1,721,010 research outputs found
Legatura bassa della vena spermatica sinistra per il trattamento del varicocele in day-hospital
No full textSurgical treatment of haemorrhoidal disease: a survey of the regional area of Campania in Italy
No full textIntroduction: In order to monitor the common practice regarding the surgical treatment of haemorrhoidal disease in Campania, a region in the South of Italy, a survey amongst one hundred specialists in general surgery and members of the Neapolitan Surgery Association (S.Na.C.) was carried out. Materials and methods: The survey was carried out through a 13-items questionnaire sent to 100 General Surgeons working in Campania. The survey sample was chosen randomly from the S.Na.C. members. Participants were given two weeks to fill in and return the questionnaire. Results: The survey, was developed to obtain a "picture" of the current situation and revealed some interesting results: the procedure preferred was the Milligan and Morgan Haemorrhoidectomy (MMH) being used in 41% of the cases, whilst stapled haemorrhoidopexy (SH) was carried out only in 19% of the cases and 44.4% of the surgeons never carried even one. With regard to postoperative complications, bleeding was the most common after SH which occurred in 10 out of 260 cases (3.8%), whereas anal pain was the most common after MMH (179%). Discussion: In keeping with the literature the analysis shows that, although fairly good results with low complication rates are reported with SH, it is still not widely accepted and is performed in only 19% of the patients in our Regional area
Surgical treatment of haemorrhoidal disease: a survey of the regional area of Campania in Italy.
No full textINTRODUCTION:
In order to monitor the common practice regarding the surgical treatment of haemorrhoidal disease in Campania, a region in the South of Italy, a survey amongst one hundred specialists in general surgery and members of the Neapolitan Surgery Association (S.Na.C.) was carried out.
MATERIALS AND METHODS:
The survey was carried out through a 13-items questionnaire sent to 100 General Surgeons working in Campania. The survey sample was chosen randomly from the S.Na.C. members. Participants were given two weeks to fill in and return the questionnaire.
RESULTS:
The survey, was developed to obtain a "picture" of the current situation and revealed some interesting results: the procedure preferred was the Milligan and Morgan Haemorrhoidectomy (MMH) being used in 41% of the cases, whilst stapled haemorrhoidopexy (SH) was carried out only in 19% of the cases and 44.4% of the surgeons never carried even one. With regard to postoperative complications, bleeding was the most common after SH which occurred in 10 out of 260 cases (3.8%), whereas anal pain was the most common after MMH (179%).
DISCUSSION:
In keeping with the literature the analysis shows that, although fairly good results with low complication rates are reported with SH, it is still not widely accepted and is performed in only 19% of the patients in our Regional area
Single incision laparoscopic anterior resection for cancer using a "QuadiPort access system".
No full textBACKGROUND:
Single incision laparoscopic surgery (SILS) is developing rapidly and different devices are already available. However there is limited data in the literature about single port laparoscopic colorectal surgery.
AIMS:
We report the first case of a single incision laparoscopic anterior resection for cancer using the device "QuadiPort Access System.
METHODS:
A 66 year old female affected by adenocarcinoma of the rectosigmoid junction underwent a radical single incision laparoscopic anterior resection performed by an experienced laparoscopic team.
RESULTS:
The preoperative staging was T2NOM0. The total operative time was 135 min. Length of hospital stay was 6 days. The length of the specimen was 27 cm and 21 nodes were isolated. The pathological examination showed adenocarcinoma staged T3N2MX; G2. There was no postoperative morbidity and at the 6 month follow-up, the patient presented in well condition with no complications and free from cancer.
CONCLUSION:
Single incision laparoscopic anterior resection for locally advanced high rectal cancer seems to be feasible and the "QuadiPort Access System seems to be a valid device. To evaluate outcomes and costeffectiveness of SILS versus the standard laparoscopic colorectal surgery multicenter prospective randomised trials are necessary and the "QuadiPort Access System" could prove to be the device of choice
Sono conciliabili il progresso tecnologico con il risparmio economico imposto al chirurgo?
No full textEndovascular versus open surgical repair of abdominal aortic aneurysm with concomitant malignancy
Full text linkBACKGROUND. The management of patients with abdominal aortic aneurysm (AAA) and concurrent malignancy is controversial. This study retrospectively assessed the outcome of endovascular repair (EVAR) and open repair (OR) for the treatment of AAA in patients undergoing curative treatment for concomitant malignancies.
METHODS:
All patients who underwent surgery for a nonruptured infrarenal AAA of > or =5.5 cm and concomitant malignancy between 1997 and 2005 were retrospectively reviewed.
