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27 noiembrie 2012
26 noiembrie 2012
Chirurgie toracica
Dupa curriculum de pregatire in specialitatea Chirurgie Toracica:
Chirurgia toracică este ramura chirurgicală ce se ocupă cu diagnosticul şi tratamentul operator al afecţiunilorperetelui toracic şi pleurei, traheobronhopulmonare, mediastinului, pericardului, esofagului, diafragmului, precum şi ale graniţelor cervico-toracică şi toracoabdominală.
Durata de pregatire: 5 ani
Dupa Pathway Evaluation Program:
nota: In SUA, chirurgia cardiovasculara si chirurgia toracica sunt grupate in Cardiothoracic surgery sau doar Thoracic surgery, chirurgii supraspecializandu-se fie pe chestiuni cardiace sau pulmonare/legate de peretele toracic. La noi se merge direct pe una dintre cele doua filiere: Chirurgie cardiovasculara sau Chirurgie toracica.
Asadar:
Thoracic surgery, also known as cardiothoracic surgery and cardiovascular and thoracic surgery, encompasses all types of surgery within the chest cavity, which includes the heart, lungs and esophagus. Thoracic surgeons are concerned with the operative, perioperative, and critical care of patients with pathologic conditions of the chest.
Surgeons in this subspecialty often focus on certain organs and procedures within the chest cavity. A general thoracic surgeon treats emphysema; tumors of the lung, esophagus, chest wall, and mediastinum; swallowing problems and gastroesophageal reflux; abnormalities of the trachea; and diseases of the diaphragm. A congenital heart surgeon performs surgical corrections of heart defects and furnishes cardiovascular support to infants and children. Any of these subspecialists may perform heart, lung, and combined heart-lung transplantations. A cardiac surgeon deals primarily with the surgical management of diseases of the blood supply to the heart, the heart valves, and the arteries and veins in the chest.
Dupa Wikipedia.fr
Les affections traitées par la chirurgie thoracique concernent:
- les affections chirurgicales de la paroi thoracique
- les affections chirurgicales des plèvres et de la cavité pleurale
- Les épanchements pleuraux bénins et malins
- Les infections pleurales et le pyothorax
- Le pneumothorax en chirurgie thoracique
- Le canal thoracique et le chylothorax
- Le mésothéliome en chirurgie thoracique
- Les techniques chirurgicales spécifiques à la cavité pleurale
- les affections chirurgicales du parenchyme pulmonaire, des bronches et de la trachée
- les affections chirurgicales du médiastin (à l'exception du cœur, qui fait l'objet d'une branche particulière de la chirurgie)
Par ailleurs, la chirurgie de l'œsophage concerne essentiellement les chirurgiens digestifs.
Link-uri interesante:
Recomand in primul rand site-ul CTSnet.org (CardioThoracic Surgery Network). Aici gasiti foarte multe articole legate de Chirurgie toracica dar si video-uri interesante din timpul operatiilor etc.
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02 noiembrie 2012
Chirurgie plastica - microchirurgie reconstructiva
Dupa Curriculum de pregatire in specialitatea Chirurgie plastica-microchirurgie reconstructiva:
Specialitatea care se ocupă cu diagnosticul şi tratamentul chirurgical al arsurilor, electrocuţiilor, traumatismelor însoţite de distrugeri de părţi moi, ale mâinilor traumatizate (leziuni tegumentare, scheletice, tendinoase, vasculo-nervoase), al tumorilor de suprafaţă, al malformaţiilor congenitale şi al unor suferinţe estetice. Este o specialitate interdisciplinară ce se ocupă cu repararea diformităţilor, corectarea deficienţelor funcţionale şi modificarea aparenţelor. Chirurgia plastică restaurează şi ameliorează forma în scopul obţinerii unei îmbunătăţiri a aspectului şi aproprierii de cel normal. Chirurgia plastică foloseşte în afara tehnicilor chirurgicale nespecializate şi tehnici caracteristice (transferare şi transplantare tisulară), dintre care unele microchirurgicale.
Durata de pregatire: 5 ani
Dupa Pathway Evaluation Program:
Plastic surgery deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, head and facial structures, hand, extremities, breasts and trunk. The specialty encompasses both cosmetic and reconstructive surgery. Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance.
A foundation in surgical anatomy, physiology and pathology is fundamental to this specialty. Plastic surgeons need to have surgical knowledge, surgical judgment, technical expertise, ethics, the ability to think in three dimensions, good aesthetic sense, creativity, and appreciation for detail. Subspecialty certifications include craniofacial surgery and surgery of the hand.
Dupa The Ultimate Guide to Choosing a Medical Specialty:
No other surgical specialist draws on a wider base of anatomic knowledge or operates in more regions of the body than does plastic surgeon. The field has developed from the efforts and contributions of people from many different backgrounds, including general surgery, orthopedics, oral and maxillofacial surgery, and otolaryngology.
Plastic surgery encompasses all of aesthetic surgery, yet it also deals with clinical entities that are often considered grotesque, including chronic wounds, limb replantation, and head and neck reconstruction. It is considered a surgical subspecialty, yet the fund of knowledge needed for even a basic understanding of the discipline requires a five- to eight-volume text.
