http://repository.usmf.md:80/handle/20.500.12710/11689 The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020 2026-04-13T19:38:01Z http://repository.usmf.md:80/handle/20.500.12710/20369 Title: MedEspera: The 8th International Medical Congress for Students and Young Doctors: abstract book, 2020 2020-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/12356 Title: The post-oncologic reconstruction of inferior limb with perforator flap Authors: Osmatescu, Angela; Stoian, Alina Abstract: Background. Many patients with tumors on both superior and inferior limbs can benefit from reconstruction surgery, using different methods, in accordance with the tumor type and how radical the surgery was performed. In our country, the most used surgical technics are related to the use of different types of flaps. Case report. A 57-year-old man with diabetes type II for 10 years, presented with a 20-year history of static non-healing ulcer at the left Achilles tendon level after a car accident. The biopsy revealed squamos cell carcinoma. The surgery includes wide resection of the Achilles tendon and calcaneus bone, with the resulting defect of 12x16 cm. The reconstruction was performed with tendon-fasciocutaneous peroneal artery perforator flap, in a propeller manner translation, with good function of the limb with minimum recovery time. Conclusions. The decision of the reconstructive technique should be taken into account regarding its consequences of the affected anatomical structures, the personal pathological antecedents and pre-existing lesions at the level of the donor area. Description: Department of Orthopedics and Traumatology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors 2020-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/12355 Title: Calcaneus fractures Authors: Sîromeatnicov, Mihaela Abstract: Introduction. Calcaneus fractures are the result of high energy trauma, falls from height, road accidents. Calcaneus fracture constitutes 60% of the Tarsian fractures, 75% of them are intraarticular and represent 2% of the total fractures, more commonly happens with men between 21-45 years (90%). Aim of the study. The study of contemporary literature with reference to the treatment of calcaneus fractures with the purpose to assess the treatment strategy. Materials and methods. There were 28 literary sources, articles and scientific papers studied. Results. Signs of calcaneus fractures are: deformation of the calcaneous region accompanied by its widening transversely, deletion of the malleolar reliefs and of the Ahilian tendon, flattening of the plantar arch and the "numeral" ecchymosis in the plantar area, mobility in the ankle joint is diminished. The degree of movement of the fragments depends on the kinetic energy of the trauma. The evaluation of a calcaneus fracture begins with radiography in 2 projections, anterior-posterior, with the calculation of the Bohler and Gissan angle and the axial projection (Harris). Bohler classification (usually 20-40) is a criterion for assessing the severity of the fracture. The gold standard in the diagnosis of calcaneus fractures is the computed tomography using the Sanders classification and in case of lack of CT examination the Broden projections are made. Treatment depends on the anatomical-clinical form of the fracture. Orthopedic treatment is indicated for fractures without displacement, as well as for the thalamic (Sanders I) and for the extratalamic ones. Graffin type gypsum immobilization is done if the soft tissues allow. f not, the foot will be put in a prone position with the mobilization of the fingers and ankle joint from the first days. Percutaneous osteosynthesis with cannulated screws is indicated for extratalamic fractures. Surgery is indicated for thalamic fractures Sanders IIIIV - open reduction and osteosynthesis with plate and screws. The optimum time for surgery is in the first 3 weeks and when the "Wrinkle" test is positive. The outcome of the surgical treatment as well as the orthopedic treatment is influenced by the factors related to the patient (diabetes, peripheral vascular disease, obesity, smoking, the elderly, late addressing, serious injuries associated) as well as the path of the fracture. Conclusions. Patients with calcaneus fracture treated surgically have a shorter rehabilitation period compared to those treated orthopedic. The functional result is better when the Bohler angle and the anatomical reduction is restored. Description: Department of Orthopedics and Traumatology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors 2020-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/12338 Title: Diagnostic and palliative treatment of head of pancreas cancer Authors: Butnari, Valentin Abstract: Introduction. Despite all improvements in both surgical and other conservative therapies, pancreatic cancer is steadily associated with a poor overall prognosis and remains the fourth leading cause of cancer-related mortality in the world. About 80% of patients who have received a diagnosis of pancreatic cancer already have other organ metastasis, as well as local tumor in the late stage. Therefore, appropriate palliation for the main symptoms, such as obstructive jaundice, duodenal obstruction, and pain, is most important. The role of palliative surgery in locally advanced pancreatic cancer mainly involves patients who are found unresectable during open surgical exploration and consists of combined biliary and duodenal bypass procedures. Aim of the study. Analysis of clinical and paraclinical methods of diagnosis and palliative surgical treatment of patients with cephalopancreatic cancer. Materials and methods. The current study presented 548 cases with malignant obstructive jaundice from the Gastrology Clinic of IMSP IO Chișinău, between 2007-2019. Excluded from this research were any patients who underwent resection, had no obstructive jaundice at the time of diagnosis, or had other periampullary cancer (distal bile duct, ampulla of Vater, and duodenum). Results. We identified 424 cases with histologically proven with cephalopancreatic cancer (263 males-58,31 % and 188 females-41,68%) who underwent palliative treatment with cancer of the head of the pancreas aged between 32 and 84, requiring palliation.Following the retrospective study, we found: the diagnosis of cephalopancreatic tumor was clinically and paraclinically established using the diagnostic methods: USG (100%), CT (86,79%); Retrograde endoscopic cholangiopancreatography (23,11%). The tumors of these patients were unresectable because of local vascular invasion to the superior mesenteric vein, portal vein, superior mesenteric artery, hepatic artery, or celiac artery. The tumor size was 5.4±2.2 cm. The tumors of these patients were all in stage 2b-4 according to the NCCN guideline of pancreatic cancer.No cases were diagnosed using preoperative biopsy. Of the 424 cases with a reported histological subtype pancreatic ductal adenocarcinoma 417(98,34%) ,Moderately differentiated-207,Well-differentiated-107,Badly differentiated-87 Solid neoplasm-4(0,98%) Acinar carcinoma 3(0,7%). All the patients underwent palliative surgery , of whom 109 (25,7%) biliar by-pass, 152 (35,84%) biliar + gastric by-pass , 65 (15,3%) stent and 23 (5,42%) external bile drainage. The postoperative mortality did not exceed 5%, the rate of postoperative complications was below 23%, an acceptable value and equivalent to the world data. Conclusions. 1. The goal of therapy for these patients is to obtain the most complete and prolonged remission of symptoms possible, with the least intervention-related morbidity and mortality. CT . 2. The gold standard in the diagnosis of cephalopancreatic tumor is abdominal Description: Department of Oncology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020 2020-01-01T00:00:00Z