Chirurgia italiana最新文献_第4页

[Five-year oncological results of laparoscopic versus open left hemicolectomy]. [腹腔镜与开放式左结肠切除术的5年肿瘤学结果]。

Chirurgia italiana Pub Date : 2009-09-01

Luca Maria Siani, Fabrizio Ferranti, Marco Marzano, Antonio De Carlo, Alberto Quintiliani

{"title":"[Five-year oncological results of laparoscopic versus open left hemicolectomy].","authors":"Luca Maria Siani, Fabrizio Ferranti, Marco Marzano, Antonio De Carlo, Alberto Quintiliani","doi":"","DOIUrl":"","url":null,"abstract":"Laparoscopic left hemicolectomy is still uncommon in surgical practice, because of both an unjustified fear of oncological inadequacy and technical difficulties with a steep learning curve. The aim of the present study was to analyse our 5-year experience with laparoscopic left hemicolectomy and its short- and long-term results. Thirty patients with non-metastatic non-infiltrating left colon cancer were treated laparoscopically and retrospectively compared to a group treated laparotomically and well matched for age, comorbidity and stage of disease in respect to the laparoscopic group. The duration of the laparoscopic procedures was longer, but intraoperative blood loss, passage of flatus and hospital stay were significantly less. Morbidity was similar and there was no 30 days mortality in either group. Specimen length and number of harvested lymph nodes were similar and 5-year cumulative survival curves showed no significant statistical difference (73.1% laparoscopic vs 70.8% open). Today, laparoscopic colon procedures are rarely performed, due both to fear of oncological inadequacy and to technical difficulties, yet several recent trials have presented evidence of safety, and oncological results comparable to those of the open counterpart. Our 5-year experience confirms these studies: our short- and long-term results show no statistical differences between the laparoscopic and \"open\" procedure. Laparoscopic left hemicolectomy is a safe, effective and oncologically adequate surgical procedure for non-metastatic non-infiltrating left colon cancer and is therefore a valid option for the surgical treatment of these neoplasms.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 5-6","pages":"579-83"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28911762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Carcinoma of the appendix and its natural history in relation to surgical management. A case report. 阑尾癌及其自然史与手术治疗的关系。一份病例报告。

Chirurgia italiana Pub Date : 2009-09-01

Silvana Leanza, Mohamed Bekheit, Danilo Coco, Angelo Bellia, Francesco Ferrara, Salvatore Sarvà, Andrea Pappalardo, Luigi Piazza

引用次数: 0

[Self-expanding oesophageal stents: comparison of Ultraflex and Choostent]. 自扩式食管支架:Ultraflex与Choostent的比较。

Chirurgia italiana Pub Date : 2009-09-01

Davide Bona, Letizia Laface, Stefano Siboni, Moshe Schaffer, Daniela Baldoli, Andrea Sironi, Francesca Sorba, Luigi Bonavina

引用次数: 0

[Rectus sheath haematoma as an early complication of laparoscopic hemicolectomy: a case report and review of the literature]. [腹直肌鞘血肿作为腹腔镜结肠切除术的早期并发症:一例报告和文献回顾]。

Chirurgia italiana Pub Date : 2009-07-01

Fabio Procacciante, Giulia Diamantini, Daniele Paolelli, Pietro Picozzi

引用次数: 0

[Giant angiomyolipoma of the kidney not associated with tuberous sclerosis: a case report and review of the literature]. 【与结节性硬化症无关的肾脏巨大血管平滑肌脂肪瘤:1例报告及文献回顾】。

Chirurgia italiana Pub Date : 2009-07-01

Valerio Panizzo, Gloria Goi, Eliana Moroni, Giancarlo Micheletto, Barbara Bruni, Piergiorgio Danelli

引用次数: 0

[Role of endoanal ultrasonography in reducing anal fistula recurrence]. 【肛管超声检查在减少肛瘘复发中的作用】。

Chirurgia italiana Pub Date : 2009-07-01

Marco Milone, Giuseppe Pesce, Maddalena Leongito, Francesco Milone

引用次数: 0

[Usefulness of plug test for the intraoperative staging of rectal mucosal prolapse]. [塞试验在直肠粘膜脱垂术中分期中的应用]。

Chirurgia italiana Pub Date : 2009-07-01

Fabio Gaj, Antonello Trecca, Pietro Crispino

{"title":"[Usefulness of plug test for the intraoperative staging of rectal mucosal prolapse].","authors":"Fabio Gaj, Antonello Trecca, Pietro Crispino","doi":"","DOIUrl":"","url":null,"abstract":"Rectal mucosal prolapse is characterised by protrusion of the rectal mucosa alone in the anal lumen. To correctly establish the intraoperative stage of rectal mucosal prolapse the authors performed a test based on the intrarectal introduction of a large-sized hydrophilic plug, to be extracted later from the anal canal. A total of 40 patients with proctological symptoms and with a diagnosis of rectal mucosal prolapse were submitted, in the outpatient setting, to a minimally invasive test with a small plug and later, in the preoperative stage, in patients under anaesthesia, using a plug entirely inserted into the rectal lumen and extracted via the anus. The same procedure was performed after surgery to verify the results of the excision. In all cases the plug test used in the preoperative stage permitted the perfect surgical evaluation of the extent of the prolapse. The plug test revealed a mucosal prolapse occupying 25% of the anal circumference in 10 patients, up to 50% in 20 patients and more than 50% in 10 patients. The first 30 patients were treated with the transfixed stitch technique, while for the others the Longo surgical technique was preferred. The plug test for the preoperative and postoperative evaluation of rectal mucosal prolapse is an effective tool for obtaining a more precise indication as to the optimal surgical intervention and for verifying the radicality of the surgical excision. The plug test, moreover, proved to be a minimally invasive and easily performed test for evaluating rectal mucosal prolapse.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 4","pages":"475-80"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28451998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Anastomotic leak following colorectal surgery: incidence, risk factors and treatment]. 结直肠手术后吻合口瘘:发生率、危险因素及治疗。

