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Melanoma is an aggressive malignant tumor that most commonly occurs on the skin; however, it can also affect other organs such as the eye, meninges, and mucous membranes. The increasing incidence in recent decades determines the need for continuous improvement of prevention, diagnosis, and treatment methods. The main treatment is surgical excision with safety margins, and the most important predictor of survival and recurrence is the status of regional lymph nodes. Currently, sentinel lymph node biopsy is the standard staging method for patients with melanoma with a tumor thickness between 1 and 4 mm and with clinically negative lymph nodes for tumor invasion. This procedure consists of identifying the first lymph node, called the sentinel node, that could be invaded by the tumor, removing it, followed by its histopathological analysis. Following the evaluation of the sentinel lymph node, the necessity for regional lymphadenectomy can be determined, and also patients can receive new adjuvant therapies such as immunotherapy and targeted therapies to improve their prognosis. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is the most common form of skin cancer, originating from the basal cells of the epidermis and skin appendages. Tumors have a slow evolution, reduced malignancy, rare metastasis, but there are also extremely recurrent forms. The main symptom of basal cell carcinoma is the slow onset of an incurable tumor, usually painless, that bleeds after trauma. BCC should be considered in any patient with a skin lesion on sun-exposed areas, which does not heal in 3-4 weeks and has a slow evolution, especially if it has a central ulceration. Patients with a history of treated BCC have an increased risk of developing a new skin tumor. The treatment of choice is surgical excision, in inoperable or recurrent cases radiotherapy being used. The prognosis is usually excellent if the lesion is removed completely; its progression is associated with significant morbidity. It rarely produces regional or distant metastases, except for the meta-typical form. [ABSTRACT FROM AUTHOR]

Non-melanoma skin cancers represent the most common cancer in white-skinned individuals, with a continuous increasing global incidence. The main risk factor for their development is chronic exposure to sunlight. Unlike basal cell carcinoma, squamous cell carcinoma arises from precancerous lesions such as actinic keratoses. The diagnosis of non-melanoma skin cancer is based on clinical examination and dermoscopy, while histopathology certifies the diagnosis. The following article will present the main types of non-melanoma cancers with their respective clinical features, along with diagnostic methods and available therapeutic options. [ABSTRACT FROM AUTHOR]

Esophageal cancer is one of the most aggressive types of digestive cancers and due to the usually late diagnosis and to the peculiar anatomical localization, approximately 70% of the patients are in an advanced locoregional stage of the disease or have distance metastases which are unknown at the time of the examination, as they are in general elderly, debilitated and malnourished, often cachectic. In the case of localized esophageal cancer without locoregional extension or metastases, resection surgery remains the best solution. Gene therapy involves a wide variety of types of treatments which use genetic material for the treatment of cancer. This therapy entailed the development of methods to insert certain genes into the genome of the cancer cells by means of various transport systems or the use of other techniques which enable the cancellation of the expression of the genes involved in carcinogenesis or the use of nucleic acid (either DNA or RNA) to influence protein synthesis. Theoretically it is possible to transform either somatic or germinal cells through gene therapy, and gene therapy may be performed both in vitro and in vivo. The medical world shows particular interest towards the introduction into the therapy of specific anti-tumoral agents (antibodies, inhibitors of growth factor receptors, antagonists of the signal transduction factors, vaccines with cells presenting with antigens) associated or not with chemotherapy. [ABSTRACT FROM AUTHOR]

