Octavian Mihalache

Dr. Octavian Mihalache

orcid

Research Focus & Metrics

Academic Career Length

2Years (2025-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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11 March 2026 in Diagnostics
Verified
Journal Article
Open access
PDF file
Dumitru Dragos ChitcaDumitru Dragos Chitca
Dumitru Dragos Chitca
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
Bobirca FlorinBobirca Florin
Bobirca Florin
CBCristian Botezatu
Cristian Botezatu
VPValentin Popescu
Valentin Popescu
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background: Anastomotic leakage (AL) remains one of the most feared complications after colorectal surgery. This study aimed to identify preoperative risk factors for AL using a five-year dataset from two Romanian surgical clinics. Materials and Methods: A retrospective cohort of 155 patients undergoing colorectal resection with primary anastomosis (105 from “Colentina” Hospital and 50 from “Dr. I. Cantacuzino” Hospital) was analyzed. Preoperative demographic, clinical, and laboratory data were extracted and assessed using univariate and multivariable logistic regression. Statistical analyses were performed using IBM SPSS. Results: The overall AL rate was 10.3%. Multivariable analysis identified high ASA class (OR 17.6; p = 0.001), emergency surgery (OR 32.2; p = 0.0007), and heavy alcohol use (OR 15.3; p = 0.004) as independent predictors of leakage. While low preoperative albumin and smoking were associated with leakage in a bivariate analysis, these did not remain significant after adjustment. Notably, all laboratory markers were based on preoperative values, distinguishing our approach from prior studies that commonly evaluated postoperative biomarkers. No statistically significant effect was found for neoadjuvant chemotherapy or radiotherapy after controlling for other covariates. Conclusions: High ASA score, alcohol abuse, and emergency surgery were the strongest independent predictors of AL in our cohort. The lack of predictive power of certain widely reported factors, such as low albumin, may reflect our dataset’s focus on preoperative optimization. These findings support the use of individualized risk assessment and reinforce the role of preoperative preparation in reducing leak incidence in colorectal surgery.

12 October 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
Laurentiu SimionLaurentiu Simion
Laurentiu Simion
HDHoria Doran
Horia Doran
ABAndra Bontea Bîrligea
Andra Bontea Bîrligea
DLDan Cristian Luca
Dan Cristian Luca
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background: Diabetes-related foot diseases represent a global health problem because of the associated complications, the risk of amputation, and the economic burden on health systems. Negative pressure wound therapy (NPWT) is a technique that uses sub-atmospheric pressure to help promote wound healing by reducing the inflammatory exudate while keeping the wound moist, inhibiting bacterial growth, and promoting the formation of granulation tissue. Objective: This study aimed to assess the effectiveness of NPWT in preventing major amputation in diabetic patients with complicated foot or lower limb infections and to contextualize the results through a review of the existing literature. Materials and methods: We conducted a retrospective study at the First Surgical Department of “Dr. I. Cantacuzino” Clinical Hospital in Bucharest, Romania, over a 15-year period, including 30 consecutive adult patients with diabetes and soft tissue foot or lower limb infections treated with NPWT. Patients with non-diabetic ulcers, incomplete medical data, or aged under 18 were excluded. All patients underwent initial surgical debridement, minor amputation, or drainage procedures, followed by the application of NPWT using a standard protocol. Dressings were changed every 2–4 days for a total of 7–10 days. Antibiotic therapy was adapted according to the culture results. The primary outcome was limb preservation, defined as avoidance of major amputation. Secondary outcomes included in-hospital mortality and wound status at discharge. Results: NPWT was associated with a favorable outcome in 24 patients (80%), defined by wound granulation or healing without the need for major amputation. Five patients (16.6%) underwent major amputation because of failure of the primary lesion treatment, and one patient died. No statistically significant association was observed between the outcomes and standard classification scores (WIFI, IWGDF, and TPI). A comprehensive literature review helped to integrate these findings into the existing pool of knowledge. Conclusions: NPWT may support limb preservation in selected diabetic foot cases. While the retrospective design and the small sample size of the study limit generalizability, these results reinforce the need for further controlled studies to evaluate NPWT in real-life clinical settings. The correct use of NPWT combined with etiological treatment may offer a maximum chance to avoid major amputation in patients with diabetes-related foot diseases.

20 January 2026 in Preprints.org
Verified
Preprint
Open access
PDF file
Dumitru Dragos ChitcaDumitru Dragos Chitca
Dumitru Dragos Chitca
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
Bobirca FlorinBobirca Florin
Bobirca Florin
CBCristian Botezatu
Cristian Botezatu
VPValentin Popescu
Valentin Popescu
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background: Anastomotic leakage (AL) remains one of the most feared complications after colorectal surgery. This study aims to identify preoperative risk factors for AL using a five-year dataset from two Romanian surgical clinics. Matherial and Methods: A retrospective cohort of 155 patients undergoing colorectal resection with primary anastomosis (105 from “Colentina” Hospital and 50 from “Dr. I. Cantacuzino” Hospi-tal) was analyzed. Preoperative demographic, clinical, and laboratory data were ex-tracted and assessed using univariate and multivariable logistic regression. Statistical analyses were performed using IBM SPSS. Results: The overall AL rate was 10.3%. Multivariable analysis identified high ASA class (OR 17.6; p = 0.001), emergency sur-gery (OR 32.2; p = 0.0007), and heavy alcohol use (OR 15.3; p = 0.004) as independent predictors of leakage. While low preoperative albumin and smoking were associated with leakage in bivariate analysis, these did not remain significant after adjustment. Notably, all laboratory markers were based on preoperative values, distinguishing our approach from prior studies that commonly evaluate postoperative biomarkers. No statistically significant effect was found for neoadjuvant chemotherapy or radiother-apy after controlling for other covariates. Conclusions: High ASA score, alcohol abuse, and emergency surgery were the strongest independent predictors of AL in our cohort. The lack of predictive power of certain widely reported factors, such as low albumin, may reflect our dataset’s focus on preoperative optimization. These findings support the use of individualized risk assessment and reinforce the role of preoperative prepa-ration in reducing leak incidence in colorectal surgery.

