Tag Archives: fistula

The Importance of Histo-pathological Factors in Setting the Long Term Prognosis for Non-small Cell Lung Cancer

Suciu B1, Bud V1, Copotoiu C1, Brânzaniuc Klara2, Copotoiu Ruxandra3, Fodor D1, Butiurcă V4

1 County Emergency Clinical Hospital Tîrgu Mureș, Surgical Clinic I
2 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Anatomy and Embriology
3 County Emergency Clinical Hospital Tîrgu Mureș, Clinic of Anesthesia and Intensive Care
4 Student, University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: In the last decades, the rate of pulmonary cancer has risen alarmingly. Pulmonary cancer represents the main cause of death in women and men in the United States of America, 100,000 new cases being registered annually in men and 50,000 new cases in women. The purpose of our study is to evaluate the importance of histo-pathological factors in the long term outcome of patients operated for lung cancer.
Material and methods: In order to write the present paper, we carried out a retrospective observational study on a period of 6 years. We used the casuistry of the Surgical Clinic I of the County Emergency Clinical Hospital Tîrgu Mureș. We studied all the patients’ papers who were admitted to Surgical Clinic I from the 1st of January 2005 till 31 December 2010. Further, we based our research on 197 patients that were admitted to Surgical Clinic I for bronchopulmonary tumors.
Results: We studied the importance of the T descriptor (tumor) from the TNM staging for establishing the long term prognosis. The value of p was 0.1676 so we didn’t obtain any value of statistical importance. We also took into consideration the value of N from the TNM staging as a prediction factor for long term survival in patients who underwent surgical intervention for pulmonary cancer. The p parameter was 0.0152 so we can say that we obtained a direct connection between the stages of lymph nodes metastasis and long term survival rate.
Conclusions: Long time survival rate of the patients depends on the histological type of the tumor. Long term survival prediction rate is better if the patients are over 60 years, compared with patients under 60 years. The N descriptor can be considered an important prediction factor, while the T descriptor’s value is useless. The existence of N’s descriptor in more stages of the TNM classification shows its limits and encourages for further improvements.

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Acute Infusion Reaction to Infliximab in a Case of Crohn’s Disease with Recto-Scrotal Fistula

Hoduț A, Simedrea I, Belei Oana, Militaru Andrea, Bojinescu Raluca, Brad Giorgiana

First Pediatric Clinic, Faculty of Medicine, University of Medicine and Pharmacy, Timișoara, Romania

Crohn disease is an inflammatory bowel disease that involves any region of the alimentary tract from the mouth to the anus and it is transmural. Children with early onset are more likely to have colonic involvement. Infliximab constitutes today one of major therapeutic approaches in severe and fistulising cases of Crohn disease. We present the case of a 16 year-old boy who was admitted to our department presenting recto-scrotal fistula, fever, tenesmus, red-bloody stools, pain during and after defecation. In order to induce remission of the disease, we administrated Infliximab. The initial response to therapy was good, but he developed an acute infusion reaction during the administration of the 3rd dose, which forced us to quit this therapy.

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The Use of Heterologous Bovine Pericardium in the Closure of Bronchial Stump After Lung Resections, Experimental Study

Bud V1, Suciu B1, Copotoiu Ruxandra2, Sin Anca3, Cotoi O3, Butiurcă V4, Cordos B5, Brânzaniuc Klara6, Copotoiu C1

1 1st Surgical Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 ICU, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
3 Department of Anatomopathology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
4 Student, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
5 Veterinarian, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
6 Department of Anatomy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: There are many authors who have devoted their time and expertise to find creative ways for an ideal suture of bronchial stump. Despite their efforts, the bronchial fistula rate reported in the specialty literature remains high, between 2–16%, depending on the author. There are two methods for closing bronchial stumps: manual and mechanical suture. The aim of this study was to experiment a new technique for closing bronchial stumps after lung resections.
Material and method: In order to carry out this study we used 15 common rabbits. We performed left inferior lobectomy in these rabbits. These rabbits were divided into three groups according to the methods used to close the bronchial stump. We used three methods for closing the bronchial stump: simple running suture, suture of the bronchial stump using two vicryl mesh patches and suture of the bronchial stump using two heterologous bovine pericardial patches.
Results: We did not notice any cases of bronchial stump fistula. The most important changes that appear during the bronchial stump healing are: inflammatory response, angiogenesis, hyperplasia of the smooth muscle fibres, migration of fibroblasts and fibrogenesis.
Conclusions: Healing signs appeared on all examined samples, but they were more intensive in the group where we used the heterologous bovine pericardium for closing the bronchial stump. Some further studies are necessary to examine the effectiveness of the use of heterologous bovine pericardium to protect the bronho-anastomosis.

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