[Hepatic hydatid cyst in minimally invasive surgery]. / Chistul hidatic hepatic în chirurgia miniinvaziva.

The hydatid cyst, especially the hepatic one has come to be considered, for some years ago, in the Mediterranean and Black Sea's countries. The distribution area of this disease has a common feature beyond the geographical area once the agricultural-economic characteristics. A disease with a therapeutic visa, especially a digestive one with highly recognized invasion can be treated using laparoscopic treatment for most of the cases, excepting cysto-digestive sutures as therapeutical solutions. That is why we inform you about some of our results, the therapeutical adapted solutions and the issued complications.

[The diagnostic and therapeutic considerations in hepatic hydatid cyst]. / Cîteva consideratii diagnostice si terapeutice în chistul hidatic hepatic.

The paper is based on 213 surgical interventions for hepatic hydatid cyst. The importance of monography in the early diagnosis, detection of multiple sites and postoperative follow-up of the cases suspected of recurrence is underlined.

[Colonic localization of Crohn's disease following a recurrent pseudotumor of the abdominal wall (problems of pathogenesis and therapy)]. / Localizarea colica a bolii Crohn, consecutiva unei pseudotumori recidivante a peretelui abdominal (probleme de patogeneza si terapeutica).

A pseudo-tumours of the abdominal wall is described, in the left hypochondrum and the left flank, that, recidivating after 5 years, invaded the splenic angle of the colon. The common histological characteristics were very clear and strongly suggested the presence of Crohn disease. The cellular elements found at the first intervention performed for the extirpation of the tumour in the abdominal wall, as well as at reintervention--consisting in the block resection of the recidivating tumour and of the segment of the colon involved (segmental colectomy)--represented by abundant plasmocytic infiltrates suggest the presence of an immune process. The problem raised is the possibility that the Crohn disease could be incriminated in both instances, since the immunological disturbances can be considered as clearly manifest.

[Splenohepatoplasty in the treatment of hepatic cirrhosis]. / Splenohepatoplastia în tratamentul cirozei hepatice

The authors review the patho-physiologic arguments that have determined Bénichoux to recommend spleno-hepatoplasty in the treatment of hepatic cirrhosis, and present a group of 7 personal observations in which they have tested this type of intervention. The technique employed is described, as well as the follow-up of the cases that had a favourable evolution. In one of the observations differences between the samples obtained by bioptic puncture before the intervention and those obtained at one and two years after surgery, have demonstrated a marked reduction in the intensity of inflammatory reactions, as well as evident reparation processes in the hepatocytes. The authors consider the intervention as a new type of therapy, allowing for re-vascularization of the ischaemic hepatic tissue, as well as for a slow porto-caval derivation with remarkable results for the cirrhotic patients.

[Morphological and enzymatic studies of the supratumoral distended colonic loop in colorectal cancers (therapeutic aspects)]. / Studii morfologice si enzimatice asupra ansei colice destinse supratumoral in cancerele colorectale (aplicatii terapeutice)

The authors carried out experimental and clinical studies in an attempt to explain the causes leading to anastomotic dehiscences, a major complication of exeresis surgery of the left colon and of the rectum. In this view they have performed in dogs incomplete stenoses at the level of the sigmoid and also made parallel studies of the morphological and histochemical changes occuring in the supra-stenosis colon wall, with those of the supra-tumoral colon wall found in human colo-rectal carcinomas, in the "sub-occlusion" stage. Histological alterations are presented, characterized by marked edema in all the layers of the wall, leading to evidently hampered colon vascularization. From the enzymological viewpoint there was noted an intensive phosphatasic and ATP-ase reaction in all the layers of the colon wall. These studies led to the conclusion that it is necessary to evaluate the degree and the duration of the supra-tumoral colic distension before a decision is taken to carry out primary colectomy or rectal resection (single-step procedure), and not to avoid the practice of a seriated intervention when necessary. The reversibility of the lesions noted by the authors allows for the possibility to perform a resection after the colic wall to be anastomosed has returned to an almost normal condition, thus avoiding the dehiscence of the sutures.