Chirurgia italiana最新文献_第8页

Laparoscopic biliopancreatic diversion: our preliminary experience with 201 consecutive cases. 腹腔镜胆胰分流术201例的初步经验。

Chirurgia italiana Pub Date : 2009-03-01

Luigi Piazza, Angelo Pulvirenti, Francesco Ferrara, Angelo Bellia, Silvana Leanza, Danilo Coco, Claudia Piazza, Giovanni Lo Giudice

{"title":"Laparoscopic biliopancreatic diversion: our preliminary experience with 201 consecutive cases.","authors":"Luigi Piazza, Angelo Pulvirenti, Francesco Ferrara, Angelo Bellia, Silvana Leanza, Danilo Coco, Claudia Piazza, Giovanni Lo Giudice","doi":"","DOIUrl":"","url":null,"abstract":"Surgery as a treatment modality for morbid obesity has shown impressive progress over the past decades because of a better understanding of the metabolic characteristics of obesity and the rationale for its surgical treatment. Biliopancreatic diversion was first performed in humans in 1976. Since then it has been an excellent operation for morbid obesity to achieve long-term weight reduction. We present our laparoscopic biliopancreatic diversion protocol, with or without distal gastrectomy (Resa's operation). From 1995 to October 2008 we operated on 201 patients; open biliopancreatic diversion was performed in 48 patients, while the remaining patients underwent laparoscopic biliopancreatic diversion (84 laparoscopic Scopinaro's operations, 69 laparoscopic Resa's operations). The mean operating time was 140 minutes for the open procedures, 180 minutes for Scopinaro's laparoscopic operation and 135 minutes for Resa's laparoscopic operation. The mean postoperative stay was 5.5 days. Our mortality rate consisted of two patients (0.99%) who had pulmonary embolisms. Other major complications were three cases of leakage from the jejuno-ileal anastomosis, 18 cases of incisional hernia, 6 cases of metabolic diseases; 1 case of acute hepatitis and 1 case of bronchopneumonia. Biliopancreatic diversion can be performed satisfactorily by laparoscopy. A factor that may reduce the technical difficulties and make the technique totally reversible is the gastric sparing. Thus an upper digestive endoscopy can determine preoperatively whether the patient will need a gastrectomy, depending on its results.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 2","pages":"143-8"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28252436","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

[Gastrointestinal stromal tumour: our experience]. [胃肠道间质瘤:我们的经验]。

Chirurgia italiana Pub Date : 2009-03-01

Antonino Versaci, Antonio Macrì, Antonio Ieni, Marialuisa Terranova, Grazia Leonello, Edoardo Saladino, Giuseppe Speciale, Ciro Famulari

{"title":"[Gastrointestinal stromal tumour: our experience].","authors":"Antonino Versaci, Antonio Macrì, Antonio Ieni, Marialuisa Terranova, Grazia Leonello, Edoardo Saladino, Giuseppe Speciale, Ciro Famulari","doi":"","DOIUrl":"","url":null,"abstract":"Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. These tumours originate in Cajal interstitial cells and the majority are located in the stomach and small intestine. They frequently develop in males aged 50-60 years. The symptoms of GIST are non-specific and depend on the size and location of the lesion. Imaging difficulties impede an early diagnosis; sometimes these tumours represent an unexpected intraoperative finding or an emergency abdominal picture. GISTs are classified as tumours with low- and high-risk of malignancy, depending on tumour size and mitotic count. Tumour site and acute onset are also significant parameters for prognostic purposes. Fifteen patients with GIST - gastric in 7 cases, ileal in 6, jejunal in 1 and colonic in 1 - were treated surgically and, in 9 cases, with adjuvant therapy (chemotherapy in 4 patients and imatinib mesylate in 5). The mean follow-up was 38 months. No postoperative mortality was recorded, and the morbidity was 13.3%. Histological examinations documented 6 benign tumours and 9 malignancies. Two patients, one with gastric and one with colonic GIST, were lost to follow-up. One patient, with two synchronous gastric neoplasms (GIST + adenocarcinoma) died after 16 months, while the other 5 patients with gastric GIST are still alive; two patients with ileal GIST, treated with chemotherapy, died after 15 and 18 months, respectively. The mean survival of patients treated with imatinib mesylate was 36 months. Surgical management and the use of imatinib constitute the therapeutic gold standard for GIST. The use of imatinib mesylate is recommended today in the treatment of advanced GIST, especially in cases with liver and peritoneal metastases.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 2","pages":"161-9"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28252438","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

