Lupaşcu C
Grigore T. Popa University of Medicine and Pharmacy
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Publication
Featured researches published by Lupaşcu C.
Jsls-journal of The Society of Laparoendoscopic Surgeons | 2011
Radu Moldovanu; Târcoveanu E; Dimofte G; Lupaşcu C; Bradea C
Even more experienced laparoscopic surgeons in this report became better prepared to perform a surgical procedure doing simple exercises on a virtual reality simulator before the actual procedure.
Legal Medicine | 2003
Ciprian Lupascu; Lupaşcu C; Daniela Beldiman
We report the case of death of a 75-year-old Caucasian woman, produced by three different ways of mechanical asphyxia: smothering and strangulation by hand and traumatic asphyxia by thoracic compression. All these criminal offences were carried out by one single assailant who compressed the mouth and the nose of the victim with the left hand, squeezed her neck with the right hand and pressed her thorax with the knees.
Acta Chirurgica Belgica | 2009
Târcoveanu E; Dimofte G; Bradea C; Lupaşcu C; Moldovanu R; Vasilescu A
Abstract Peritoneal tuberculosis is uncommon in developed countries, but as the general incidence of tuberculosis is on the rise in Romania so is the case with peritoneal localization of the disease. The present study retrospectively analyzed 18 patients (8 males and 10 females, mean age 50 years, range 17–74 years) diagnosed in our department with peritoneal tuberculosis between 1995 and 2007. Results: Ascites was present in all but one case. Other common findings were weight loss (12 cases), weakness (5 cases), abdominal pain (16 cases), anorexia (6 cases) and night sweat (3 cases). Abdominal ultrasound has been used to demonstrate ascites in 16 cases. Only two patients had chest radiography suggestive for active tuberculosis. Laparotomy was performed in four cases, laparoscopy in 14 cases (two conversions). Intraoperative findings included multiple diffuse involvements of the visceral and parietal peritoneum, white “miliary nodules” or plaques, enlarged lymph nodes, ascites, “violin string” fibrinous strands, and omental thickening. Biopsy specimens showed granulomas, while ascitic fluid showed numerous lymphocytes. We conclude that the symptoms of abdominal tuberculosis vary greatly, and laparoscopy can be essential for diagnosis and management. The operation is safe, reliable with few complications and permits a prompt diagnosis, necessary to cure the patient.
Hepato-gastroenterology | 2011
Lupaşcu C; Moldovanu R; Andronic D; Ursulescu C; Vasiluţă C; Răileanu G; Fotea; Târcoveanu E
Pancreaticoduodenectomy is the best treatment for the patients with malignant tumors of the pancreatic head. However, the procedure is also recommended in some benign pancreatic tumors. The posterior approach allows early dissection of the superior mesenteric artery, portal vein and retroportal pancreatic lamina, before any pancreatic or digestive transection. We present a 42 year old woman diagnosed with a pancreatic tumor. The clinical and biological data suggested the diagnosis of insulinoma. The computed tomography showed a nodule located in the pancreatic head with a typical vascular pattern for endocrine tumor. The exam also revealed a rare vascular variant, a common hepatic artery which arises from the superior mesenteric artery. A pancreaticoduodenectomy has been performed. We used the posterior approach which allowed the correct dissection and exposure of the abnormal common hepatic artery. The postoperative course was uneventful. Posterior approach during the pancreaticoduodenectomies avoids arterial injuries that might compromise the liver arterial supply. It is especially indicated when preoperative imaging studies diagnose anatomic variants of the hepatic arteries.
