1,720,980 research outputs found
Surgical strategy in primary retroperitoneal tumours.
No full textSixty-nine patients with primary retroperitoneal tumours (17 benign, 52 malignant including 4 malignant tumours of uncertain origin) were reviewed to determine the best form of surgical strategy. Total resection was performed in 88 per cent of benign cases and in 65 per cent of malignant cases. In 62 per cent of the total resections for malignant tumours, en bloc excision included adjacent organs or anatomical structures. Operative mortality rate (in terms of the total number of operations performed) was 5 per cent. Postoperative complications occurred in 14 per cent and recurrences in 35 per cent. The overall 5-year survival rate was 67 per cent in patients with totally resected tumours and zero in patients whose tumours were treated by partial resection or biopsy. An aggressive surgical approach aimed at total excision of the tumour is the best form of therapy currently available. In the totally resected retroperitoneal tumour, the use of adjuvant radiotherapy and/or chemotherapy depends on the grade of the malignancy and clearance as assessed histologically. Careful follow-up based on the use of computerized axial tomography and ultrasound allows early identification of recurrence at a stage when the recurrence is amenable to total resection
The role of local resection of ampullary neoplasms (ampullectomy) 100-year after Halsted description
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The Dagradi-Serio-Iacono operation central pancreatectomy
No full textCentral pancreatectomy (CP) is a segmental pancreatic resection indicated to remove benign or low-grade malignant
tumors of the isthmus and proximal part of the body of the pancreas. The main advantage of this operation compared with major
resections is that it permits to spare normal pancreatic parenchyma;moreover, spleen and upper digestive and biliary tracts are saved.
The description of the complete operation was reported for the first time by Dagradi and Serio in 1984 and subsequently spread
worldwide by Iacono and Serio. In our opinion, it should be called the Dagradi–Serio–Iacono operation, by the names of the
surgeons who first performed it (Dagradi and Serio), and by the names of the surgeons responsible for reporting it worldwide
with precise indications (Iacono and Serio). Operation requires a midline or a bilateral subcostal incision; the lesser sac is entered
through dissection of the transverse colon from the omentum or by transecting the gastrocolic ligament. The pancreatic segment
harboring the lesion is then mobilized and its posterior surface carefully dissected from the splenic vein and artery. Subsequently,
the pancreatic portion harboring the tumor is isolated at its superior margin from the splenic artery after the pancreas is transacted.
The extent of the resection of the central segment is limited on the right by the gastroduodenal artery and on the left by the need
to leave at least 5 cm of normal pancreatic remnant. The resected pancreatic specimen is sent to the pathologist for confirmation
of diagnosis and to check if the resection margins are adequate. Hemostasis of the two raw surfaces is achieved with interrupted 5
or 4/0 nonabsorbable stitches. When it is not stapled, theWirsung’s duct of the cephalic stump is sutured selectively with a figureof-
eight nonabsorbable stitch. An end-to-end invaginated pancreaticojejunostomy is carried out with a single layer of interrupted
stitches. The operation is concluded with the construction of an end-to-side jejuno-jejunostomy about 50 cm distal to the
pancreatic anastomosis. Other techniques for reconstruction of the distal stump using jejunum or stomach have been described.
One or two soft drains are brought out on the right side. The fluid collected from this drain is checked for amylase level on
postoperative days 3, 5, and 7; if the level is low or absent, the drain is removed. Central pancreatectomy is a safe technique for
benign or low malignant tumors of the pancreatic neck that allows curing the tumor with evident functional results without
increasing the risk for the patient. We can say that CP has a clear role like pancreaticoduodenectomy and distal pancreatectomy
and we think that a pancreatic surgeon has to include this procedure in his/her technical skills. In order to obtain excellent results,
correct indications and experience in pancreatic surgery are recommended
[Vascular problems in destructive pancreatic surgery].
No full textObstacles of vascular type may hinder or prevent pancreatic destruction for tumours of the pancreas or periampullary tumours. Out of 72 major pancreatic demolitions (cephalic duodenopancreatectomy or subtotal pancreatectomy from rt to lt) there were vascular difficulties on 26 occasions (36\%), of which 15 were in existence prior to development of the neoplasia (anomalies of rise and course of peripancreatic vessels, stenosis/obliteration of the common hepatic artery in pancreatic head or periampullary tumours) and 11 due to tumoral growth (direct involvement of the mesenteric-portal tract, the hepatic artery and the superior mesenteric artery). The technical solutions used are discussed individually in the light of the physiopathological repercussions consequent on any temporary or permanent interruption of important hepatic and splanchnic vascularisation vessels (hepatic artery and various mesenteric a.), in relation to operating mortality and the prospects of long-term survival. In the most complex cases of direct vascular involvement by the neoplasia, the Author's trend was orientated to a position which, while accepting demolition decisions useful for the widening of the surgical radicality margins, nevertheless avoids extensive demolition solutions imposed by conditions of necessity or considerations of principle that probably do not bring significant advantages as regards long-term prognosis for these tumours
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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