1,721,044 research outputs found
Response to K. Slim and P.L. Fagniez in the article: Endoscopic, percutaneous and laparoscopic treatment of acute biliary pancreatitis
No full textRuolo dell’ecografia nella diagnosi delle aderenze peritoneali.
No full textTecnica ecografica per la diagnosi di aderenze peritoneali
Second Surgery for Recurrence of Malignant Pleural Mesothelioma after extrapleural Pneumonectomy.
No full textBACKGROUND:
Extrapleural pneumonectomy is a treatment option for malignant pleural mesothelioma (MPM), but disease recurrence is common. Among different therapeutic options for recurrence, we have found no reports for second surgical procedures.
METHODS:
We retrospectively evaluated the types and outcomes of surgical management of solid recurrences of MPM, in a series of 74 patients treated with extrapleural pneumonectomy over a 20-year period.
RESULTS:
Of 57 patients for whom follow-up data were available, 11 patients experienced recurrent disease in the form of a solid mass, 1.5 to 12 years after the initial treatment; 8 of these patients had sufficiently good clinical conditions to undergo a second surgery with curative intent. Chest wall resection was performed in 4 cases of parietal recurrence, radical retroperitoneal resection was done in 3 cases of retroperitoneal relapse, and segmental resection of the remaining lung was done in one case of pulmonary metastasis. In this latter case, although computed tomographic images showed a solid mass, at surgery the disease was found to have a serosal nature, precluding the possibility of a curative surgery. Median survival after the second surgery was 14.5 months (range, 6 to 29); no association between survival and site of recurrence, age or disease-free interval was found.
CONCLUSIONS:
In this series, the second surgery did not offer the expected survival benefit of curative treatment strategies and should therefore be considered palliative. Second surgery may be a treatment option in a subset of patients who experience a solid recurrence of MPM that is symptomatic or near vital organs and who cannot undergo additional radiotherapy
Biliary LithiasisBasic Science, Current Diagnosis and Management
No full textThe book provides an overview on biliary lithiasis, twenty years after the first laparoscopic cholecystectomy, including all its clinical pictures. Gallbladder, main bile duct and intra-hepatic stones, in their uncomplicated and complicated forms will be illustrated. Chapters are focused on basic science, epidemiology, diagnostic and therapeutic approaches of biliary lithiasis. The different diagnostic procedures described include invasive and non invasive imaging, and treatment options take into consideration medical treatment, open and minimally invasive surgery, endoscopic and percutaneous approaches, individually or as combined procedures.
The book contents are not limited to the most used therapeutic approaches reported in the literature, but they also address new and innovative therapeutic strategies for biliary lithiasis.
Thanks to its comprehensive approach, the volume will therefore be of interest not only for GPs amd specialists in this field, but also for family doctors and residents of different disciplines
Chirurgia epatica
No full textQuesta pubblicazione, scritta da alcuni tra i più importanti esperti del settore, è indirizzata ai chirurghi in formazione e agli specialisti come aggiornamento sulla maggior parte delle tecniche chirurgiche mininvasive oggi a disposizione. Suddiviso in tre sezioni - tecniche di base, chirurgia generale, chirurgia specialistica - è organizzato in una struttura comune che facilita la lettura: introduzione-indicazioni, preparazioni del paziente, accorgimenti anestesiologici, tecnica e fasi dell'intervento, indicazioni post-operatorie, analisi dei risultati ed infine conclusioni. Le appendici finali trattano argomenti di grande attualità: la chirurgia robotica e la formazione ed educazione continua. Oltre 400 immagini e disegni che illustrano ed esemplificano i diversi tempi delle procedure trattate
Le tecniche chirurgiche mini-invasive.
No full textIllustra le tecniche di chirurgia mini-invasiva dell'esofago
Role of percutaneous cholecystostomy before laparoscopic cholecystectomy in severe acute cholecystitis.
No full textIntroduction: The aim of the study was to investigate the role of percutaneous cholecystostomy before laparoscopic cholecystectomy in gangrenous and phlegmonous cholecystitis. Patients and Methods: Medical records of 100 patients submitted to cholecystectomy with a definitive diagnosis of severe acute cholecystitis were reviewed. The surgical outcomes of 40 patients submitted to cholecystostomy (PC + Cholecystectomy Group) prior to cholecystectomy were compared to those of 60 patients submitted directly to cholecystectomy (Cholecystectomy Group). Results: No differences were found in the rate of first intention laparoscopic cholecystectomy, conversion rate of laparoscopy, the duration of cholecystectomy, post-operative complications, in-hospital mortality and post-operative stay. A higher rate of pre-operative adverse events, longer time lapses since admission to cholecystectomy and longer overall post-operative stays were observed in the PC + cholecystectomy group. Significant failure of cholecystostomy in resolving the acute clinical picture was found in cases of gangrenous cholecystitis. Cholecystostomy allowed resolution of acute phase in phlegmonous cholecystitis but no benefits of pre-operative cholecystostomy were observed in these cases. Conclusion: Percutaneous pre-operative cholecystostomy appears to be of limited utility in patients with severe acute cholecystitis candidate for cholecystectomy
Colica biliare e colecistite acuta. In Casagrande I, Cavazza M, Magnacavallo A. Medicina di Emergenza-Urgenza.
No full textDurante il work up di una apparente patologia biliare includi sempre
nella diagnosi differenziale il sistema cardiaco e respiratorio
• Acquista esperienza nelle studio ecografico della colecisti
• Se il sospetto clinico è alto per una colecistite acuta e l'ecografia
evidenzia una colecisti senza calcoli ma con pareti ispessite pensa
ad una colecistite acalcolosa
• Nell'anziano con diagnosi di colecistite acuta prescrivi precocemente
antibiotici ad ampio spettro che coprono Gram-negativi ed anaerobi
• Condividi al più presto con il chirurgo un caso di sospetta colecistite
acuta, soprattutto se il paziente è anzian
Studio della via biliare principale in corso di lapracolecistectomia.
No full textStudio della via biliare principale in corso di lapracolecistectomia
The use of defunctionalized loop of the small intestine in esophageal surgery.
No full textIntestinal loop in esophageal cancer surgery
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