1,720,985 research outputs found
ABDOMINAL HERNIA REPAIR IN CIRROTHIC PATIENTS A SAFE APPROACH IN ONE DAY SURGERY
No full textIl trattamento della patologia di parete nel paziente cirrotico costituisce un importante filone di ricerca della X Divisione di Chirurgia - SUN -, collegata con il reparto di Malattie Infettive - SUN - per la cura chirurgica dei pazienti cirrotic
Carcinoma of the cervical esophagus. Problems of surgical technique
No full textThe tape shows the surgical technique used by the Authors for the alimentary tract reconstruction after total esophagectomy for cancer of the upper esophagus. A review of the main reconstructive techniques used for this disease is reported
Hepatic cirrhosis and groin hernia: binomial or dichotomy? Our experience with a safe surgical treatment protocol
No full textAdditional prognostic factors in right colon cancer staging.
No full textBased on the theory--which is now acknowledged-of a clinical difference between
proximal and distal colon cancer and on the results of recent genetic and
microbiological studies, a minority of authors have assumed that also in the
sphere of right-sided colon cancer, tumors at three different locations, namely,
the cecum and ascending and transverse colon, can be considered to be
biologically different. These studies have provided the basis for a retrospective
study carried out on 50 patients admitted to our department from 1996 to 2008 for
tumor pathology of the right colon. The tumor was considered to be a unified
biological entity and assessed in relation to the three above-mentioned
locations. The results verify that the aggressive of the tumor increases from the
cecum to the transverse, with a higher percentage of cecal tumors being in I
stage, more tumors in the ascending colon being in II stage, and more transverse
tumors, with the largest percentage of N+ and M+, in stages III and IV. This
difference in biological behavior for the three tumor locations has been also
found in terms of sensitiveness, both pre- and post-operation, of tumor markers
CEA, TPA, and CA19-9. Clinical data revealed a binary relationship between the
transverse, cecum, and ascending tumors, which ultimately affects patient
mortality, which increases in a directly proportional way from the cecum to the
transverse-in the case of a tumor at one of these locations
Further observations on the behavior of carcinoembryonic antigen in patients with cancer of the breast
No full textNonpalpable breast lesions. Diagnostic and therapeutic considerations
No full textThe early detection of breast cancer is of primary importance, as one method which many reduce the unacceptably high mortality rate associated with this disease. In fact, it is well stated that the most concrete possibility of therapeutic success in the treatment of breast cancer is represented by early treatment, while the disease is still localized. Then a screening program is necessary in asymptomatic women, to diagnose the disease as early as possible even in case of non palpable lesion. Mammography is nowadays the most specific and sensitive investigation for clinically occult breast cancer. In this study we searched for mammographic findings with the best predictive value for cancer and we tested the most careful techniques for preoperative localization and surgical biopsy of nonpalpable breast lesions. Seventy-one asymptomatic women (age range: 31-76 years, mean: 53.6) underwent stereotaxic needle localization to perform surgical biopsy of mammographically suspicious but nonpalpable breast lesions. Mammographic findings were classified as: a) well defined and smooth bordered opacities (11.3% of cases); b) poorly defined, irregular, spiculated and stellate opacities (32.4% of cases); c) lowly suspicious microcalcifications, larger, rounder, fewer in number (19.7% of cases); d) highly suspicious microcalcifications, with irregularities on shape, density and size described as clustered and polymorphic (36.6% of cases). Cancer was found in 22 cases (31%); 12 of those (54.5%) were associated with highly suspicious microcalcifications, 10 of those (45.5%) were associated with stellate and poorly defined opacities. On the contrary, all cases of lowly suspicious microcalcifications and all cases of well defined opacities resulted histologically benign lesions; fibrocystic disease accounted for more than half of these. Other findings included fibroadenomas, cysts, ductal or lobular hyperplasia. Fourteen of the cancers (63,6%) were 1 cm or less in diameter and all the others were less than 2 cm; sixteen of the cancers (72.7%) had negative axillary lymph nodes. However the rate of detection of cancer should be significantly improved, beacuse the positive predictive value of mammography currently is not very high. With the increasing specificity of mammographic findings, more strict criteria in the selection of patients undergoing breast biopsy will found, so that surgery must be performed only in very highly suspicious mammographic lesions, decreasing the unnecessary overall biopsy cost. Then, in these cases, stereotaxic technique for hook-wire needle guided biopsy can be very useful in detecting small, early and do potentially curable breast cancer
Laparoscopic cholecystectomy in the morbidly obese.
No full textIn the early days of video-assisted laparoscopic cholecystectomy (VLC), obesity
was considered a contraindication for the procedure. We reviewed charts from 304
patients undergoing VLC; 90 patients were obese, and among these, according to a
classification currently used by medical nutritionists and based on BMI, 45 were
overweight (BMI > or = 25 < or = 29.9), 27 were considered conventionally obese
(BMI > or = 30 and or = 40). In this study we
considered only the morbidly obese patients (5 males and 13 females). The average
age was 42.3 years (range: 21-65) and the average weight 275 Ib (range: 186-331
Ib). Six patients had previously undergone abdominal surgery. All patients were
symptomatic for gallstones, and 5 of them were suffering from acute
cholecystitis. Mean operative time was 20 minutes (range: 10-45 minutes) longer
than that of non-obese patients. No open conversion was necessary. No major
postoperative morbidity and no cases of mortality occurred. The mean hospital
stay and resumption of normal diet were similar to those of non-obese patients.
Regardless of the higher postoperative risks after open cholecystectomy in obese
patients (pulmonary complications, thromboembolism, wound infections and
cardiovascular complications), we suggest VLC as the procedure of choice for
cholecystectomy in these patients
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