1,721,051 research outputs found
L’uretere retrocavale associato ad anomalia della giunzione uretero vescicale:case report
No full text
L’uretere retrocavale associato ad anomalia della giunzione uretero vescicale: case report
No full textThe Lortat-Jacob operation by laparoscopic access to treat gastroesophageal reflux in pediatric patients. Preliminary results
No full textBACKGROUND: Even in the pediatric field, the technique most commonly used in the laparoscopic treatment of GERD is 360 degrees fundoplication (according to Nissen and variants), but this is not devoid of serious complications or sequelae, such as persistent dysphagia or the "gas bloat syndrome." In fact, there has been no lack of proposals of alternative techniques in literature aiming to reduce these negative postoperative events, especially in pediatric patients. At our pediatric surgical clinic at Bari University, the first choice technique is the Lortat-Jacob operation, used in traditional surgery for over 20 years and that has yielded excellent results both as regards control of GER and the complication and sequelae rate. Aim of this study, based on purely preliminary results, was to demonstrate the feasability of the Lortat-Jacob operation by laparoscopic access in pediatric patients, even younger than 1 year old. To our knowledge, there are no other references in literature to the use of this technique by laparoscopic access in pediatric patients.
METHODS: Antireflux plasty sec. Lortat-Jacob by laparoscopic access was performed in 10 patients of ages ranging between 10 months and 11 years. The technique adopted took into account all the recognized principles of the traditional surgical approach. The most delicate stage was the extensive mobilization of the distal esophagus at the level of the mediastinum, owing to the risk of bleeding, and of pleural and vagal lesions. Mean operative time was 100' (80'-120'). All the operations were performed laparoscopically, and no intraoperative complications were recorded. The nasogastric probe was removed within 24 h postoperatively, and liquid feeding was recommenced within 36 h. All patients were discharged within 72 h.
RESULTS: No complications or short or medium term sequelae were observed. Follow-up is still in the early stages, but the first radiological endoscopic, and pH monitoring controls have shown excellent results.
CONCLUSION: The initial data on our recent, limited experience show that the Lortat-Jacob operation can be performed by laparoscopic access in expert hands, provided scrupulous attention is paid to the timing and principles laid down for the traditional surgical approach. Moreover, laparoscopic access allows even greater care to be taken to prevent damage to the vagal nerves during mobilization of the terminal esophagus at the mediastinic level, as they are easier to identify even in children under 1 year old, thanks to the magnification of the image. The good control of GER and absence of complications or short or medium term sequelae justify our choice to use this operation. However, our results are still preliminary and need to be confirmed by an increasing number of patients and longer term follow-up
Espressione renale e livelli urinari di MCP-1 and EGF nella pielonefrite xantogranulomatosa
No full textLa terapia dei lnfangiomi : Chirurgia versus Sclerosanti
No full textSono descritti í risultti terapeutici in 25 bambini(15 moschi,10 femmine),di età compresa tra 2 giorni
e 9 onni, affetti da linfongiomi(23 casi) o igroma cistico (2 casi),ottenuti con exeresi chirurgica (15
cosi tra cui 2 igromi cistíci del collo,) exeresi chirurgica parziale più corticosteroidi intralesionali (1 caso),
soltanto corticosteroidi intralesionoli (2 casi),terapia sclerosonte c n OK-432(7 casi).In 2 cosi trattati con terapia chirurgica l'uno e con
terapia chirurgica associata a terapia cortisonica o intralesionole l'altro,si
è avuta l'exitus per compliconze infettíve. A prescindere da questi 2 casi,l'incidenza di effetti collaterali
è stato signíficativo per tutti i tipi di trattamento. L'OK-432 è un liofilizzato di Streptococco piogene
beta-emolitico di gruppo A ottenuto dopo íncubazione a 37"C con benzilpenicillina(Penicillina G ).Il trattamento sclerosante viene praticato previa diluizione di 0,1 mg di OK-432 in 10 ml di soluzione fisiologica.
Il farmaco così ricostituito viene iniettato all'interno delle cisti del linfangioma dopo aver drenato la lifa
in esse contenuto; iníettando una quantità di soluzione pari allo quantità di linfa drenata,secondo lo schema
proposto da Ogita; in coso d scarsa o mancata risposta all'oaione sclerosante,la dose è stata incrementata nelle applícazion successive fino ad un massimo di 0,3mg /10ml di OK-432.
Sulla base della loro esperíenza,gli Autori ritengono che l'OK-432 intralesionale sia il trattamento iniziale di scelta, perché riduce i tempi di degenza, i rischí legati all'intervento chirurgico e non comporta i danni estetici leegati alla ferita chírurgica
- …
