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Ursu CP, Ciocan A, Ursu Ș, Ciocan RA, Gherman CD, Cordoș AA, Vălean D, Pop RS, Furcea LE, Procopeț B, Ștefănescu H, Moiș EI, Al Hajjar N, Graur F. Prognostic Indicators of Overall Survival in Hepatocellular Carcinoma Patients Undergoing Liver Resection. Cancers (Basel) 2024; 16:1427. [PMID: 38611104 PMCID: PMC11010842 DOI: 10.3390/cancers16071427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is the predominant form of primary liver cancer and the third contributor to malignancy-related deaths worldwide. The hepatic venous pressure gradient (HVPG), transient elastography-liver stiffness measurement (TE-LSM), and the association between TBS (tumor burden score), alpha-fetoprotein levels, and the Child-Pugh classification (TAC score) can serve as valuable prognostic indicators for these patients. Therefore, the main objective of our research was to analyze the prognostic value of the HVPG, TE-LSM, TBS, and TAC scores. An observational and survival study was conducted on 144 subjects. Our findings indicated that HVPG greater than 10 mmHg, AFP surpassing 400 ng/mL, an advanced C-P class, and low TAC score are independent predictors of overall survival. During the multivariate analysis, AFP serum levels and C-P class proved statistically significant. The present study revealed significant differences in overall survival between the two groups divided upon HVPG values and settled by the cutoff of 10 mmHg (p = 0.02). Moreover, by dividing the cohort into three groups based on the TAC score (very low, low, and moderate), statistically significant differences in overall survival were observed across the groups (p = 0.004).
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Affiliation(s)
- Cristina-Paula Ursu
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Andra Ciocan
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Ștefan Ursu
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Răzvan Alexandru Ciocan
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy, Marinescu Street, No. 23, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.); (A.-A.C.)
| | - Claudia Diana Gherman
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy, Marinescu Street, No. 23, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.); (A.-A.C.)
| | - Ariana-Anamaria Cordoș
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy, Marinescu Street, No. 23, 400337 Cluj-Napoca, Romania; (R.A.C.); (C.D.G.); (A.-A.C.)
- Romanian Society of Medical Informatics, 300041 Timișoara, Romania
| | - Dan Vălean
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Rodica Sorina Pop
- Department of Community Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Avram Iancu Street, No. 31, 400347 Cluj-Napoca, Romania;
| | - Luminița Elena Furcea
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Bogdan Procopeț
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
- Department of Internal Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Horia Ștefănescu
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Emil Ioan Moiș
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Nadim Al Hajjar
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
| | - Florin Graur
- Department of Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (C.-P.U.); (Ș.U.); (D.V.); (L.E.F.); (E.I.M.); (N.A.H.); (F.G.)
- “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (B.P.)
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Vălean D, Zaharie R, Țaulean R, Usatiuc L, Zaharie F. Recent Trends in Non-Invasive Methods of Diagnosis and Evaluation of Inflammatory Bowel Disease: A Short Review. Int J Mol Sci 2024; 25:2077. [PMID: 38396754 PMCID: PMC10889152 DOI: 10.3390/ijms25042077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Inflammatory bowel diseases are a conglomerate of disorders causing inflammation of the gastrointestinal tract, which have gained a significant increase in prevalence in the 21st century. As they present a challenge in the terms of diagnosis as well as treatment, IBDs can present an overwhelming impact on the individual and can take a toll on healthcare costs. Thus, a quick and precise diagnosis is required in order to prevent the high number of complications that can arise from a late diagnosis as well as a misdiagnosis. Although endoscopy remains the primary method of evaluation for IBD, recent trends have highlighted various non-invasive methods of diagnosis as well as reevaluating previous ones. This review focused on the current non-invasive methods in the diagnosis of IBD, exploring their possible implementation in the near future, with the goal of achieving earlier, feasible, and cheap methods of diagnosis as well as prognosis in IBD.
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Affiliation(s)
- Dan Vălean
- Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania; (D.V.); (R.Ț.); (F.Z.)
- Department of General Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, 400347 Cluj-Napoca, Romania
| | - Roxana Zaharie
- Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania; (D.V.); (R.Ț.); (F.Z.)
- Department of Gastroenterology, University of Medicine and Pharmacy “Iuliu Hațieganu”, 400347 Cluj-Napoca, Romania
| | - Roman Țaulean
- Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania; (D.V.); (R.Ț.); (F.Z.)
- Department of General Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, 400347 Cluj-Napoca, Romania
| | - Lia Usatiuc
- Department of Patophysiology, University of Medicine and Pharmacy “Iuliu Hațieganu”, 400347 Cluj-Napoca, Romania;
| | - Florin Zaharie
- Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania; (D.V.); (R.Ț.); (F.Z.)