The breadth of anatomy seen within a typical week (or even within a single day) often includes the head, neck, chest, abdomen, lower and upper extremities, breast, and hand. Some may view this as a liability. Most plastic surgeons, however, welcome the variety and tend to become bored if repeatedly faced with the same types of clinical problems. They enjoy the beauty of anatomy, especially that of the more intricate regions, such as the hand and face.
Some plastic surgeons say they find their work particularly rewarding because the results are often so visible. For example, after a cleft lip repair, the surgeon’s efforts are seen repeatedly for the next 70 years or more. Seeing a parent smile after their child’s cleft lip has been repaired is one of the most fulfilling experiences in all of surgery and medicine. Likewise, when a patient awakes
upon replantation of a severed limb (or scalp, ear, nose, or even penis) and sees the successfully reattached part, it reaffirms the plastic surgeon’s choice of a career.
Physician–patient relationships in plastic surgery can be quite lengthy and involved. Most plastic surgeons find these relationships in particular to be quite rewarding. For example, in the case of congenital deformities, patients often require 10 or more operations prior to reaching adulthood.
Plastic surgery can be physically demanding. Some operations are lengthy or technically challenging. Most plastic surgeons have participated in operations that lasted more than 24 hours. Some have said that microsurgery, in particular, is a young surgeon’s sport. Not only can these procedures be long, but the anastomosis of small vessels can sometimes be quite challenging.
- Aesthetic Surgery
Common aesthetic procedures performed by plastic surgeons include rhinoplasty (reshaping of the nose), facelift, aesthetic eyelid surgery, laser skin resurfacing, Botulinum toxin injection, breast augmentation, liposuction, and body lifts.
The field of cosmetic surgery is unique among surgical disciplines. First, aesthetic operations are performed on an elective basis for no truly functional purpose (although it has been argued that the
function of the face, for example, is to look good). In other words, patients are subjected to the risks of anesthesia and surgery despite their being physiologically healthy. These patients can suffer all types of complications that are possible with other types of surgery, including nerve damage, hematomas, infections, skin loss, significant scarring, myocardial infarctions, cerebrovascular accidents, and even death. The aesthetic surgeon must be comfortable knowing that these adverse events will doubtless occur at some point despite even the most careful patient selection, perfect surgical technique, and smooth anesthesia.
Honest two-way communication is essential to be sure that patients’ aesthetic expectations are realistic.
For those with artistic abilities, aesthetic surgery offers a means of sculpting the human body into living art. Patients with facial aging can often be made to look literally decades younger and more energetic.
- Burn Surgery
Burn surgeons treat patients with thermal injury, chemical injury, and cold-related injury. Plastic surgeons often focus on burn reconstruction rather than acute burn care. The care of these patients can be quite challenging and highly rewarding. Much of burn reconstruction requires bread and butter plastic surgery, such as local flaps, skin grafts, and tissue expansion. However, many cases require multiple stages, strategic planning, and advanced techniques.
- Craniofacial Surgery
Craniofacial surgeons treat diseases of the bones and soft tissues of the face and skull. They often work with children, treating such conditions as craniosynostosis (premature fusion of the sutures of the skull), cleft palate, hemifacial microsomia (delayed growth of one side of the face), and conditions such as Apert, Crouzon, Treacher-Collins, and Pfeiffer syndromes. They can also work with
adults, treating patients with untreated congenital anomalies, craniofacial trauma, and tumors of the skull base, as well as orthognathic deformities.
- Hand and Upper Extremity Surgery
Hand surgeons treat a variety of conditions of the hand and upper extremity, including fractures, tendon lacerations, traumatic amputations/devascularizations, rheumatoid arthritis, nerve entrapment syndromes, tumors, and congenital anomalies. In a single day, a hand surgeon may perform a replantation from an industrial accident, see a newborn with complete syndactyly, and perform implant arthroplasties to restore function in a patient with rheumatoid arthritis. Restoring pain-free function is the top priority in hand surgery. Cosmesis is also a secondary goal once pain and function have been addressed.
- Microvascular Surgery
Microsurgeons are trained to manipulate tissues by creating microvascular anastomoses and microneural coaptations. They can, for example, replant a severed extremity by locating and repairing the vessels and nerves under the operating microscope. Microsurgical techniques are also used to perform free tissue transfers (free flaps). For example, if a woman has a mastectomy for cancer and desires an autologous (from her own tissue) reconstruction, then an excellent option
is the transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, in which muscle, skin, and fat are removed from the abdomen and placed on the chest wall to reconstruct the breast. Similarly, in cases of congenital facial paralysis, the gracilis muscle can be transferred to the face to make facial expression possible.
- Pediatric Plastic Surgery
Conditions treated by pediatric plastic surgeons include craniofacial anomalies (if they have also pursued craniofacial training), cleft lip and palate, velopharyngeal insufficiency (nasal speech), separation of conjoined twins, congenital anomalies affecting the face, hands and upper extremities,
trunk, and chest wall, and vascular anomalies including hemangiomas and vascular malformations. In addition, pediatric plastic surgery encompasses pediatric burn reconstruction, soft tissue tumors, and traumatic reconstruction, particularly of the face, hands and lower extremity.
WHAT MAKES A GOOD PLASTIC SURGEON?
- Prefers working with his or her hands.
- Enjoys trying new approaches to the same problem.
- Is an independent and creative thinker.
- Likes seeing the immediate results of treatment.
- Is a perfectionist who pays close attention to details.
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