Neurologia Medico-chirurgica | 2013
Mihai Popescu; Valentin Titus Grigorean; Crina Julieta Sinescu; Lupaşcu C; George Popescu; Aurelia Mihaela Sandu; Iancu Emil Plesea
Cavernous haemangioma (cavernoma) is a benign vascular lesion, exceptionally located in cauda equina. We report a case, diagnosed and operated in the Department of Neurosurgery from Pitesti County Emergency Hospital, of a 60-year-old woman with history of lumbar region distress, who presented with low back pain, paravertebral muscle contracture, and bilateral lumbar radiculopathy, with sudden onset after lifting effort. The preoperative diagnosis was done using computed tomography (CT) and magnetic resonance imaging (MRI), and the patient underwent surgery—two level laminectomy, dural incision, and tumor dissection from the cauda equina nerve roots under operatory microscope. Histopathological examination confirmed the positive diagnosis of cavernoma of cauda equina. The patients outcome was favorable, without postoperative neurological deficits.
Acta Chirurgica Belgica | 2011
Târcoveanu E; Dimofte G; Şt. Georgescu; Vasilescu A; Lupaşcu C; Bradea C; R. Van Hee
Abstract Laparoscopic removal of retained abdominal foreign bodies represents an obscure domain of minimally invasive surgery. Although not an infrequent situation in general surgical practice, there are very few papers presenting laparoscopic approache in these circumstances. An iatrogenic foreign body following surgery, is a serious complication that may lead to medico-legal problem. We present our experience and a literature review. Methods : In the last 20 years 48 patients with abdominal foreign bodies were referred to us. Out of these four gossypibomas were managed laparoscopically. Results : Retained swabs represent the most common iatrogenic abdominal foreign bodies. Removal of gossypiboma present more problems in laparoscopic environment due to encapsulation and difficulties in localisation, as retained swabs unusually display radio-opaque markings. There was one conversion due to dense adhesion to the gastric wall. Postoperative recovery was uneventful in all cases. Conclusions : Gossypibomas, among abdominal foreign bodies, represent a certain reality with significant legal implications. Prevention should prevail and all efforts should be made in such respect. Laparoscopic approach is possible in selected cases (small swabs, encapsulated, no complications).
Gastroenterology Research and Practice | 2014
Georgescu S; Ursulescu C; Valentin Titus Grigorean; Lupaşcu C
Background. Pancreaticoduodenectomy is the potentially curative treatment for malignant and several benign conditions of the pancreatic head and periampullary region. While performing pancreaticoduodenectomy, early neck division may be impossible or inadequate in case of hepatic artery anatomic variants, suspected involvement of the superior mesenteric vessels, intraductal papillary mucinous neoplasm, and pancreatic head bleeding pseudoaneurysm. Our work aims to highlight a particular hind right approach pancreaticoduodenectomy in selected indications and assess the preliminary results. Methods. We describe our early hind right approach to the retropancreatic vasculature during pancreaticoduodenectomy by mesopancreas dissection before any pancreatic or digestive transection. Results. We used this approach in 52 patients. Thirty-two had hepatic artery anatomic variant and 2 had bleeding pancreatic head pseudoaneurysm. The hepatic artery variant was preserved in all cases out of 2 in which arterial reconstruction was performed. In nine patients with intraductal papillary mucinous neoplasms the pancreaticoduodenectomy was extended to the body in 6 and totalized in 3 patients. Seven patients with adenocarcinoma involving the portomesenteric axis required venous resection and reconstruction. Conclusions. Early hind right approach is advocated in selected cases of pancreaticoduodenectomy to improve locoregional vascular control and determine, safely and early, whether there is mesopancreas involvement.
