stiinte med 1 2012.indd - Academia de Ştiinţe a Moldovei

Ştiinţe Medicale
Bibliografie
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laparoscopică S. Duca (sub red.), Editura “Paralela
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Rezumat
Lucrarea dată prezintă un studiu al tratamentului chirurgical
a 115 pacienţi cu formaţiuni de volum suprarenale,
trataţi în Clinica de Chirurgie nr. 2 a USMF „Nicolae Testemiţanu”
pe parcursul anilor 1996-2012. Prin abord deschis
(lumbotomie sau laparotomie) au fost operaţi 82 (70,68%)
de bolnavi, iar 34 (29,31%) au fost operaţi laparoscopic.
S-a remarcat că adrenalectomia laparoscopică este însoţită
de mai puţine complicaţii intra- şi postoperatorii, comparativ
cu adrenalectomia deschisă.
Summary
This report presents a study of a surgical treatment
of 115 patients with adrenal tumors treated in Clinic of
Surgery 2 of State Medical University ”N. Testemitanu”,
during the period of 1996-2012 years. By open
adrenalectomy (lumbotomy or laparotomy) were treated 82
(70,68%) patients, and 34 (29,31%) of them were operated
laparoscopically. Was remarced, that in laparoscopic
adrenalectomy where less operatory or postoperatory
complications, then in open adrenalectomy.
245
Резюме
В данной работе представлены результаты хирургического
лечения 115 больных с новообразованиями
надпочечников, прооперированных в клинике хирургии
nr. 2 ГУМФ «Николае Тестемицану» за период с
1996 по 2012 г. Открытым доступом (люмботомия или
лапаротомия) были оперированы 82 (70,68%) больных,
лапароскопически – 34 (29,31%) больных. Было выявлено,
что при лапароскопических адреналэктомиях
встречаются меньше осложнений, чем при открытых
операциях.
ACUTE GENERALISED PERITONITIS
IN CHILDREN.
TERAPEUTHICALLY OPTIONS
_______________________________________
Eva Gudumac, Professor, Academician,
Natalia Cojuşneanu, doctoral study,
Jana Bernic, Ph.D.M., Professor, The State
Medical and Pharmaceutical University
„Nicolae Testemitanu”
Actuality
Acute generalized peritonitis is the most common
cause of lethality in abdominal surgery in children.
The clinical trials determined that the most common
cause of peritonitis is acute complicated appendicitis.
In the case of perforated or gangrenous appendicitis,
the morphopathologically changes are typically not
only for acute appendicitis, but for local peritonitis,
diffuse or generalized. In this case, the diagnosis
should be enlarged in this manner to be complete [1,
2, 4, 5].
A massive inoculation of bacteria in abdominal
cavity is present in the case of perforation or gangrene
of appendix (through the wall of appendix). The
inflamation of appendix is due to an association of
bacteria, especially anaerobic. This fact determines
major disturbances, clinical signs and severe
prognosis in acute appendicitis, in comparison with
acute perforation of stomach, duodenum, etc. [4, 8,
9, 11, 13].
The acute appendicitis presents the clinical signs
of peritonitis, at least after 24-48 hours of illness
which are dependent of appendix position, type of
defense reaction of peritoneum, omentum and of
growing host organism [7, 12, 13].
In some cases, there are very untypical clinical
features, because of anomalies of gastrointestinal
tract, and abnormal position of caecum and appendix.
Sometimes, an abscess may be formed, behind
of perforation of appendix at which, omentum is
adhered [5, 11]. In all the cases of positive diagnosis,
an emergency surgical treatment is indicated.