Background and Aim. The aim of this study was to assess the efficiency of ablative treatment for HCC stage 0 and A BCLC. Material and Methods. 90 patients diagnosed with HCC<5 cm, at the 3rd Medical and Surgical Clinic, Cluj-Napoca, were included in this retrospective study. 45 patients were treated with percutaneous ablative methods (group A) and 45 patients were treated by surgical resection (group B). All patients had post-operative follow up and the assessments were done at 1 month, 3 months and every 6 months. Follow-up schedule included a biochemical and imaging assay (abdominal ultrasound, contrast enhanced ultrasound or computed tomography). Results. The Male population (71%) has a higher incidence of HCC than the female population (29%). Median follow up was 39 months (range 3-58 months) in the group A and 47 months (range 4-60 months) in the group B, 23 patients (51.9%) had died in group A and 23 patients (51.6%) in the group B. The 1, 3 and 5 years survival rates for group A were 95.5%, 66.7%, 57.7% and for group B were 91.1%, 71.1% respectively 62.2%. Local recurrence was significantly higher in the group A with 57.8% of cases, compared to 8.89% of cases in group B (p=0.0032). Surgery had the most number of post operative complications as compared to (24.4% vs. 4.44%). The hospital stay was longer for patients who had undergone Surgery with a mean of 12.4±4.60 (2-24) days, compared to a mean of 6.71±3.31 (2-18) days in patients who had percutaneous ablation. Conclusion. Percutaneous ablation appears to be as safe and effective as surgical resection and both treatments can be considered first line options for HCC stage BCLC 0 and A. [ABSTRACT FROM AUTHOR]

Background and Aim. The aim of this study was to assess the efficiency of ablative treatment for HCC stage 0 and A BCLC. Material and Methods. 90 patients diagnosed with HCC⩽5 cm, at the 3rd Medical and Surgical Clinic, Cluj-Napoca, were included in this retrospective study. 45 patients were treated with percutaneous ablative methods (group A) and 45 patients were treated by surgical resection (group B). All patients had post-operative follow up and the assessments were done at 1 month, 3 months and every 6 months. Follow-up schedule included a biochemical and imaging assay (abdominal ultrasound, contrast enhanced ultrasound or computed tomography). Results. The Male population (71%) has a higher incidence of HCC than the female population (29%). Median follow up was 39 months (range 3-58 months) in the group A and 47 months (range 4-60 months) in the group B, 23 patients (51.9%) had died in group A and 23 patients (51.6%) in the group B. The 1, 3 and 5 years survival rates for group A were 95.5%, 66.7%, 57.7% and for group B were 91.1%, 71.1% respectively 62.2%. Local recurrence was significantly higher in the group A with 57.8% of cases, compared to 8.89% of cases in group B (p=0.0032). Surgery had the most number of post operative complications as compared to (24.4% vs. 4.44%). The hospital stay was longer for patients who had undergone Surgery with a mean of 12.4±4.60 (2-24) days, compared to a mean of 6.71±3.31 (2-18) days in patients who had percutaneous ablation. Conclusion. Percutaneous ablation appears to be as safe and effective as surgical resection and both treatments can be considered first line options for HCC stage BCLC 0 and A. [ABSTRACT FROM AUTHOR]

Although considerable progress has been made in the early diagnosis of cancer, there has not been a comparable advance in the accuracy of predicting the patient's prognosis. Prediction of prognosis in colorectal cancer is vital for the choice of an optimal therapeutic plan and, in particular, for identifying patients at high risk who have indication of adjuvant therapy. The prognostic factors with most influence on colorectal cancer are the histopathological ones. First among them is the tumoral stage, but also the degree of differentiation and histological type and subtype, all well known factors. Recent research in this area has led to the definition and understanding of additional factors considered to have stage-independent prognostic value, such as perineural invasion, tumor budding, extramural cancer deposits or intratumoral lymphocytic infiltration. In this article, the predictive value of these elements, as well as guidelines for their interpretation, are reviewed in detail. [ABSTRACT FROM AUTHOR]