RESULTS:
Identified were 25 patients (22 men; mean age, 70.3 years) with nonruptured infrarenal AAA of > or =5.5 cm (mean size, 6.4 cm) and concomitant malignancy amenable for curative treatment. EVAR was used to treat 11 patients, and 14 underwent OR. The EVAR patients had a smaller mean aneurysm size (5.9 cm vs 6.8 cm; P = .006) than the OR patients. The mean cumulative length of stay for all patients who received treatment for both AAA and cancer was 12.8 days (range, 4 to 26) for EVAR and 18.2 days (range, 9 to 42 days) for OR. In the EVAR group, no patients died perioperatively; in the OR group, three patients died perioperatively (21.4%; P = NS). Postoperative complications occurred in one patient in the EVAR group and in seven in the OR group for a morbidity rate, respectively, of 9.1% and 50% (P = .04). One late complication (9.1%) occurred in the EVAR group. The mean follow-up was 37.7 months (range, 16 to 60 months) in the EVAR group and 29.6 months (range, 11 to 55 months) in the OR group. At 1 and 2 years, survival rates were 100% and 90.9% in the EVAR group and 71.4% and 49% in the OR group (log-rank P = .103)
CONCLUSIONS:
With low morbidity and mortality, EVAR is a safe technique for the treatment of AAA in patients with concomitant malignancy and could be considered as an alternative to OR
Laparoscopic colon resection: evidence based results
No full textAbout 90-92% of patients with carcinoma of the colon are treated surgically. For other surgeons, laparoscopic surgery for the treatment of malignancies remains controversial because of concerns about the adequacy of lymphadenectomy, the extent of resection, early findings of port-site metastasis and the lack of data on long-term results. In our experience, there are no differences between the laparoscopic and laparotomic techniques, and only advantages if the laparoscopic technique is use correctly. We essentially agree with the good results of many studies published in the last ten years, but we are extremely confident that it is necessary to have a good learning curve and a high-volume cases hospital to obtain good results through a laparoscopic approach. So laparoscopic colorectal surgery should be performed only by surgeons who have completed training in this approach and who perform the procedure often enough to maintain a good level of competence
Something must happen before first breath
Full text linkBackground: Definition and concept of the ‘beginning of human life’ are weakened by co-existing contrasting hypotheses based on humanistic or religious beliefs rather than scientific foundations. This plethora of conceptually distant views have important common concerns in different fields of science and shape, in turn, several societal aspects including laws related, for instance, to inheritance eligibility or abortion, end-of-life care and euthanasia, and reproductive technology. Also, they are fundamental to evaluate opportunity for resuscitation vs. palliative care in extremely preterm infants. In this article, we address one of the most common tenets in medicine: the acceptance that human life starts with first breath, even though several events are well-documented to take place before its occurrence. Main text: Several studies show how pivotal physiological events take place before first breath. Evidence of a number of neurological events occurring before first breath opens the way to the primacy of the Central Nervous System, given its immediate extra-uterine activation at birth. This activation eventually sets specific physiological conditions that allow the complex sequence of events determining the muscle activity associated with the influx of air in the lung and the settling of a continuous and successful extra-uterine respiration. We would like to invite the scientific community to endorse a clear-cut position against the paradigm of ‘first breath’ as the beginning of life. Herein, we also assume how, a still undefined, yet possibly specific quid in the external environment triggers further physiological response in newborns. Better understanding of the critical events that occur at the beginning of human life is likely to cause great concern and expectations in scientists, researchers and physicians working in the domain of brain, and its physiology, and mental health. Conclusions: The comparison between beliefs and evidence-based observations generates confusion, misperceptions and false expectations in society, hence, in the scientific and medical community. Different and more solid alternatives about the carachterization of the ‘beginning of human life’ are indeed available and require to be explored and defined
Developmental vulnerability to psychosis: Selective aggregation of basic self-disturbance in early onset schizophrenia
No full textTrait-like anomalies of subjective experience (aka, Basic Self-disturbance or Self-disorder, SD) have been empirically identified as schizophrenia-specific markers of vulnerability in several clinical and genetic high-risk populations. However, such specificity is still to be tested in developmental years, where emerging psychopathology is less crystallized and diagnostic boundaries more blurred. Thus, the current study explores the distribution of SD in adolescent help-seekers (age range 14 to 18) and tests the specificity of SD with respect to the severity of their diagnostic staging (Early Onset schizophrenia-spectrum psychosis [EOP], ultra high-risk [UHR] and clinical help-seeking controls [CHSC]). For this purpose, 96 help-seeking adolescents consecutively referred to specialized Child and Adolescent Units for diagnostic evaluation, underwent a comprehensive psychopathological examination including the specific interview for SD (i.e. the Examination of Anomalous Self-Experience, EASE). One-way ANOVA was used to test the diagnostic distribution of SD (EASE score), whereas multinomial logistic regression was used to test the effect of SD on the diagnostic outcome. SD frequency (both in terms of EASE total score and domain sub-scores) was decreasing progressively from EOP to CHSC, with intermediate levels in UHR. The EASE total score increased the risk of belonging to the more severe diagnostic stages (i.e, UHR and EOP vs CHSC as reference class) and allowed the correct reclassification of the 75% of the sample. The results confirm the schizophrenia-spectrum specificity of SD in adolescence, highlighting their potential value for early differential diagnosis and risk stratification
Laparascopic colon resection for cancer: evidence based results.
No full textAbstract
About 90-92% of patients with carcinoma of the colon are treated surgically. For other surgeons, laparoscopic surgery for the treatment of malignancies remains controversial because of concerns about the adequacy of lymphadenectomy, the extent of resection, early findings of port-site metastasis and the lack of data on long-term results. In our experience, there are no differences between the laparoscopic and laparotomic techniques, and only advantages if the laparoscopic technique is use correctly. We essentially agree with the good results of many studies published in the last ten years, but we are extremely confident that it is necessary to have a good learning curve and a high-volume cases hospital to obtain good results through a laparoscopic approach. So laparoscopic colorectal surgery should be performed only by surgeons who have completed training in this approach and who perform the procedure often enough to maintain a good level of competence
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