- Department of General Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, 400347 Cluj-Napoca, Romania
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Moiș E, Hajjar NA, Moldovan S, Nechita VI, Vălean D, Puia IC, Furcea L, Puia A, Iancu C, Popa C, Zaharie F, Rusu I, Graur F. Microscopic Positive Margins in Gastric Adenocarcinoma Following Oncological Resection: Prognostic Factors and Long-Term Survival. Ann Ital Chir 2024; 95:91-97. [PMID: 38469603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
BACKGROUND In the context of gastric cancer, surgical resection stands as the sole curative treatment. Central to influencing overall survival are the resection margins. This research aims to identify the factors influential in determining microscopically positive resection margins (R1) and to evaluate overall survival. METHODS Our study encompassed 549 patients diagnosed with adenocarcinoma of the stomach who underwent curative-intent surgery between January 2011 and December 2021 in our Surgery Department. We investigated the incidence of positive margins (R1) and their impact on survival rates, as well as the determinants of R1. The standardization of R1 involved ensuring a margin distance of less than 1 mm from the tumor line to the margin. RESULTS The incidence of R1 margins was 13.29% (73 patients). Among these, proximal R1 margins were observed in 29 patients (39.72%), while 49 cases (67.12%) presented circumferentially positive margins, with 20 cases (27.39%) exhibiting distally positive margins. Nineteen patients (26.02%) had two R1 margins, and 3 patients had all resection margins microscopically positive (4.10%). Factors such as tumor dimension, invasion of other organs, pT stage, pN stage, pL1 stage, pV1 stage, pPn stage, Lauren type, and tumoral grading demonstrated significance (p < 0.01) in the occurrence of positive R1 margins. CONCLUSION Tumor dimension, invasion of other organs, pT stage, pN stage, pL1 stage, pV1 stage, pPn stage, Lauren type, and tumoral grading could be regarded as factors for predicting microscopically positive margins. Moreover, positive resection margins have a detrimental impact on overall survival.
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Affiliation(s)
- Emil Moiș
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Nadim Ai Hajjar
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Septimiu Moldovan
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Vlad-Ionuţ Nechita
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Medical Informatics and Biostatistics, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Dan Vălean
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Ion-Cosmin Puia
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Luminița Furcea
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Aida Puia
- Department of Community Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Cornel Iancu
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Călin Popa
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Florin Zaharie
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
| | - Ioana Rusu
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania
| | - Florin Graur
- "Octavian Fodor" Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania; Department of Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400162 Cluj-Napoca, Romania
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Moiș E, Graur F, Horvath L, Furcea L, Zaharie F, Vălean D, Moldovan S, Al Hajjar N. Perineal Hernia Mesh Repair Using Only the Perineal Approach: How We Do It. J Pers Med 2023; 13:1456. [PMID: 37888067 PMCID: PMC10608043 DOI: 10.3390/jpm13101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Perineal hernia is a rare complication of rectal surgery. Different types of surgical approach have been described, but none of them have proven their superiority. Although there are many methods of closing the defect, we selected two cases to present from a series of five cases, in which the perineal hernia was successfully resolved surgically using only the perineal approach. The reconstruction of the perineal floor and closure of the defect were performed using a synthetic polypropylene mesh. The significance of this Technical Note article lies in the fact that we describe, step by step, a surgical technique for perineal hernia using just a perineal approach.
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Affiliation(s)
- Emil Moiș
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Florin Graur
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Levente Horvath
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Luminița Furcea
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Florin Zaharie
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Dan Vălean
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Septimiu Moldovan
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
| | - Nadim Al Hajjar
- 3rd Department of Surgery, University of Medicine and Pharmacy “Iuliu Hațieganu”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania; (E.M.); (L.H.); (L.F.); (F.Z.); (D.V.); (S.M.); (N.A.H.)
- Regional Institute of Gastroenterology and Hepatology “O. Fodor”, Croitorilor Street, No. 19–21, 400162 Cluj-Napoca, Romania
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Zaharie RD, Popa C, Schlanger D, Vălean D, Zaharie F. The Role of IL-22 in Wound Healing. Potential Implications in Clinical Practice. Int J Mol Sci 2022; 23:3693. [PMID: 35409053 PMCID: PMC8998254 DOI: 10.3390/ijms23073693] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/14/2022] Open
Abstract
Wound healing is a complex process that is mediated and influenced by several cytokines, chemokines, and growth factors. Interleukin-22 (IL-22) is a cytokine that plays a critical role in tissue regeneration. Our study is a systematic review that addressed the implications of IL-22 in the healing of wounds caused by external factors. Thirteen studies were included in our review, most of them being experimental studies. Three clinical studies underlined the potential role of IL-22 in day-to-day clinical practice. IL-22 plays a central role in wound healing, stimulating the proliferation, migration, and differentiation of the cells involved in tissue repair. However, overexpression of IL-22 can cause negative effects, such as keloid scars or peritoneal adhesions. The results of the presented studies are promising, but further research that validates the roles of IL-22 in clinical practice and analyzes its potential implication in surgical healing is welcomed.
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Affiliation(s)
- Roxana Delia Zaharie
- Gastroenterology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania;
- Gastroenterology Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Călin Popa
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Diana Schlanger
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Dan Vălean
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Florin Zaharie
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
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