The authors have operated a number of 416 patients with gastric cancer, between 1988 and 2001. Among them, 305 patients were resectable. The resection rate was of 73,3%. Total Gastrectomy (TG) was performed in 161 patients (52,8% of resections). TG with omectectomy was performed in 44 patients. 96 patients underwent splenectomy, 19 patients underwent splenectomy with resection of the left side of the pancreas and in 8 patients, other organs' resection was performed with the standard TG; two field lymphadenectomy has been performed only in the past few years. Uneventful recovery followed in 100 cases, (62%), 61 patients, (38%) suffered complications in the postoperative period. The most frequent surgical complications were anastomotic leak, which was observed in 8 patients (5%). Septic complications, intraluminal bleeding postoperative pancreatitis, intra abdominal bleeding, pancreatic fistula and small bowel obstruction were the most frequent surgical complications. Most general complications occurred in the cardiorespiratory system. In 9 patients, re-operation was necessary. Eight patients (5%) died in the postoperative period. In the patients with extended gastrectomy, significant more complications occurred compared with gastrectomy plus omentectomy. This could also be observed in the patients with splenectomy only. If more organs were removed or resected with T G. and splenectomy, the complications rate increased only if pancreatic resection was performed. Mortality rate increased in these patients as well. The esophageal or other neighbouring organs (colon, intestine, liver etc) resection had no influence on the postoperative morbidity and mortality. Extended operations should be performed as the risk is acceptable, if there is hope for tumour clearance. [ABSTRACT FROM AUTHOR]

Introduction Major liver resections, defined as removal of more than three hepatic segments, are surgical interventions marked by the risks of pre and postoperative hemorrhage and postoperative hepatic failure. There are several techniques of vascular control used to minimize blood loss during hepatectomies. Material and method This paper reports on a retrospective study of 50 patients hospitalized in Ist Surgical Clinic Tîrgu-Mureş who underwent major hepatectomies during 1st of January 2003-31st of December 2010. We evaluated the method used for vascular control, the amount of perioperative blood loss, changes in biological status and postoperative evolution. Results Most of the patients underwent right hepatectomies for both primary and secondary malignant tumors. In each case a vascular control technique was used. Remnant liver injury was appreciated by assessing changes in transaminases, bilirubine and INR values. Discussions Hepatic vascular exclusion was a more effective technique on reducing the blood loss in patients included in our study. Conclusions Typical liver resections require a good acknowledgement of hepatic anatomy in order to obtain minimal bleeding and morbidity. Vascular control is necessary and must be adapted to each individual case. [ABSTRACT FROM AUTHOR]

Inverted papilloma is a benign tumor that can have a malign clinical evolution. It appears most frequently on the lateral wall, with a maximum incidence at ethmoid sinus level. In most cases it is unilateral, causing nasal obstruction. Treatment implies total resection because of malignity and relapse risk. [ABSTRACT FROM AUTHOR]

Cutaneous melanoma (CM) is the skin cancer type with the worst prognosis. Melanoma thickness measured according to the Breslow method represents the main parameter used to establish the width of surgical margins of excision as well as to select patients for sentinel lymphnode biopsy. Several methods were proposed for the preoperative evaluation of melanoma thickness: palpation of the tumor, high-frequency sonography and dermoscopy. In case of the accurate preoperative assessment of melanoma thickness, the sentinel lymphnode biopsy could be performed together with the primary excision of the tumor. [ABSTRACT FROM AUTHOR]

Whenever periapicaly pathology remain under endodontic threatment considered correct by surgical endodontics - in this case the apical resection, it can remove the apical and periapical pathological focus, thereby creating the conditions for healing periapicaly pathological processes, tissue restructuring being complete; avoid tooth extraction, leaving a situation as favorable for future prosthetic devices. [ABSTRACT FROM AUTHOR]

