Surgery, Gastroenterology and Oncology

Read article Due to the mixed etiology of liver disease, cirrhotic patients with hepatocellular carcinoma may have either a pro-thrombotic or a bleeding tendency. Haemostatic assessment and blood management represent key issues during liver transplantation (LT) having a significant impact on survival and postoperative outcome. Our aim was to assess haemostatic profile in liver transplant recipients with hepatocellular carcinoma (HCC) and to evaluate its impact on perioperative anaesthetic management. We prospectively included 122 patients that underwent liver transplantation between January and D....[more]

Read article Hepatocellular carcinoma is a common malignancy which, in specific stages, benefits from transarterial chemoembolization. The survival of treated patients depends on the accurate interpretation of follow-up studies after the procedure, with focus on the early detection of residual tumor or tumor recurrence. Dynamical contrast enhanced CT and MRI are sensitive methods in evaluating tumor response, although diffusion weighted imaging and other new modalities can improve the diagnostic role of these tests. A strong knowledge of common and rare imaging signs of neoplastic tissue in a che....[more]

Read article Introduction: Complete resection is the most important prognostic factor in surgery for pelvic tumors. In locally advanced and recurrent pelvic malignancies, radical margins are sometimes difficult to obtain because of close relation to or growth in adjacent organs structures. Total pelvic exenteration (TPE) is an exenterative operation for these advanced tumors and involves en bloc resection of the rectum, bladder, and internal genital organs (prostate seminal vesicles or uterus, ovaries and or vagina).
Methods: Recommendations with respect to extended surgical sta....[more]

Read article The objectives of the study: Advanced or recurrent sinonasal malignancies sometimes need, besides an ablative step,a reconstructive step.If this occurs, the reconstructive step may require advanced knowledge of reconstructive surgery because of the complex remnant defects after ablation.
The methodology: The authors present a surgical reconstructive solution that can be used in cases of advanced sino nasal tumors which associate the destruction of the malar region.This requires a midfacial flap which will provide a solid support for the paramedial forehead flap.more]

Read article Introduction: Budd-Chiari syndrome associated with inferior vena cava (IVC) thrombosis extended to the right atrium is a rare condition, which requires liver transplantation with different techniques of caval reconstruction. The procedure is technically demanding, especially if it is performed solely transdiaphragmatically.

Case presentation: An orthotopic liver transplantation (OLT) was performed in April 2014 in a 24-year old male patient with Budd-Chiari syndrome due to idiopathic thrombophilia and complete thrombosis of the retrohepatic IVC, up to its intrap....[more]

Read article Background: In the last few decades central pancreatectomy is increasedly adopted in treatment of benign pancreatic lesions situated in the body of the pancreas, especially in young patients. With recent advances in technology, patients with these lesions could benefit from the advantages of the robotic approach.

Case presentation: We present the case of a 30-years old woman investigated for epigastric pain. CT showed a 3 cm cystic tumor located in the proximal part of the pancreas body. Robotic central pancreatectomy with pancreatogastrostomy was performed.
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Read article Cervical cancer is an aggressive gynecologic malignancy with a high capacity of local tumor spread and involvement of the surrounding organs. In these cases multiple pelvic organ resection might be needed to obtain a good local control of the disease.
Although plevic exenteration has been considered for long time as a debilitant procedure associated with unacceptable risks of postoperative complications, in the last few decades it has been recognised as a salvage therapy and the only possible chance for cure for these cases which can be safely applied in elderly patients too. more]

Read article Introduction: The palatine tonsil is one of the most common locations of oropharyngeal cancer. In the early stages T1, T2 and selected cases T3 the transoral surgical approach is preferred.
Case presentation: We present the case of a 42 years old patient, who underwent the surgical removal of malignant tumor located at the level of the right tonsil extended to the soft palate, retromolar trigone and hypopharynx, through combined approach followed by modified radical neck dissection. The postablative defect was reconstructed using a rotated musculo-cutaneous flap fro....[more]

Read article Vulvar cancer is a common gynecologic malignancy affecting especially elderly women worldwide, which is usualy diagnosed in patients with HPV positive cytology.
The most frequently seen histopathological subtype remains squamous cell vulvar carcinoma.

We present the case of a 73 year old patient who presented with a giant vulvar carcinoma in which a radical hemivulvectomy with bilateral inguinal lymph node dissection was performed.