Neurologia I Neurochirurgia Polska | 2017
Valentin Titus Grigorean; Aurelia Mihaela Sandu; Mihai Popescu; Ioan Stefan Florian; Lupaşcu C; Ursulescu C
INTRODUCTION Hydrocephalus represents impairment in cerebrospinal fluid (CSF) dynamics. If the treatment of hydrocephalus is considered difficult, the repeated revisions of ventriculo-peritoneal (VP) shunts are even more challenging. OBJECTIVE The aim of this article is to evaluate the efficiency of ventriculo-epiplooic (VEp) shunt as a feasible alternative in hydrocephalic patients. MATERIAL AND METHODS A technical modification regarding the insertion of peritoneal catheter was imagined: midline laparotomy 8-10cm long was performed in order to open the peritoneal cavity; the great omentum was dissected between its two layers; we placed the distal end of the catheter between the two epiplooic layers; a fenestration of 4cm in diameter into the visceral layer was also performed. A retrospective study of medical records of 15 consecutive patients with hydrocephalus treated with VEp shunt is also presented. RESULTS Between 2008 and 2014 we performed VEp shunt in 15 patients: 5 with congenital hydrocephalus, 8 with secondary hydrocephalus and 2 with normal pressure hydrocephalus. There were 7 men and 8 women. VEp shunt was performed in 13 patients with multiple distal shunt failures and in 2 patients, with history of abdominal surgery, as de novo extracranial drainage procedure. The outcome was favorable in all cases, with no significant postoperative complications. CONCLUSIONS VEp shunt is a new, safe and efficient surgical technique for the treatment of hydrocephalus. VEp shunt is indicated in patients with history of recurrent distal shunt failures, and in patients with history of open abdominal surgery and high risk for developing abdominal complications.
Gastroenterology Research and Practice | 2015
Lupaşcu C; Tom Darius; Pierre Goffette; Jan Lerut
Diffuse splanchnic venous thrombosis (DSVT), formerly defined as contraindication for liver transplantation (LT), is a serious challenge to the liver transplant surgeon. Portal vein arterialisation, cavoportal hemitransposition and renoportal anastomosis, and finally combined liver and small bowel transplantation are all possible alternatives to deal with this condition. Five patients with preoperatively confirmed extensive splanchnic venous thrombosis were transplanted using cavoportal hemitransposition (4x) and renoportal anastomosis (1x). Median follow-up was 58 months (range: 0,5 to 130 months). Two patients with previous radiation-induced peritoneal injury died, respectively, 18 days and 2 months after transplantation. The three other patients had excellent long-term survival, despite the fact that two of them needed a surgical reintervention for severe gastrointestinal bleeding. Extensive splanchnic venous thrombosis is no longer an absolute contraindication to liver transplantation. Although cavoportal hemitransposition and renoportal anastomosis undoubtedly are life-saving procedures allowing for ensuring adequate allograft portal flow, careful follow-up of these patients remains necessary as both methods are unable to completely eliminate the complications of (segmental) portal hypertension.
Chirurg | 2018
Târcoveanu E; Ștefan Georgescu; Alin Vasilescu; Andronic D; Nicolae Dănilă; Lupaşcu C; Bradea C
Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. Methods: We prospectively evaluated a series of 8 patients admitted to First Surgical Clinic, St. Spiridon Hospital, Iasi during the period 2011-2017. Results: Out of 8 patients, 6 were operated on, one patient refusing surgery (followed periodically); the patient who was 91 years old had serious associated diseases that made surgery contraindicated. Symptomatology was nonspecific: in 5 cases Morgagni hernia was discovered during the exploration of an associated pathology, either with cardiopulmonary symptoms of dyspnea or palpitations. In 2 cases, the clinical aspect suggested an occlusive syndrome (the herniated organ is usually the transverse colon). The laparoscopic approach was used in all cases: two conversions were recorded due to the tight adherences of the herniated viscera (gastric, colon, epiplon). In 4 cases, the surgical cure of hernia was performed by suture and in 2 cases with prosthesis: dual mesh in one case and polypropylene mesh in another case. We did not register morbidity and the mean postoperative stay was 4 days (range 2-6 days). Conclusions: Hernia Morgagni betrays a rare pathology. The most common is asymptomatic but in complicated cases it is a cause of acute surgical abdomen. Surgical treatment is indicated even for asymptomatic cases due to serious complications Morgagni hernia may develop. The laparoscopic approach is ideal, as reduction of viscera in the abdomen is easy and the defect will be repaired by suturing or using a prosthesis, depending on its size.