1,720,970 research outputs found
Peritoneal carcinomatosis from unusual cancer origins: Is there a role for hyperthermic intraperitoneal chemotherapy?
No full textComplete cytoreductive surgery (CCRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is the gold standard for curative treatment of peritoneal carcinomatosis (PC) arising from colorectal cancer, peritoneal mesothelioma and peritoneal pseudomyxoma peritonei (PMP). The results of HIPEC remain controversial in PC that originates from ovarian cancer, stomach cancer, neuroendocrine tumors, or sarcoma. HIPEC has also been used, although very rarely, for other malignant carcinomatoses. Its use has been exceptional due either to the rarity of the tumor or because such disease is usually widespread and rarely confined to the peritoneum. The aim of this study was to evaluate the results of CCRS plus HIPEC in patients with PC of unusual origin
Outcome of chronic pilonidal disease treatment after ambulatory plain midline excision and primary suture
No full textAbstract BACKGROUND: Pilonidal sinus (PS) is a common chronic disorder of the sacrococcygeal region. The optimal treatment for PS remains controversial, and recent reports have advocated different surgical approaches. METHODS: A prospective study was performed on 103 patients with nonrecurrent quiescent chronic discharging sinus. Excision with primary closure was performed on all patients. Patients were subdivided randomly into 2 groups. In group A, the excision was associated with drainage of the wound; in group B, the wound was not drained. RESULTS: Excision with primary closure and drainage was performed in 53 patients (group A). Drainage was omitted in 50 patients (group B). Minor wound complications occurred in 3 patients in group A and in 36 patients in group B. No complete dehiscence of the wound was observed in patients in group A and in 8 patients in group B. Complete healing was fastest in patients in group A. Sinus recurrence occurred in 1 patient in group A and in 2 patients in group B. CONCLUSION: Short- and long-term results suggest that limited midline excision with primary closure and wound drainage is a simple and effective procedure in the surgical treatment of uncomplicated PS. More demanding flap techniques and plasties should be reserved for complicated PS, which requires a wider excision
Use of Cold-Stored Vein Allografts for Venous Reconstruction During Pancreaticoduodenectomy
No full textHanging of the hepatic veins septa: A safe control prior and during outflow anastomosis in liver transplantation
No full textLaparoscopic first step approach in the two stage hepatectomy
No full textResection is the gold standard therapeutic option for patients with colorectal liver metastases. However, only 20-30% of patients are resectable. In patients with a concomitant future liver remnant (FLR) less than 25-30%, a single stage resection is not feasible. The aim of this study is to evaluate the feasibility and the rates of morbidity and mortality of the laparoscopic approach in the first-step of two stage hepatectomy. From 2004 to March 2014, 73 patients underwent a two stage hepatectomy: of these, four underwent a totally laparoscopic first step [wedge left liver resection and right portal vein ligation (PVL)]. All the patients were male. Median age was 55 years. One patient underwent an atypical wedge resection of segment II-III and a laparoscopic PVL (LPVL), one patient had a first wedge resection of segment II and LPVL, and two patients underwent a wedge resection of segment III and LPVL. First step surgical mean time was 189 (range, 160-244) min, mean blood loss was 22 (range, 0-50) cc. No transfusion was required in this series. The results of our study demonstrate that the first step of hepatic resection and PVL is feasible with a laparoscopic approach in patients with bilobar liver metastases
Circulating stem cells in colorectal cancer: new tools and potential therapeutic targets.
No full textAim: Circulating tumour cells (CTCs) are responsible for tumour dissemination.
However, low numbers and scarce propensity to expand have hampered the molecular
characterization of CTCs in colorectal cancer (CRC) and the identification of
cancer stem cells (CSCs) among CTCs. Taking advantage of a new in vivo model
of CTC generation, we analysed colorectal CTCs with specific focus on CSCsrelated
features.
Method: CRC cells derived from surgical specimens are infected with lentiviral
particles containing a luciferase-GFP reporter and injected orthotopically into the
cecal wall of immunecompromised mice to generate patient-derived xenografts
(PDX). Following the appearance of liver metastases, blood is collected via cardiac
puncture to isolate CTCs and both metastases and primary tumours are harvested for
subsequent analyses.
Results: PDX-derived CTCs (PDCs) exhibit stem cell features, being able to generate
organoids in vitro and secondary tumours in vivo and contain a subpopulation
of cells expressing markers of CSC and/or metastatic cells. Gene expression and proteomic
analyses reveal significant differences in pathway activation in PDCs as compared
to primary tumour and metastasis-derived cells.
Conclusion: Recapitulating the process of CTCs dissemination with primary
tumour cells offers an unprecedented opportunity to explore the mechanisms of
metastasis formation and to identify new potential therapeutic target
Treatment of hydatid bronchobiliary fistulas: 30 years of experience
No full textBackground: Bronchobiliary fistula (BBF) is an uncommon but severe complication of hydatid disease of the liver. Operation is considered the treatment of choice but the most appropriate operation is uncertain. The aim of this study was to evaluate the early and long-term outcomes following different surgical procedures. Methods: A retrospective evaluation of 31 patients with BBF was performed. Surgical access consisted of laparotomy, thoracotomy or a thoracoabdominal (TA) incision. Surgical procedures for the treatment of the cyst were classified as conservative or radical. Results: Radical treatment including lung resection and pericystectomy was performed in all patients in whom the surgical exposure was obtained by either thoracotomy or TA. Of the patients treated by laparotomy, two had a pericystectomy, and four had drainage of the cyst. There were two deaths among the seven thoracotomy patients and one among the 18 TA patients. Pleural effusion was observed in six of the TA, two of the thoracotomy, and three of the laparotomy patients. Biliary fistula occurred in two of the five thoracotomy patients surviving operation and in two laparotomy patients (2/6). Progression of the lung disease was observed in four laparotomy patients and in one thoracotomy patient. Conclusions: The better outcome achieved in TA patients is the result of the simultaneous radical treatment of all the pathological aspects of BBF
- …
