anastomosis, restorative proctocolectomy with ileoanal anastomosis. In a series of eight patients with FAP we performed mostly subtotal colectomy with ileorectal anastomosis. Of five patients who underwent a form of subtotal colonic resection, one was lost from follow up and two developed carcinoma in the remaining rectal mucosa, which necessitated completion of the resection with proctectomy and permanent ileostomy. Nevertheless, in the increasing number of patients amenable to regular outpatient supervision, there are strong points for recommending sphincter-saving operations.

Polipoza adenomatoasa familiala--care operatie? [Familial adenomatous polyposis--which operation?].

Familial adenomatous polyposis (FAP) syndromes are well recognized entities that benefit from surgical treatment which should not be delayed. Screening of first degree relatives is important. The aim of removing the colorectal mucosa with significant potential of malignant transformation can be achieved by means of three distinct procedures: panproctocolectomy and ileostomy, subtotal colectomy with ileorectal anastomosis, restorative proctocolectomy with ileoanal anastomosis. In a series of eight patients with FAP we performed mostly subtotal colectomy with ileorectal anastomosis. Of five patients who underwent a form of subtotal colonic resection, one was lost from follow up and two developed carcinoma in the remaining rectal mucosa, which necessitated completion of the resection with proctectomy and permanent ileostomy. Nevertheless, in the increasing number of patients amenable to regular outpatient supervision, there are strong points for recommending sphincter-saving operations.

[The clinical, diagnostic and therapeutic characteristics in antral gastric cancer]. / Particularitati clinice, diagnostice si terapeutice în cancerul gastric antral.

This paper is part of a comprehensive study on subphrenic digestive cancer carried out between 1984 and 1988, representing the experience of the III-rd, I-st, IV-th and emergency surgical clinics of Iasi (1530 cases). The peculiarities of gastric cancer with antral site in 231 out of a total of 612 cases, representing the experience of the III-rd Surgical Clinic, are presented. Clinically, the relative early occurrence of the symptoms, the need for an endoscopic examination and biopsy for all gastric ulcer lesions, for the antral ones particularly, are mentioned. The treatment is surgical, but it has to be associated with adjuvant therapy. For the antral site, the oncological subtotal gastrectomy was the surgery of choice (157 cases), the need of restoring the transit in a gastrojejunal manner being underlined. Total gastrectomy was performed in 12 cases.

[The diagnosis and treatment of benign tumors of the subdiaphragmatic digestive tract]. / Diagnosticul si tratamentul tumorilor benigne ale tubului digestiv subdiafragmatic.

One hundred twenty-two benign tumors of subdiaphragmatic digestive tract admitted in the interval 1975-1988 at the III-rd Surgical Clinic of Iasi are reported. Out of these patients 120 required surgical treatment, the remainder of 2 being treated conservatively (diffuse intestinal angiomatosis, Peutz-Jeghers' syndrome). The clinical evolution being atypical, the surgical intervention was required, in most of the cases, due to hemorrhagic and occlusive complications. Histologically, the polyps and schwannomas were prevalent. The diagnostic difficulties, especially in the cases with jejuno-ileal localization, are mentioned.

[Antireflux surgery in the treatment of peptic esophagitis]. / Operatiile antireflux în tratamentul esofagitelor peptice.

This paper deals with the outcome of the various "antireflux" surgical procedures performed in 21 patients having esophagitis. Immediate and long-lasting results are better for those methods which restore the gastroesophageal competence: Hill's operation (4) and Nissen's fundoplication (3). The participation of the stomach in producing reflux is stressed and is emphasized the necessity to treat the gastric lesions simultaneously. The duodenal diversion following Harrington procedure offers good results with minimal surgical risk in some particular cases.