Multimodal Treatment for Cancer of the Esophagus

There are about 500,000 new cases of cancer of the esophagus and 400,000 esophageal cancer-related deaths recorded annually around the world. The disease is three to four times more frequent in men than in women, being the sixth most common cancer and the fifth most frequent cancer-related death among men. The prognosis of esophageal cancer is quite poor, despite advances in surgical procedures (two-field and three-field lymph node dissection) and perioperative management, which is still controversial. The use of chemotherapy and radiotherapy in combination with surgery might be a new approach for future treatment. Progress in optical technology has led to the development of a new minimally invasive surgical approach for the treatment of esophageal cancer, namely esophagectomy

Nano-Antimicrobial Solutions Using Synthetic-Natural Hybrid Designs

Nanotechnology potential in antimicrobial therapy is increasingly demonstrated by various data. Results reveal antibacterial properties, comparable to that of conventional antibiotics. Working on parallel experiments, researchers continue to bring evidence demonstrating age-old-recognized antibacterial properties of various natural components of plant and animal origin. Later years brought an increasing trend for combining synthetic and natural composition in new constructs. The tendency aims to bring more on different essential aspects, such as active substance release, improvement of antibacterial effect, and up-regulation of the mechanisms at the structure-cell interface. Present chapter structures the up-to-date achievements in the field, including the concept of design, biological effects, benefits, mechanisms, and limitations of the field. Also, expected future research directions are to be discussed

Laparoscopic approach of acute pancreatitis collections: a serie of four cases

Introduction: Acute pancreatitis (AP) is one of the most unpredictable pathologies of the digestive system. AP can be associated with multiple local or systemic complications. Approximately 15-20% of patients develop moderate severe or severe pancreatitis. The moderate severe form of disease is associated with local complications, as necrosis of the pancreatic and/or peripancreatic tissue and transient organ failure. One of the most common local complications in AP is the development of peripancreatic fluid collections (PFC). Proper management of PFC necessitates accurate diagnosis and treatment by a multidisciplinary team. Moreover, tratment has turned from open surgery (associated with high mortality and morbidity), therefore the latest literature shows data justifying the use of minimally invasive procedures. Case presentantion: We present a serie of 4 patients, with ages comprised between 54 and 70 years old with peripancreatic fluid collections, more precisely, walled-off necrosis (WON), infected WON in the lesser sac and one with ANC treated laparoscopically. Conclusion: Minimally invasive procedures of PFC, especially for acute necrotic collections (ANC) include radiological, endoscopic or surgical approach. Formerly, a primary necrosectomy was the frontrunner treatment, however it is associated with high rates of mortality and morbidity. At the present moment the step-up approach management is preferred. The main and most common issue of all minimally invasive procedures is the difficult removal of the necrotic debris and the adequate drainage of the collection in one procedure. To conclude, even though pancreatitis has an unforeseeable evolution, the minimally invasive techniques seem to be promising in the managament of PFC. Case particularities: This present paper presents a serie of four cases of AP complicated with PFC admitted to the Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca. All cases were managed pure laparoscopically

Trends in Minimally Invasive Approaches for Liver Resections–A Systematic Review

Background: SILS (single incision laparoscopic surgery) and NOTES (natural orifice transluminal endoscopic surgery) are considered breakthroughs in minimally invasive surgery, the first consisting in the surgeon working via a single entrance site and the second via a natural orifice (e.g., oral cavity). Methods: Since 2000 until 2022, the original articles published in the online databases were analyzed. Eligible studies included information about the current therapy of patients with liver surgical pathology and how the two new techniques improve the surgical approach. Results: A total of 798 studies were identified. By applying the exclusion criteria, nine studies remained to be included in the review. Two out of nine studies examined the NOTES approach in liver surgery, whereas the other seven focused on the SILS technique. The age of the patients ranged between 24 and 83 years. Liver resections for hepatocellular carcinoma or colorectal metastases were undertaken and biliary or hydatid cysts were removed. The mean procedure time was 95 to 205 min and the average diameter of the lesions was 5 cm. Conclusions: When practiced by multidisciplinary teams, transvaginal liver resection is feasible and safe. The goals of SILS and NOTES are to be less intrusive, more easily tolerated and aesthetic