Soft tissue infections (skin and annexes, subcutaneous tissue, muscles and fasciae) represent a relatively rare pathology, but very important in patients with diabetes mellitus, with high frequency and gravity because of immunodeficient status related to metabolic imbalance periods, or association of vascular, nervous, cardiac complications. Surgical treatment represents one of the important part of the complex management of these infections. This paper studies 186 patients with diabetes mellitus who have this kind of infection and indicates surgical interventions performed, also the type and the frequency of the reoperation and the relationships with the infection's severity. Based on the severity of the infections patients were classified in two groups: first is low severity, non necrotizing and infections group affecting skin and superficial layer of subcutaneous tissue, 117 patients and second - severe necrotizing infections group involving deep subcutaneous tissue, fasciae and muscles, 80 patients. The paper shows that the first operation in-group 2 is more complex than in first group, sometimes being necessary some organ excisions; in some cases there were accounted over 4-5 surgical interventions. Morbidity, advocated by length of hospitalization, and also mortality are higher in group 2 (7 deceased from 80 patients) than in group 1 (just 3 patients died in 117 patients), especially from those with sepsis at admission. More than that, the mortality raise in patients with delay interventions 6 patients died comparative with 2 deceased in patients with emergency surgery. In conclusion, for soft tissue infections in patients with diabetes mellitus, it is imposed appropriate urgent surgery, even with organ resection if it is necessary. For better results, surgical treatment must be integrated into a complex management and a multi team care. [ABSTRACT FROM AUTHOR]

Colorectal cancer is one of the most frequent cancers from over the world (1). Colonoscopy is for a very long time accepted as the most efficacy method for colorectal diagnosis and prevention. Neoplasic colonic lesions are polipoid type and non-polypoid type. Japanese classification of superficial colonic lesions (0 type) is unanimity accepted. Colonic polyps are easy to recognize. Endoscopic resection of polyps is necessary for correct diagnosis and treatment. Non-polypoid tumors are, sometimes difficult to recognize. Laterally spreading tumors typically extend laterally and circumferentially rather than vertically along the colonic wall and the frequency of invasive carcinoma is lower than for polypoid lesions of similar size. Depressed type has a high risk of malignancy even at small size. Magnification chromoendoscopy, narrow-band imaging and confocal endoscopy can improve the detection of colonic lesions and differentiating between malign and benign. [ABSTRACT FROM AUTHOR]

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The article presents abstracts related to bladder cancer which include the comparative study of the urinary cytology and cystoscopy concerning the detection of the early recurrences during follow up of patients with non-invasive bladder tumours, the study on the hexaminolevulinate (Hexviv) blue light cystoscopy (BLC) method, and the comparison of transurethral resection only with transurethral resection plus early instillational treatment for non-invasive (Ta,T1) bladder cancer.

Soft tissue sarcoma are tumours of extrabone joint tissue. These are tumours of locomotion structure and of support structures. Malignant soft tissue tumours are: hystiocitoma, lyposarcoma, leiomiosarcoma, rabdomiosarcoma, hemangiosarcoma, synovial sarcoma or another tumours like alveolar sarcoma, extrabone Ewing sarcoma. Classical prognostic factors used to evaluate muscle-bone tumours are conected to the site of initial tumour, size, stadialization, recurrent disease and resection edge. It appears that some factors which are pulmonary diseminated soft tissue sarcoma metastase-related like uni-/bilateral metastases presence, time of birth of pulmonary metastases are of great impact on survival rate towards classical prognostic factors. [ABSTRACT FROM AUTHOR]

Nasal tip is one of the most important esthetic entities of the nose and hence an important domain for a plastic surgeon to try to correct its various malpositions. Often, during the correction of nasal deformities, it is important to correct even the tip of the nose. To develop an efficient therapeutic plan, it is important to meticulously analyse all anatomic structures involved in tip rotation and its correlation with other sectors of the nose. The therapeutic plan for the correction of ptotic nasal tip includes surgical maneuvers, including resections, sutures or a number of cartilage grafts judiciously placed caudally, alar crus, supratip or alar margins to give a normal configuration to the nose. [ABSTRACT FROM AUTHOR]

