RESUMEN
BACKGROUND: During the pandemic, our hospital became a COVID support hospital and consequently the cardiology clinic had restricted activity; thus, it received only suspect and/or patients confirmed positive with the various COVID-19 strains that were associated with a chronic/flaring cardiovascular pathology. METHODS: Two batches of patients admitted during a one-year period were compared in the cardiology clinic over two different periods of time: BATCH I (1 April 2019 to 31 March 2020), in a non-COVID context (BATCH I N-COV) and BATCH II (1 July 2020 to 30 June 2021) comprising patients that presented with respiratory infection of SARS-CoV-2 (BATCH II COV-2), associated with chronic and/or acute cardiovascular condition. To determine the profile of the patients admitted in our clinic, we observed the following parameters: age, type of cardiac condition, and admission mode (for the N-COV group). RESULTS: The data obtained as absolute numbers and as percentages in relation to the total number of admissions were presented in separate tables and graphs for both of the studied groups. CONCLUSIONS: The SARS-CoV-2 pandemic, in its almost two years of evolution, has divided the medical world in two main categories: COVID and non-COVID. Admission of the patients with chronic, but non-COVID cardiac conditions, in our case, dropped to almost one-quarter when we compared the two absolute admission numbers: 1382 in the year prior to pandemic compared with only 356 in the pandemic year. We believe that the number of deaths due to SARS-CoV-2 infection was infinitely higher than the reported ones and uncountable, in as much as COVID-19 did not kill only the infected patients, but it has also yielded a very large number of collateral victims among chronic patients who had no contact with the disease, but were unable to be admitted and treated for chronic heart disease.
RESUMEN
AIM: To present our experience in esophagogastric cancer. MATERIAL AND METHOD: Fifty nine subjects with esophagogastric junction cancer (52 men and 7 women, aged between 41 and 74 years), selected from 79 esophageal cancer patients admitted in the last 20 years (1982-2002) were analysed. The diagnosis was established on the clinical picture (esophageal syndrome 54 cases, weight loss 51 cases, anemia 49 cases), on the imaging tests (chest X-ray, barium swallow and CT scan) and endoscopy. The delay of the diagnosis was more than 1 year in 71.5% of cases. 47 (79.7%) cases were operated on; we performed 18 resections (14 total esophagogastrectomies with end-to side esophagojejunostomy and 4 partial esophagogastrectomies with intrathoracic esophagogastrostomy), 24 gastrostomies and 5 exploratory laparotomies. The surgical approach was left thoracotomy with frenotomy in all 18 resectable cases. All resected cases were adenocarcinomas, belonging to the II B and III pTNM stages. RESULTS: refer only to the resected cases. We registered: fair evolution in 13 cases (72.2%), postoperative morbidity rate of 27.8% (5 cases) and postoperative mortality rate of 5.5% (1 case). We also registered the following long term survival: 7 cases less than 6 months, 6 cases between 6 months and 1 year, 3 cases between 1 and 3 years and 2 cases over 5 years. CONCLUSIONS: 1. preoperative assessment of the local invasion and lymphatic spread is very difficult; 2. surgical exploration is the only certain method for the assessment of resectability; 3. left thoracotomy with VII or VIII rib resection and frenotomy is the best surgical approach; 4. total esophagogastrectomy with end-to side esophago-jejunostomy is the main surgical procedure in the esophagogastric junction cancers.
Asunto(s)
Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/cirugía , Unión Esofagogástrica , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: To point out the morphologic, clinic and therapeutic aspects of pancreatic cystic tumors. MATERIAL AND METHOD: 34 pancreatic cystic tumors (21 males and 13 females, aged between 21 and 68 years), admitted in the last 15 years were analyzed. They were true cysts in 3 cases (9.9%) and pseudocysts in 31 cases (91.1%), located on the head of the pancreas in 8 cases, on the body in 19, on the tail in 6 and on the body and tail in 1 case. We noticed in the past medical history of the patients with pseudocysts a recent acute pancreatitis attack (26 cases), chronic pancreatitis (4 cases) or a recent abdominal trauma (1 case). The delay between the acute pancreatitis attack and the onset of the pseudocyst varied between 18 days and 2 months. The diagnosis was established by clinical picture (Shefer-Silvis triad), laboratory findings and imaging tests (barium meals, ultrasound test and/or CT test). Thirty cases (27 pseudocysts and 3 true cystic tumors) were operated on: the main surgical procedures were cystogastrostomy (12 cases), cystojejunostomy (6 cases) or cystoduodenostomy (3 cases); we also performed distal pancreatectomy (3 cases), laparostomy or external drainage in 5 cases. RESULTS: We registered 1 death (mortality rate of 3.3%), 2 pancreatic fistulae, 1 pancreatic abscess and 2 recurrences. CONCLUSIONS: 1. The pseudocyst, as an evolutionary complication of acute or chronic pancreatitis, is the most frequent cystic tumor of the pancreas, true pancreatic cysts being extremely rare. 2. The diagnosis is established by clinical pictures, laboratory findings and imaging tests. 3. The treatment is surgical, cystogastrostomy or cystojejunostomy being the main surgical procedures.