Nicolae Bacalbașa

Distal conservative urinary tract resections and reconstructions for locally advanced gynecologic malignancies

Due to the anatomical proximity of the urinary and gynecological tract, malignant processes originating from the gynecological viscera might involve the distal segments of the urinary tract, imposing the performance of en bloc resections. However, the demanded procedure widely varies in regard to the location of the invaded area as well as the other anatomical particularity of the patient. This is a literature review of the most commonly performed urinary tract resections and reconstructions for locally advanced gynecologic malignancies including ureteral resection and reimplantation, partial cystectomies with cystoraphy or augmentation cystoplasties and anti-reflux procedures such as psoas hitch or Boari flaps.

Large cell neuroendocrine cervical tumor treated by radical surgery and adjuvant chemotherapy: A case report and literature review

Neuroendocrine carcinomas of the uterine cervix are rare, but extremely aggressive, gynecological malignancies that are associated with an overall poor prognosis. The present study reports the case of a 41-year-old patient diagnosed with large cell neuroendocrine cervical tumor. A radical total hysterectomy with bilateral adnexectomy, pelvic and lymph node dissection was performed. The post-operative course was uneventful, and the patient was discharged on post-operative day 8.

Multiple digestive resections as part of primary cytoreduction in advanced stage epithelial ovarian cancer

The absence of residual disease remains the strongest predictor for disease free and overall survival in patients with advanced stage or relapsed ovarian cancer. However in most cases this desiderates is achieved after performing multiple visceral resections. Extended pelvic disease usually involves the surrounding pelvic viscera and leads to the necessity of digestive resections such as rectosigmoidectomy. In other cases other digestive resections such as right ileocolectomy might be needed. We present the case of a 64 year old patient in which an R0 resection was feasible after association of rectosigmoidectomy, right ileocolectomy and segmental ileal resection.

Multicentric collaborative database in obstetrics and gynecology. Interdisciplinary Multicentric Working Group on Antenatal Research

Notwithstanding the type of study that is planned (retrospective or prospective), a multicentric and interdisciplinary approach assures a much better progress of the data collection than a single center approach does. We present herein the potential applicability of the system adapted by us in the national projects budgeted by the Romanian Academy of Medical Sciences. In our research we use an adapted version of Astraia - a database for women’s health data management. The database allows the documentation of main medical data about pregnant women, birth and neonates. The database was adapted to allow documentation of information about the biological samples collected and stored from patients. Queries were edited to allow identification and recognition of samples in the database. Our previous research recommends our platform for use in the following projects of the Romanian Academy of Medical Sciences: National Registry of Malformations and New Strategies in Health Prevention Measures.

Lymph node involvement in endosalpingiosis. A case report and literature review

Endosalpingiosis is a rare benign gynaecologic condition characterised by the presence of epithelial inclusions resembling tubal epithelium outside the fallopian tubes. It is usually found incidentally in postmenopausal women. The ovary seems to be the most common site of the lesions; however it can develop almost in any pelvic or abdominal organ including the lymphatic structures. We present the case of a 49-year-old patient who was submitted to surgery for bilateral ovarian tumors strongly resembling to malignant tumors. A total hysterectomy with bilateral adnexectomy, pelvic lymph node dissection and omentectomy were performed. The histopathological studies revealed the presence of bilateral ovarian endosalpingiosis associated with lymph node involvement.

Carcinoma of the cervical stump. A case report and literature review

Subtotal hysterectomy for benign uterine disease was a common surgical procedure in the past decades. Keeping in place the uterine cervix predisposes to late complications such as cervico-vaginal prolapse, chronic cervicitis or even malignant transformations of the cervical stump. We present the case of a 56 year old patient who was submitted to subtotal hysterectomy for a large uterine fibroma 4 years before and who presented vaginal bleeding and pelvic pain. She was diagnosed with cervical stump carcinoma and a radical resection including trachelectomy with pelvic and para-aortic lymph node dissection was performed. The histopathological studies revealed a well differentiated squamous cell cervical cancer.

Cytoreductive surgery for late recurrence after surgically treated stage IV ovarian cancer-a case report

Recurrence is a common finding after surgically treated ovarian cancer even in cases submitted to initially R0 resection. However, it is well known that an aggressive surgical approach is perfectly justified at the moment of relapse, being the only solution in order to increase the survival rates. We present the case of a 62 year old patient who was previously submitted to surgery for stage IV ovarian cancer followed by 6 cycles of adjuvant chemotherapy. At 4 years follow up she was diagnosed with disseminated abdominal recurrences and she was submitted to secondary cytoreduction. Postoperatively, adjuvant chemotherapy with platinum based regimens was instituted.

Prognostic factors and outcomes in surgically treated endometrial stromal sarcomas of the uterus. A literature review

Endometrial stromal sarcomas (ESS) are rare mesenchymal tumors of the uterus characterized by an indolent behavior and favorable outcomes. However, late recurrence is a common event even in cases diagnosed in an early stage of the disease. The present review presents the largest studies which focused on determining the prognostic factors and outcomes after surgically treated ESS. In this respect, we also presents various answers for the most significant unsolved questions regarding the role of bilateral adnexectomy and the benefits of pelvic and para-aortic lymph node dissection.