During January 2004 – December 2009, we performed a clinical study based on the casuistry of the 1st Plastic Surgery Department, Mures County Hospital, Targu Mureş. We analyzed the incidence of basal cell carcinoma according to age groups, gender, type of basal cell carcinoma, localization and surgical techniques used to cover skin and soft tissue defects after tumour excision. Extensive, intensive indexes and mean values were calculated. We also measured the differences between the variations of series by using Person's chi-square statistic. The F (Fisher) test was applied to check if the two distributions present significant differences. Through our research, we wished to contribute to a common understanding necessary for anatomical and surgical studies in relation to possible approaches to minimally invasive surgical techniques in the context of interdisciplinary clinical approach. [ABSTRACT FROM AUTHOR]

The orbit represents a complex area situated on the border between cranial and facial regions. The treatment of orbital pathology is multidisciplinary with the involvement of neurosurgeons, ophalmologists, ENT surgeons, maxillofacial surgeons, oncologists and neuro-opthtalmologists. This paper presents the surgical approaches realized for tumoral orbital pathology. Modern medicine includes the orbit surgery in the skull base surgery, with continuous improvements in the last decades. The surgical treatment of the orbital tumours includes many approaches; in order to choose an approach, it is necessary to take into consideration the localization and the extension of the tumour, as well as the patient's clinical status. The tumours might be situated in any region of the orbit and an adequate approach is based on a very good imagistic study. Surgical techniques aim at accomplishing one of the following objectives: biopsy, debulking or gross total tumoral resection. [ABSTRACT FROM AUTHOR]

Duplicative tongue is a very rare anomaly. Only a few cases were reported in the literature. It can cause upper airway obstruction or eating disorders. Radical surgical excision leads to a good functional outcome. We present a case of tongue duplication associated with a mandibular outline duplication and the presence of aberrant sublingual glands. The case was surgically treated in our clinic. [ABSTRACT FROM AUTHOR]

Oral and facial defects resulted after large tumoral excision requires a reconstructive option adapted to esthetic and functional needs of the patients. Local and regional options of flaps proves to be predictibile, easy to harvest and the postoperative complications almost nule. In the ladder of reconstructive options pericranial flaps standing at the base, are going to permit selection of other complex reconstructive possibilities if needed. The temporal and fascial tempora-parietal flap through theirs large area, wide rotation angle are primary options in the reconstruction of the oral and facial defects consecutive to tumor excision. [ABSTRACT FROM AUTHOR]

Patients with large oral and cervical defects after excision of malignant tumors will present different degrees of functional and esthetic impairement. From the myriad of reconstructive options the sternocleidomastoidian muscle flap becomes an accessible, easy to perform and predictable solution. The major criteria of exclusion from the reconstructive plan is represented by the adherent cervical adenopaties to the muscle. Being a versatile solution it can be used in composite defects utilizing skin, fascia, muscle and even bone. [ABSTRACT FROM AUTHOR]

In order to evaluate the functional results, 32 cases with surgical treatment were followed, namely 19 in which the open reduction and Herbert screws fixation was attempted and 13 in which the excision of fragments was conducted. All the cases in which the excision was used showed instability, while instability was identified in only one case of osteosynthesis. The cases in which excision was used showed a clearly inferior evolution as compared to those in which osteosynthesis was used. The deterioration of the MAYO score for the cases in which excision was used is due mainly to residual instability [ABSTRACT FROM AUTHOR]

The aim of this study was to clarify whether gastric cancer in elderly patients warrants surgical resection of 300 patients whit laparotomy for gastric cancer, 33 were older and 267 were younger than 75 years (control group). Mortality, morbidity, clinio-patological features, and survival were compared between the two groups. There were no significant differences in mortality, 5 - year survival rate and morbidity between the two groups (elderly 2,9%, 36, 1% and respectively : control 0,7%, 24, 6%). Death from other diseases was 38,5% in the elderly group, and 9,1% in the control group. Conclusions: Gastric cancer in elderly patients warrants surgical resection, the benefits in early and long-term outcomes are the same as for younger patients. [ABSTRACT FROM AUTHOR]