1,721,368 research outputs found
Tumori del colon retto
No full textThe increasing aging of the population points out the problem of an evidence-based approach to the elderly (≥ 65 years old) in the setting of adjuvant chemotherapy, whose benefit is established only in younger patients. Currently the cornerstone trials in these fields are planned for patients aged less than 65 and the extrapolation of these results to elderly patients is not methodologically correct. On the other hand, the search for a survival benefit should be balanced by the acknowledgement that aging gradually reduces the functional reserves of the body, so such treatments could be harmful. The favorable outcomes were mostly related to breast cancer, due not only to its high prevalence and social impact, but also to the dual opportunity of chemotherapy and hormonal treatment. Chemotherapy has also proved effective in colorectal cancer and to a lesser extent in lung cancer, despite the limits of such studies. Some recent clinical trials have however demonstrated that fit elderly patients may show similar outcomes in comparison with their younger counterparts. These results then display again the need for a comprehensive geriatric assessment in treatment planning, also in the adjuvant setting, in order to balance the benefit of this treatment with the possible harms linked to age-associated disorders
A technical modification of heart-lung transplantation in rats
No full textHemodynamic studies were carried out on a series of rats undergoing heart-lung transplantation according to the technique of Sun Lee. The results suggested a new hypothesis of blood circulation in the heart-lung block by demonstrating the lack of necessity for the venovenous anastomosis. A new technique, with just one aortoaortic anastomosis, was therefore evaluated. Its value and reliability in a series of 30 rats are discussed
Minilaparoscopic colorectal resections : technical note
Full text linkLaparoscopic colorectal resections have been shown to provide short-term advantages in terms of postoperative pain, general morbidity, recovery, and quality of life. To date, long-term results have been proved to be comparable to open surgery irrefutably only for colon cancer. Recently, new trends keep arising in the direction of minimal invasiveness to reduce surgical trauma after colorectal surgery in order to improve morbidity and cosmetic results. The few reports available in the literature on single-port technique show promising results. Natural orifices endoscopic techniques still have very limited application. We focused our efforts in standardising a minilaparoscopic technique (using 3 to 5 mm instruments) for colorectal resections since it can provide excellent cosmetic results without changing the laparoscopic approach significantly. Thus, there is no need for a new learning curve as minilaparoscopy maintains the principle of instrument triangulation. This determines an undoubted advantage in terms of feasibility and reproducibility of the procedure without increasing operative time. Some preliminary experiences confirm that minilaparoscopic colorectal surgery provides acceptable results, comparable to those reported for laparoscopic surgery with regard to operative time, morbidity, and hospital stay. Randomized controlled studies should be conducted to confirm these early encouraging results
La chirurgia laparoscopica nel tumore del colon-retto
No full textOver the past decade advances in laparoscopic surgery have revolutionized the surgical approach to many diseases. Although the first case series on laparoscopic segmental colectomy in patient with sigmoid cancer was described in 1991, this technique has not been readily accepted. Despite reduced morbidity and improved convalescence after laparoscopic surgery for benign disorders, surgeons have been sceptical about similar advantages of laparoscopic colectomy for cancer. Several randomized trials were initiated in the early 1990s to compare the short and long-term outcomes of patients undergoing minimally invasive and conventional open surgery for colon cancer. This review examines recent data from randomized, controlled trials and meta-analysis, that report the short and long-term outcomes after laparoscopic colectomy for cancer
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