The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Sunday, December 17 2017 @ 09:15 EET

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Single-Stage Reconstruction of Distal Third of the Dorsum Nasi Using a Nasolabial Flap after Removal of Basal Cell Carcinoma

2017-01

Tiberiu Paul Neagu, Mirela Tiglis, Ioana Cristina Grintescu, Sebastian Valcea, Serban Arghir Popescu, Ioan Lascar

The nose represents a common site for skin cancer, especially for Basal Cell Carcinoma (BCC) which is the most common malignant tumor in humans[1-3]. The removal of the tumor will lead to a defect that can involve skin, cartilage and even nasal mucosa. Therefore, reconstruction of this tridimensional structure can be a challenge even for the most experienced surgeons[4]. There are many techniques described in the literature for restoring the lining and skeletal framework[1-8], but all of these techniques should be adapted to the patientís needs. In this paper we described our preferred surgical method to cover a medium defect of the distal third of the dorsum nasi after tumor excision using a nasolabial flap. In order to perform a single-stage reconstruction, we pushed the limits of the flap measurements and did some tricks so as the pedicle to be well fitted, leading to good aesthetic results. [...]

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Transmandibular Excision of Symptomatic Large Parapharyngeal Rhabdomyoma - Case Presentation and Literature Review

2017-01

Andreea Nae, Patrick Sheahan

Adult rhabdomyoma is a very rare slow-growing tumor arising in the head and neck region. It has a male predilection and a mean age of 60 at presentation. The most common head and neck sites for this tumor are floor of mouth, oral cavity and parapharyngeal space[1-3]. Common presenting complains of the patients are fullness around the angle of the mandible or airway obstruction if the tumor is present in the parapharyngeal space. Investigations should include FNA or biopsy and imaging of the neck. Imunohistological studies should be performed as due to its rarity, the rhabdomyoma sometimes could be difficult to diagnose on routine histology and also for confirmation of the diagnosis. Complete surgical excision is mandatory as recurrences occur in incomplete removal of the rhabdomyoma. [...]

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Iatrogenic Ureteral Injury Following Radical Hysterectomy - Case Presentation

2017-01

Dragos Radu Marcu, Ovidiu Gabriel Bratu, Dan Arsenie Spinu, Ioana Sorina Oprea, Ileana Adela Vacaroiu, Bogdan Florin Geavlete, Camelia Diaconu, Dan Mischianu

Iatrogenic ureteral injuries represent an important complication of abdomino-pelvic surgery with serio-us consequences in the absence of a prompt diagnostic and adequate treatment. According to literature it has been estimated that over 75% of all ureteral injuries are iatrogenic and that the incidence of ureteral lesions during an abdomino-pelvic surgery ranges from 0.5% to 10%[1-5]. Studies concerning this pathology have shown that obstetric and gynecological surgery accounts for approximately 50-60% or even more, followed by colorectal surgery 10-25%, vascular surgery (aortoiliac and aorto-femural bypass) and urological surgery 15-30% (classic, laparoscopic and endoscopic approach)[5-11]. [...]

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Breast Reconstruction Particularities after Radiotherapy - Case Report

2017-01

Iulia Gabriela Marcu, Ovidiu Stefanescu, Cristian Radu Jecan, Laura Raducu, Tiberiu Paul Neagu, Ioan Lascăr

Postmastectomy radiation therapy decreases the incidence of locoregional disease recurrence in patients with invasive breast cancer and has been proven to reflect a survival advantage for patients with node positive disease[1,2]. The optimal timing and technique of breast reconstruction procedures in patients requiring post-mastectomy radiation therapy are controversial[1] . Patients undergoing postmastectomy breast reconstruction, with a history of prior radiation therapy, present a particular clinical scenario. This is because of their well-documented higher complication rates, secondary to deleterious effects of irradiation on the soft tissue envelope of the remaining breast. [...]

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Multivisceral Resection for Pancreatic Adenocarcinoma. Case Report and Literature Review

2017-01

Sebastian Valcea, Octavian Enciu, Cosmin Pantu, Mihaela Vartic, Tiberiu Paul Neagu, Mircea Beuran

Pancreatic cancer (PC) remains a deadly disease with a dismal prognosis in which the mortality rate nearly equals its incidence [1,4]. Despite advances in modern chemoradiotherapy, the best and only chance of cure for patients with PC is an oncological surgical resection aimed at complete removal of all gross and microscopic disease[5]. Early disease and curative-intent surgery are the best predictors of outcome. Locally advanced cancer of the pancreatic tail involving adjacent organs is often considered unresectable. Radical distal pancreatectomy with en bloc resection of the invaded viscera with or without vascular reconstruction was introduced to treat these tumors[2,3]. Tumors of the body and tail have evidence of involvement of surrounding structures either by tumor infiltration or inflammatory adhesions. In such circumstances, it is advisable to perform en bloc resections to obtain negative surgical margins[6]. According to Shoup, multivisceral resections are technically feasible and, based on the limited data available, these resections are associated with improved survival (5-year survival rates of 16-22%) [7,8]. Given the high morbidity and mortality associated with these procedures, they should be performed only when the possibility of achieving R0 seems distinctly feasible[3,6,8]. [...]

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