RezumatIntroducere: Diverticulul Zenker constituie o patologie rară, selecţia pacienţilor pentru tratamente invazive este discutabilă, precum şi metoda terapeutică aplicată. Scopul studiului este de a evalua principalele metode de tratament-chirurgical clasic si endoscopic, în această patologie şi de a corela aspectele fiziopatologice cu consecinţele clinice. Material şi metodă: Am inclus în lotul de studiu 36 pacienţi cu diverticuli cervicali Zenker trataţi în perioada 2010/2017 în două clinici universitare: 7 pacienţi prin abord chirurgical clasic la Clinica de Chirurgie Generală şi Esofagiană a Spitalului Clinic Sfânta Maria Bucureşti şi 29 de pacienţi cu abord endoscopic la Departamentul de Endoscopie Digestivă de Diagnostic şi Intervenţională din cadrul Institutului Regional de Hepatologie şi Gastroenterologie Prof. Dr. Octavian Fodor, Cluj-Napoca. Vârsta pacienţilor a fost cuprinsă între 42 şi 84 ani şi în decada a 7a -15 pacienţi. Rezultate: Miotomia cricofaringiană s-a efectuat la toţi pacienţii. Diverticulectomia s-a practicat la 7 pacienţi, cei trataţi chirurgical. Durata de spitalizare medie a fost de 4 zile. Complicaţii intraprocedurale au prezentat 3 pacienţi trataţi endoscopic şi au constat în apariţia hemoragiei laminare. La 2 pacienţi s-a practicat hemostază endoscopică cu clipuri şi pensă caldă iar la un pacient s-a efectuat hemostază endoscopică cu clipuri. Complicaţiile postprocedurale au fost: dureri locale, leucocitoză, melenă, febră,

This study does not propose to elucidate how adiponectin secretion is regulated, but how its adiponectin concentration is an indicator of heart disease. About adiponectin, it is not known whether it is functionally an enzyme, or very likely a cytokine/chemokine/hormone, secreted by fat cells/adipocytes in the abdomen. Abdominal fat secretes 67 hormones, and all of which cause disease. For example, adiponectin generates diabetes and ischaemic heart disease via dyslipidemia. Based on clinical symptoms, electrocardiographic and echocardiographic parameters, a group of 208 patients with diastolic cardiac dysfunction with or without preserved systolic function, developed on a background of painful chronic ischaemic heart disease, stable angina on exertion, was constituted. The serum levels of adiponectin, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were measured. Using the identified values, it was appreciated whether adiponectin correlates with the type of any of the two conditions, so that it can be recognised as a diagnostic and risk stratification marker.

Background: Mucosal perforation during laparoscopic esocardiomyotomy is quite frequent, and its consequences cannot always be neglected. The purpose of the study is to investigate the risk factors for intraoperative mucosal perforation and its implications on the postoperative outcomes and the functional results three months postoperatively. Material and methods: We retrospectively identified the patients with laparoscopic esocardiomyotomy performed at Sf. Maria Hospital Bucharest, in the period between January 2017–January 2022 and collected the data (preoperative—clinic, manometric and imaging, intra-and postoperative). To identify the risk factors for mucosal perforations, we used logistic regression analysis. Results: We included 60 patients; intraoperative mucosal perforation occurred in 8.33% of patients. The risk factors were: the presence of tertiary contractions (OR = 14.00, 95%CI = [1.23, 158.84], p = 0. 033206), the number of propagated waves ≤6 (OR = 14.50), 95%CI = [1.18, 153.33], p < 0.05), the length of esophageal myotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), the length of esocardiomyotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), and a protective factor—the intraoperative upper endoscopy (OR = 0.037, 95%CI = [0.003, 0.382] p < 0.05). Conclusions: Identifying risk factors for this adverse intraoperative event may decrease the incidence and make this surgery safer. Although mucosal perforation resulted in prolonged hospital stays, it did not lead to significant differences in functional outcomes.

No abstract

Background: Patients with chronic pancreatitis can suffer from a range of intense pain, as well as problems related to the functioning of the digestive organs, the evaluation of the quality of life can provide valuable information about the level of physical and emotional discomfort felt by the patients after the surgical intervention. Methods: A prospective study was carried out in the period 2014-2020 in which 113 patients with benign pancreatic pathology treated surgically admitted to the CF2 Clinical Hospital in Bucharest were included. For this study, the statistical method of simple linear regression was applied. Results: Patients' quality of life can also be influenced by the level of social support and medical care they receive. A strong support network, which can provide emotional and practical support, as well as access to appropriate and specialist medical care, can play an important role in managing symptoms and improving patients' quality of life. Conclusions: Although patients in this study experienced significant improvement in symptoms and ability to perform daily activities, it is important to pay attention to and manage persistent symptoms and postoperative complications to ensure the best possible quality of life.