11 October 2025 in Medicina
Verified
Journal Article
Open access
PDF file
Bobirca FlorinBobirca Florin
Bobirca Florin
DDDan Dumitrescu
Dan Dumitrescu
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
HDHoria Doran
Horia Doran
CACristina Alexandru
Cristina Alexandru
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background and Objectives: Diabetic foot gangrene remains a major cause of lower limb amputation, driven by vascular, neuropathic, and infectious mechanisms. Identifying predictors for amputation type is essential to optimizing outcomes and reducing disability. We aimed to analyze the burden of diabetic foot gangrene and the patients’ characteristics according to the type of surgery, minor or major amputations. Methods: We conducted a retrospective observational study including 295 diabetic patients who underwent surgery for foot lesions at a Romanian tertiary center (January 2023–December 2024). Patients were classified according to surgical outcome as minor (toe/foot-level) or major (below/above-knee) amputations. Clinical, demographic, and pathological variables were compared between groups. Statistical analysis was performed with IBM SPSS Statistics 20.0. Categorical variables were expressed as frequencies and percentages, and continuous variables as mean ± SD or median (min–max). Group comparisons used Student’s t-test, Mann–Whitney U, Chi-square, or Fisher’s exact test, and binary logistic regression was applied to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: Among the patients included (mean age 64.8 ± 10.8 years; 69.2% male), 191 (64.7%) underwent minor amputations/debridement and 104 (35.3%) required major amputations. Patients with major amputations were older (66.8 ± 11.3 vs. 63.7 ± 10.4 years, p = 0.012) and less frequently male (56.7% vs. 75.9%, p = 0.001). Lesion extension to the foot or beyond strongly predicted major amputation (p < 0.001). Peripheral arterial disease was more prevalent in the major group (85.6% vs. 65.4%, OR = 3.13, 95% CI = 1.68–5.84), while neuropathy was associated with minor procedures (12.6% vs. 3.8%, p = 0.015). Anemia (70.2% vs. 56.5%, p = 0.021) and leukocytosis (68.3% vs. 49.2%, p = 0.002) were also independent predictors of major amputation. Conclusions: The study highlights the need for early detection, coordinated multidisciplinary care, and personalized assessment of diabetes burden and its complications to minimize the risk of major limb amputation.

9 April 2026 in Preprints.org
Verified
Preprint
Open access
PDF file
Bobirca FlorinBobirca Florin
Bobirca Florin
DDDan Dumitrescu
Dan Dumitrescu
FGFlorentina Gherghiceanu
Florentina Gherghiceanu
ABAnca Bobirca
Anca Bobirca
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background/Objectives: The main objective of the study was to determine the frequency of patients who underwent breast conserving surgery (BCS) and those with modified radical mastectomy and to compare the clinical-paraclinical parameters between these groups. Methods: We conducted an observational, retrospective study, which included 101 patients diagnosed with breast cancer that had surgical interventions between January 2024 and April 2025. Results: The BCS category was represented by 36.6& cases, while 63.4% were in the mastectomy subgroup. Hemoglobin at the time of admission had an average of 13 g/dL, the difference between the 2 categories of patients being statistically significant. (13.7 vs 12.7, p=0.010). Conclusions: Although it has been a hotly debated topic in recent years, the choice of surgical technique for breast tumors still presents novelties and interest in surgical specialties. Selection criteria such as disease stage, histopathological subtype, and the intervention chosen by the surgeon may vary and oncological results may be comparable.

Verified
Journal Article
Open access
PDF file
Bobirca FlorinBobirca Florin
Bobirca Florin
DDDan Dumitrescu
Dan Dumitrescu
FGFlorentina Gherghiceanu
Florentina Gherghiceanu
ABAnca Bobirca
Anca Bobirca
Octavian MihalacheOctavian Mihalache
Octavian Mihalache
TPTraian Pǎtraşcu
Traian Pǎtraşcu
Background/Objectives: The main objective of the study was to determine the frequency of patients who underwent breast-conserving surgery (BCS) and those with modified radical mastectomy and to compare the clinical–paraclinical parameters between these groups. Methods: We conducted an observational, retrospective study, which included 101 patients diagnosed with breast cancer that had surgical interventions between January 2024 and April 2025. Results: The BCS category was represented by 36.6% cases, while 63.4% were in the mastectomy subgroup. Hemoglobin at the time of admission had an average of 13 g/dL, the difference between the two categories of patients being statistically significant. (13.7 vs. 12.7, p = 0.010). Conclusions: Although it has been a hotly debated topic in recent years, the choice of surgical technique for breast tumors still presents novelties and remains a subject of interest within surgical specialties. Selection criteria such as disease stage, histopathological subtype, and the intervention chosen by the surgeon may vary and oncological results may be comparable.