1,721,171 research outputs found
Formazione e aggiornamento di personale medico ed infermieristico nel campo della chirurgia laparoscopica e video assistita
No full textAggiornamenti in Videochirurgia
No full textGli autori curano in questo CD-ROM 17 capitoli nei quali diversi co-autori mettono a fuoco le tematiche più attuali ed interessanti della chirurgia laparoscopica e mininvasiv
Collagen tampons as drug carriers to prevent infections in prosthetic surgery of groin hernias
No full textI tumori della tiroide
No full textGli autori descrivono in questo capitolo del trattato di chirurgia oncologica, la gestione dei tumori della tiroide. Si parte dalla classificazione e si trattano tutte le problematiche più o meno note. Vengono descritte l'epidemiologia, i fattori di rischio, gli aspetti istopatologici e di diagnosi e trattamento. Il tutto sulla scorta di una valida ed attuale bibliografia
Collagen tampons as aminoglycoside carriers to reduce postoperative infection rate in prosthetic repair of groin hernias.
No full textOBJECTIVE: To find out whether collagen tampons treated with gentamicin would prevent postoperative infections in patients operated on for groin hernias by insertion of prostheses. SETTING: University hospital, Italy. DESIGN: Prospective randomised trial. PATIENTS: 595 patients who required prosthetic repair of a groin hernia. INTERVENTIONS: All repairs were by our standard surgical technique including prophylactic ceftriaxone, local anaesthesia, and insertion of a polypropylene mesh. 301 patients also had a gentamicin laced collagen tampon placed in front of the prosthetic mesh before the aponeurosis of external oblique muscle was sutured. RESULTS: 1/301 patients in the gentamicin group (0.3\%) developed a postoperative wound infection compared with 6/294 in the control group (2.0\%), (p = 0.04 Fisher exact test). CONCLUSIONS: Gentamicin-laced collagen tampons are effective in reducing the postoperative infection rate in patients operated on for groin hernia by insertion of a prosthesis
Laparoscopic Staging of Abdominal Malignancies
No full textObjectives: To assess the efficacy of laparoscopic evaluation of abdominal malignancies in terms of mortality, morbidity, sensitivity, specificity.
Methods: A prospective randomized study on 62 patients affected by different malignant neoplasms whose tumor staging needed a confirmation by explorative laparotomy as requested from oncologists. Tumor histology was available in 22 cases of ovarian cancers previously treated and requiring a second look, in 12 operated pancreatic cancers and in 2 cases of ampullary malignancies resected via a Whipple procedure. The remaining
cases were explored on imaging basis. 30 patients underwent a standard explorative laparotomy, the remainders were explored by laparoscopy. Both groups of patients received multiple biopsies.
Results: No difference was found in terms of sensitivity or specificity (p>0.05) Chi2) between laparoscopy and laparotomy regarding the specimens final histology and thus to reach a diagnosis. Morbidity was significantly lower (p< 0:05 Chi2) in the laparoscopic group. No peroperative deaths occurred.
Conclusions: Laparoscopy may avoid an unnecessary laparotomy whenever a diagnostic confirmation is required. Laparoscopy may play a key role both to determine the neoplasm operability or the need for adjuvant therapies. Especially immuno- compromised cancer patients may receive an advantage in avoiding, if requested, a staging laparotomy
Brush citology: a reliable method in detecting helicobacter pylori infection
No full textBackground. In the last few years heficobacter pylori (HP) has been increasingly recognized as main etiologic factor of gastris and peptic ulcer, therefore modifying the diagnostic and therapeutic approach to these diseases. New less invasive diagnostic techniques have been developing to make a correct diagnosis and evaluate the effectiveness of medical treatment.
Objective. The goal of this study was to assess the usefulness of brush cytology and compare its diagnostic accuracy with urease test in detecting HP in patients suffering from gastric or peptic ulcer.
Patients. The study group consisted of 213 consecutive patients who underwent elective gastroduodenoscopy. Twenty-six (10%) patients had duodenal ulcer, 27 (34%) chronic gastritis and the remaining 115 (56%) had duodenal ulcer but were on treatment with omeprazole (75 patients) or ranitidine (40 patients).
Methods. At endoscopy accurate brushing was obtained prior to biopsy. Cytology material was smeared and methilene blue-stained sections were then prepared for light microscopy. Biopsies obtained were treated for the ureasc test. Results of both methods were available within one hour.
Results. Brush cytology was more sensible than urease test in detecting HP in patients with either chronic gastritis (55% vs 36%) or duodenal ulcer after omeprazole treatment (75% vs 51%). In the remaining patients with duodenal ulcer with no concomitant medication or ranitidine therapy. Brushing has accuracy equal to that of urease test in identifying HP (i.e.94% vs 84%).
Conclusions. Brush citology is a simple, reliable, relatively non-invasive and inexpensive method in detecting HP in persons with gastritis or peptic ulcer. This technique is more sensible than the urease test for assessing HP colonization when gastric density is low (i.e. after omeprazole therapy or in chronic gastritis)
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