No abstract

Introduction: The surgical approach for treating ventral hernia is still under debate, as well as the optimal devices to be used for such treatment. For small size defects, the tendency is to use the open approach, due to the lower cost/efficiency ratio. However, for medium-size defects, even though costlier, laparoscopy provides better results. The present study analyzes the results of a simple and effective laparoscopic technique for mesh repairing of small and medium size ventral defects using Ventralex® ST patch. Method: Between January 1, 2015 and January 31, 2020, 93 patients with ventral primary nonobstructive abdominal wall defects (up to 3 cm) treated laparoscopically using the intraperitoneal onlay mesh repair technique with Ventralex® patch (22 patients) and Ventralex® ST patch (71 patients). Results were prospectively analyzed based on postoperative complications, postoperative pain, recurrent hernia, and quality of life. Results: The technique was used in 60 patients with umbilical hernia (64.5%), 18 patients with juxta-umbilical hernia (19.3%), and 15 patients with epigastric hernia (16.1%). Out of these, 22 patients had nonreducible (nonobstructive) hernia. The median operating time was 55 minutes (range 40–80 min). Minor complications were recorded in 15 cases (16.1%). The mean hospitalization time was 1.24 days (range 1–2). After a median follow-up of 39 months (range 20–81), the recurrence rate was 11.1% and nil (p = 0.010), and other complaints were recorded in 11.1% and 3.3% of patients (p = 0.293), for Ventralex® patch and Ventralex® ST patch, respectively. Conclusions: In conclusion, the use of Ventralex® ST patch for laparoscopic intraperitoneal onlay mesh repair of small and medium size ventral hernia is simpler and more cost-effective than standard laparoscopic patches, with superior results when compared to Ventralex® patch.

The rupture of the inter-ventricular septum is a rare, but extremely severe mechanical complication of the acute myocardial infarction, which in most cases of no immediate surgery is fatal (30 days death rate – 80%). The incidence of the septum ventricular defect post-acute myocardial infarction was 1-3% in the period before crash injury therapy, dropping to 0.2% after introducing the thrombolytic treatment. The acute mitral failure and the septum ventricular defect are two mechanical complications of the acute myocardial infarction associated with high death rate, regardless of the progress made in medical and surgery therapeutic approach. This paper highlights the peculiarities of a clinical case like the acute myocardial infarction as the first manifestation of heart disease in a patient with no history of cardiovascular disease but with risk factors (obesity, dyslipidemia, hypertension), the ECG evident changes in the anterior territory and more discrete in the inferior territory, which established the initial diagnosis to be myocardial infarction and the presence of two mechanical threatening complications: ventricular septal flaw and acute mitral failure through posterior papillary muscle incomplete rupture.

Pelvic inflammatory disease (PID) plays an important role in the evolution of sexually transmitted diseases (STD). The most frequently identified microorganisms are Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium. The case report presented deals with a severe ominous presentation of bilateral adnexal compromise in a 52 year old woman, and the events that leaded to a bilateral adnexectomy.

Background: The last decades have been marked by debates based on the importance of lymphadenectomy in gastric cancer, lymphadenectomy being a topic of controversy between the Western Surgical Societies and the Asian side. Lymphadenectomy is currently a globally accepted standard in the treatment of gastric cancer. Methods: The present study was performed prospectively on a number of 93 patients diagnosed with gastric cancer, who underwent radical gastrectomy with lymphadenectomy in the Surgery Department of the Emergency County Clinical Hospital, Constanta, between January 2012 - December 2016. In 70 cases, an extended D2 or standard D2 lymphadenectomy was performed, and for 23 patients: D1 + lymphadenectomy. The data were statistically analyzed in order to determine the prognostic value of lymphadenectomy in gastric cancer. Results: The average age was 65.88 ± 8.80 years. The mean number of lymph nodes harvested in D2 lymphadenectomy was 22.8 ± 7.60, with limits between 15 and 43, and the number of positive lymph nodes ranged from a minimum of 0 to a maximum of 37. Histopathological exam of specimens showed that only 17.2% of patients with gastric cancers were without lymph node metastases (pN0), while 45.16% were in the pN3 stage. Analysis of survival curves revealed that 5-year survival was significantly higher in D2 lymphadenectomy compared to D1 + lymphadenectomy (23.8% vs. 8.7%). Conclusions: The current study validates D2 lymphadenectomy as a standard technique and the superiority of the prognosis in gastric cancer patients through results obtained in terms of 5-year survival.