Chirurgia italiana Pub Date : 2009-07-01

Enrico Erdas, Alessandro Zedda, Antonella Pitzalis, Daniela Scano, Michela Barbarossa, Simona Aresu, Sergio Licheri, Mariano Pomata, Giampaolo Farina

{"title":"[Anastomotic leak following colorectal surgery: incidence, risk factors and treatment].","authors":"Enrico Erdas, Alessandro Zedda, Antonella Pitzalis, Daniela Scano, Michela Barbarossa, Simona Aresu, Sergio Licheri, Mariano Pomata, Giampaolo Farina","doi":"","DOIUrl":"","url":null,"abstract":"The aim of this study was to assess the incidence and identify the risk factors associated with colorectal anastomotic leakage. A further objective was to investigate the therapeutic choices. We reviewed the clinical files of 124 patients who underwent mechanical end-to-end anastomosis after colorectal resection during the period 2000-2007. The mean age was 66.9 years and the male:female ratio was 1.2:1. Indications for surgery were malignant neoplasms in 109 cases (87.9%) and benign disease in 15 cases (12.1%). The anastomosis was always performed in an elective setting in the framework of a procedure of one or more stages (87.9% and 7.3% respectively). A pelvic drain was positioned in a routine manner and no protective ileostomies were constructed. Among the various risk factors, co-morbidities, ASA risk and low anastomotic level were the most important we examined. Student's t-test, the Chi-square test and Fisher's test were used for comparative univariate analysis, with significant results for p < or = 0.05. The incidence of anastomotic leak was 10.5% (13/124), but only 4.8% (6/124) required a second operation or failed to heal with simple conservative therapy. The pelvic drain was always effective in allowing the early diagnosis of leakages and limiting the spread of peritoneal inflammation. Mortality was 1.6% (2/124) overall, but, if leakages alone were considered, it increased to 15.4%. Among the risk factors examined, only low anastomotic level was confirmed by statistical analysis. In conclusion, the study confirms low anastomotic level as a negative prognostic factor for the healing of colorectal anastomosis. The pelvic drain proved to be effective in allowing early diagnosis and conservative management of leakages.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 4","pages":"407-17"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28451052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Laparoscopic splenectomy in haematological diseases: short- and medium-term results in thirty initial cases]. [腹腔镜脾切除术治疗血液病:30例初诊病例的中短期疗效]。

Chirurgia italiana Pub Date : 2009-07-01

Massimo Carlini, Cristiano Giovannini, Fabio Castaldi, Paolo Cianciulli, Francesco Sorrentino, Edoardo Mercadante

{"title":"[Laparoscopic splenectomy in haematological diseases: short- and medium-term results in thirty initial cases].","authors":"Massimo Carlini, Cristiano Giovannini, Fabio Castaldi, Paolo Cianciulli, Francesco Sorrentino, Edoardo Mercadante","doi":"","DOIUrl":"","url":null,"abstract":"In 1991 Delaitre and Maignien described the first laparoscopic splenectomy, since when a rapid spread of this technique has been observed and the procedure has become the gold standard in the surgical management of benign and malignant haematological diseases. In the present study, the results of the first 30 laparoscopic splenectomies performed at the Division of General Surgery of the S. Eugenio Hospital of Rome are reported. The operations were performed in patients with benign (27 cases) and malignant (3 cases) haematological diseases, treated in the Regional Haematological Centre of the same hospital. The procedures were carried out according to criteria corresponding to those recently described in the guidelines of the European Association for Endoscopic Surgery. As regards the results, two procedures (6.7%) were converted to open surgery. One postoperative haemorrhage was observed, requiring a laparoscopic reoperation for haemostasis. No other major local or general complications were observed. Mortality was nil. The mean postoperative hospital stay was 4.2 days (range: 4-8 days). Medium-term surgical and haematological results were excellent. Laparoscopic splenectomy is the surgical gold standard, but should be performed in advanced centres in close cooperation with a haematology centre. The procedure is indicated in all patients who are candidates for splenectomy, with the sole exception of those affected by portal hypertension or with general contraindications to laparoscopy. In advanced centres, better early and late results can be achieved, in addition to the well-known benefits of the minimally invasive technique, particularly in aesthetic terms, which in younger patients affected by benign haematological pathologies are very important.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 4","pages":"427-33"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28451054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biliary stent migration into the abdominal wall: a case report. 胆道支架向腹壁内移位1例。

Chirurgia italiana Pub Date : 2009-07-01

Vincenzo Minutolo, Giuseppe Gagliano, Alessandro Buttafuoco, Orazio Minutolo, Francesco Mosca, Stefano Puleo

引用次数: 0