189 research outputs found
Beware of the difference between randomized controlled trials and daily clinical practice (in reply to “Surgery or antibiotics for acute appendicitis? Take care about study’s design and methodology!”, by Ceresoli M, et al.)
No full textNo abstract
Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis: Time to change the goal of our research?
No full textGIST: a clinical dilemma
No full textThe authors report a clinical case of malignant gastric and duodenojejunal GIST, in which the only surgical treatment seems to be definitive. In a 69-year-old female, a surgical resection of the gastric and duodenojejunal tumor was performed. Histological analysis showed two spindle cells stromal tumors with mitotic rate >20/10 HPF and its uncommitted origin was demonstrated. Despite the high malignancy degree, the patient refused chemotherapy treatment and there were no local recurrence nor metastasis at a follow-up of 8 years. For this reason and because of the uncertain behavior of histologically benign GIST, the authors propose a lifelong follow-up of all patients managed with potentially curative surgical resection
Importance du background génétique dans le dépistage du carcinome médullaire familial de la thyroïde.
No full textCan intraoperative cholangiography be avoided during laparoscopic cholecystectomy?
No full textControversy exists as to whether intraoperative cholangiography should be performed routinely or selectively during laparoscopic cholecystectomy. The aim of the present study was to assess in which circumstances intraoperative cholangiography can be avoided during laparoscopic cholecystectomy. From January 1999 to June 2002, 168 patients undergoing laparoscopic cholecystectomy for cholelithiasis without intraoperative cholangiography were prospectively evaluated at our Department. Inclusion criteria were established according to a preoperative diagnostic protocol, considering only those patients with normal liver function tests and ultrasound common bile duct diameters < or = 5 mm or > 5 mm, but with normal magnetic resonance cholangiopancreatography findings. Laparoscopic cholecystectomy was carried out without intraoperative cholangiography and postoperative results and follow-up data were recorded and analysed. No major biliary injuries were encountered and no patients had residual bile duct stones after at least a one-year postoperative follow-up. A complete preoperative diagnostic work-up proved to be of fundamental importance for decreasing the incidence of residual bile duct stones. When protocol criteria are satisfied, intraoperative cholangiography may be safely omitted during laparoscopic cholecystectomy and meticulous laparoscopic technique is the main way to reduce the incidence of iatrogenic biliary lesions to a minimum
Dosaggio intranodulare della calcitonina: ruolo nella strategia operatoria del carcinoma midollare della tiroide.
No full textFattori di rischio predittivi di ipoparatiroidismo definitivo dopo tiroidectomia totale.
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One-stage treatment in emergency setting for obstructing colorectal cancer
No full textThe aim of this study was to evaluate the indications for one-stage treatment of obstructing colorectal cancer. From January 1998 to December 2003, 19 patients were operated on at our department for obstructing colorectal cancer. Thirteen patients underwent one-stage operation with immediate anastomosis without diversion, while 6 patients were managed palliatively. We performed resection and anastomosis following intraoperative irrigation in obstructing sigmoid cancer without colonic wall lesions, while subtotal colectomy was carried out in case of massively distended colon with ischemic lesions. Colostomy was indicated in 6 high-risk patients with unresectable lesions. In case of obstructing left colorectal cancer, an experienced surgeon can perform one-stage resection and anastomosis on good general status patients, conversely defunctioning colostomy may be ideal for surgeons with little experience in colorectal surgery and in very poor prognosis patients
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