1,721,195 research outputs found
in Regina G, Greco L. La chirurgia degli aneurismi dei tronchi sovraortici. EFFEBIEMME EDITORE; PARMA, 1999
No full textInnovazioni terapeutiche nella proctite attinica cronica: valutazione della radiofrequenza endoscopica come alternativa alle tecniche tradizionali.
No full text1. Abstract Introduction Chronic actinic proctitis is a late complication of pelvic radiotherapy, caused by ischemic microvascular lesions that lead to chronic rectal bleeding, anemia, and a reduction in quality of life. Traditional therapies, including argon plasma coagulation (APC), although effective, are burdened by ulcerations and stenosis. Materials and Methods Radiofrequency ablation (RFA), already successfully used for esophageal lesions, provides controlled and superficial necrosis, promoting mucosal re-epithelialization. The aim of the study is to evaluate the efficacy and safety of RFA in the treatment of refractory chronic actinic proctitis, comparing it with conventional endoscopic techniques. Selected patients were treated with a BarrxTM through-the-scope catheter, applying an energy of 10 J/cm2 (300 W). Endoscopic follow-up, using white light and narrow-band imaging (NBI), monitored re-epithelialization and the onset of complications. Results: Between January 1, 2023, and October 31, 2024, 15 patients with symptomatic CRP refractory to conventional medical therapy were enrolled. All patients underwent endoscopic treatment with RFA and subsequent follow-up until October 31, 2025. Control of rectal bleeding was achieved in thirteen patients (86.6%) after 1 or 2 sessions. In the remaining two cases, a significant reduction in bleeding was observed, although not complete remission. Ten patients received a single session (66.6%), while five patients required a second application after 6-8 weeks (33.3%). The complete remission of bleeding observed in 86.6% of patients and partial remission in the remaining 13.4% confirm the hemostatic efficacy of RFA, in line with the findings of major international trials. The progressive improvement in hemoglobin levels and the elimination of transfusion requirements within the first few months after treatment indicate an early and lasting clinical response. Endoscopically, the complete re-epithelialization of the rectal mucosa, with regression of telangiectasias and normalization of the vascular pattern, documented in all patients at the 24-month follow-up, demonstrates that the healing achieved is not only morphological but also functional. The complete absence of ulcerations, stenosis, or late fibrosis confirms the precision and selectivity of radiofrequency-induced superficial ablation, which allows for the preservation of the structural integrity of the rectal wall. Discussion This study represents one of the most recent experiences of the application of endoscopic radiofrequency (RFA) in the treatment of refractory chronic actinic proctitis (CRP), a complex and highly disabling clinical condition that can arise in patients undergoing pelvic radiotherapy for prostate, rectal, endometrial, or cervical cancer. The results obtained in our series highlight the high efficacy of RFA in controlling rectal bleeding and mucosal regeneration, with an excellent safety profile and significant clinical improvement maintained over time. Conclusions Endoscopic radiofrequency has been confirmed as an effective, safe, and minimally invasive method for chronic actinic proctitis, capable of ensuring long-lasting bleeding control and excellent mucosal healing
Atti (Video) XIII Congresso Latinoamericano di Chirurgia-VI Congresso Cubano di Chirurgia
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Atti (volumi I e II) del III Congresso Nazionale Società Polispecialistica ltaliana dei Giovani Chirurghi. Bari 26-28 aprile 1990
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[Acute pancreatic necrosis complicated by infection and gastro-intestinal translocation: pathogenesis correlation and therapeutic implication]. FT Necrosi pancreatica acuta infetta e translocazione batterica intestinale: correlazioni patogenetiche e implicazioni terapeutiche.
No full textThe authors define pathogenetics correlations as a acute necrotizing pancreatitis complicated by infection and bacterial translocation. Acute necrotizing pancreatitis infection occurs for gastrointestinal bacterial translocation due to structural and functional modifications of intestinal mucosa. These modifications are results of mucosa ischemic-reperfusion system caused by systemic emodynamic instability in micro- and macro-circulation of splanchnic district. Emodynamic systemic instability has a central role in different multiple physiopathologic phenomena (ipovolemic shock; pancreatic shock, SIRS), which is caused by acute pancreatic necrosis and carries to common way established by severe systemics emodinamics modifications; these changes promote growth of adverse events which conduce by means of process previously described to bacterial translocation and infection of acute pancreatic necrosis. Indeed, emodynamic systemic instability of any etiology, can determine for one way bacterial translocation and on the other acute ischemic pancreatitis; both phenomena concur lead to cause beginning of acute necrotizing pancreatitis complicated by infection. The authors confirm that improved knowledge of acute pancreatic necrosis complicated by infection and own pathogenetic correlations with bacterial translocation, allows the realization of therapeutic measures aimed to prophylaxis of infection of acute pancreatic necrosis. Central emodynamic stability regularization of splanchnic perfusion and antibiotic prophylaxis, have a central role in prophylaxis of infection of acute pancreatic necrosis. Antibiotic is given by systemic (imipenem e.v.) and selective decontamination of gastrointestinal tract (SDD). SDD provides for oral antibiotic prophylaxis (PTA protocol) and systemic antibiotic prophylaxis (cefotaxime and gentamicin), in addition to microbiologic and gastrointestinal monitoring. If on the one hand the role of SDD about mortality reduction is not clear, however, on the other it is well recognized capacity of reduction the intercurrents and pulmonary infections. Other Authors think that SDD is insignificant on early mortality, whereas, is a good option to reduce late and overall mortality of acute pancreatic necrosis complicated by infection
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