Proiectul POSDRU/88/1.5/S/58965 cofinantat din Fondul Social European
prin Programul Operational Sectorial pentru dezvoltarea resurselor umane 2007 - 2013.
EN RO
Vlad Nuţu
Lucrare doctorat:
Posibilităţile şi perspectivele tratamentului chirurgical în tumorile hepatice
Coordonator doctorat: Prof. univ. dr. Eugen Târcoveanu
Data naşterii: 25 noiembrie 1974
Studii:
1993 – 1999: Medic specialist chirurgie generală – Clinica I Chirurgie, UMF „Gr. T. Popa” Iaşi
2006 – 2009: Facultatea de Medicină Generală, şef de promoţie USMF „N. Testemiţanu” Chişinău, R. Moldova
Contact: nutu.vlad@d.umfiasi.ro
Lucrari publicate
-
TRANSPLANTUL HEPATIC – O POSIBILITATE DE TRATAMENT A CANCERULUI HEPATOCELULAR DEZVOLTAT PE CIROZĂ NON-VIRALĂ
Autori: N. Vlad, C. Ducerf, J. Baulieux, C. Gouillat, S. Mezoughi, J.Y. Mabrut
Descriere lucrare: LIVER TRANSPLANTATION – A PARADIGM IN THE SURGICAL TREATMENT OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH NON-VIRAL LIVER CIRRHOSIS (Abstract): BACKGROUND: Worldwide the rate of hepatocellular carcinoma (HCC) is continuing increasing and the survival rate, without treatment, varies between 6 and 20 months. The actual surgical management comprises liver resections, focal ablation and liver transplantation. Apparently the liver transplantation is the best treatment both for liver cirrhosis and HCC. However, the literature data about liver transplantation for HCC associated with non-viral liver cirrhosis (NVLC) are limited. METHODS: We performed an observational study about the patients who underwent orthotopic liver transplantation for HCC arising in NVLC. Different clinical, operative, pathological and follow-up data were recorded into a MS Excel Database and statistically analyzed. RESULTS: We included 12 patients with a mean age of 59.3±2.8 years old (range: 56-64). All the patients were men. According to Child-Pugh score, 16.6% (N=2) were in stage A, 41.7% (N=5) in stage B and the other 41.7% (N=5) in stage C. The median value of MELD score was 21. The mean operation time was 405±102 min and intraoperative mean blood loss was 1850±1560 mL. The tumors have a mean diameter of 27.5 (range: 10-60). Major postoperative complications were noted in 5 cases. We noted no postoperative deaths. The overall survival rate was 91.67%; one death was noted 8 months after the operation. The mean survival time was 34.9±265 months (median: 33 months). No loco-regional recurrence was noted. CONCLUSIONS: Liver transplantation represents a good choice for HCC associated with NVLC. The long term results are apparently superior to the others surgical procedures, with low rates of recurrence. — Download -
EPIDEMIOLOGIA, ETIOPATOGENIA ŞI DIAGNOSTICUL HEPATOCARCINOMULUI
Autori: N. Vlad
Descriere lucrare: EPIDEMIOLOGY, ETIOPATHOLOGY AND DIAGNOSTIC OF HEPATOCELLULAR CARCINOMA (ABSTRACT): Hepatocellular Carcinoma (HCC) is among the most common of solid human malignancies, with an annual incidence of 100.000 new cases. The worldwide distribution of HCC is not uniform, the highest rates are found in Southeast Asia and Sub-Saharian Africa. The HCC imcidence in Romania varies between 4-10 cases to 100.000 inhabitants per year. HCC is more likely to develop in men than in women, the sex ratio being approximately 8:1 in high-incidence areas. Chronic hepatitis B virus and C virus have been implicated as important etiologic factors in the development of HCC, being responsable for 80% of the cases. The most of the carcinomas are developped on the cirrhotic liver. A number of other risk factors also are involved in HCC: diabetes mellitus, obesity, chronic ethilism, oral contraceptives, smoking and dietary intake of aphlatoxines. HCC is usually diagnosed at a late stage. The clinical presentation are not typical, suggesting only the basic liver pathology. Ultrasounds, CT- scan and MRI confirm the presence of a mass in the liver. Alfa-fetoprotein (AFP), alfafetoprotein L3 fraction and des-gammacarboxiprotrombina (also known as PIVKA II test) are considered as serological markers for HCC. The indication of screening is for the patients with liver cirrhosis or chronic hepatitis B and/ or C virus. The level of AFP and liver ultrasounds are mandatory to be done as screening tests to every 6 months to the risk patients. — Download -
METASTAZĂ SCAPULARĂ A CARCINOMULUI HEPATOCELULAR – PREZENTARE DE CAZ
Autori: N. Vlad, R. Moldovanu, C. Lupaşcu, G. Răileanu, M. Borcea, D. Ferariu, Liliana Vlad
Descriere lucrare: A SCAPULAR METASTASIS OF THE HEPATOCELLULAR CARCINOMA – CASE REPORT (Abstract): Hepatocellular carcinoma (HCC) is a primary liver cancer frequently related with liver cirrhosis; the common way for metastasis spread is the blood stream. The bone metastasis from a HCC is uncommon. We present an unusual scapular metastasis from a HCC as a first sign of the liver tumor. A 76 year old man has been reffered to our surgical unit presenting a solid painful tumor located in the scapular region. The clinical and ultrasound examination established the diagnosis of a soft tissue tumor. Intraoperative exploration revealed a brown sponge mass, extremly soft and bleeding. The resection of the tumor has been performed. The pathologic exam revealed the diagnosis of a metastasis from a well differentiated HCC. The postoperative abdominal ultrasound exam was performed and revealed two tumors situated in V-th and VII-th segments. The patient refuse other imagistic exams and surgical procedures. — Download