[Mesenteric Castleman's disease and inflammatory fibroid polyp of the stomach: a case report and review of the literature]. [肠系膜Castleman病合并胃炎性肌瘤息肉1例报告及文献复习]。

Chirurgia italiana Pub Date : 2009-03-01

Mauro Andreano, Vito D'Ambrosio, Massimo Antropoli, Raffaele Fioretto, Luciano Vicenzo, Marco Clemente

引用次数: 0

Voluminous bleeding stomach GIST: reflections on etiopathogenesis, diagnosis and therapy. 胃大出血GIST:对病因、诊断和治疗的思考。

Chirurgia italiana Pub Date : 2009-03-01

Valerio Caracino, Gustavo Maggi, Simone Altobelli, Carlo Lambiase, Costantina Danza, Giampiero D'Amico

引用次数: 0

[Intestinal intussusception due to metastatic melanoma: a case report]. 【转移性黑色素瘤致肠套叠1例】。

Chirurgia italiana Pub Date : 2009-03-01

Carmine Ammaturo, Salvatore Pastore, Costantino Cerrato, Massimiliano Santoro, Romualdo Rossi, Flavio Fabozzi, Rossella Brunaccino, Miaria De Nigris, Pietro Paolo Podio, Raffaele De Luca

{"title":"[Intestinal intussusception due to metastatic melanoma: a case report].","authors":"Carmine Ammaturo, Salvatore Pastore, Costantino Cerrato, Massimiliano Santoro, Romualdo Rossi, Flavio Fabozzi, Rossella Brunaccino, Miaria De Nigris, Pietro Paolo Podio, Raffaele De Luca","doi":"","DOIUrl":"","url":null,"abstract":"Although the gastrointestinal tract is a fairly frequent site of melanoma metastases, reports of small bowel intussusception caused by this condition are rare. The presence of intestinal metastases is an expression of what is already a disease at an advanced stage and, therefore, the prognosis of these patients is generally poor with only sporadic cases of long-term survival after resective surgery. We describe the case of a patient referred to our department with a clinical picture of frank occlusion. Ileo-ileal intussusception was diagnosed preoperatively thanks to ultrasound and abdominal CAT scans. The patient was unaware that he had a cutaneous melanoma and, moreover, the diagnosis of a metastasised melanoma was possible only after histological examination of the surgical specimen and the subsequent search for and identification of the primary lesion at the level of the dorsal skin. We performed an extensive ileal resection with an end-to-end entero-enteroanastomosis. Ten months after the operation the patient is still alive but in poor general condition due to the presence of diffuse liver metastases and ascites. We believe that radical resective surgery affords valid palliation for these patients, with disappearance of symptoms and minimal postoperative morbidity and mortality.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 2","pages":"217-21"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28251821","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

[Neuroendocrine carcinoma of the breast: a rare entity]. [乳腺神经内分泌癌:罕见病例]。

Chirurgia italiana Pub Date : 2009-03-01

Alberto Sartori, Serena Scomersi, Arrigo Spivach, Silvia Vigna

引用次数: 0

Adult idiopathic intussusception: a case report and review of the literature. 成人特发性肠套叠1例报告及文献复习。

Chirurgia italiana Pub Date : 2009-03-01

Giuseppe Pisano, Alessandro Manca, Stefania Farris, Alberto Tatti, Jenny Atzeni, Pietro Giorgio Calò

{"title":"Adult idiopathic intussusception: a case report and review of the literature.","authors":"Giuseppe Pisano, Alessandro Manca, Stefania Farris, Alberto Tatti, Jenny Atzeni, Pietro Giorgio Calò","doi":"","DOIUrl":"","url":null,"abstract":"Adult intussusception is a rare condition. Most of the cases are due to an organic lesion and unlike the incidence in children idiopathic forms are really exceptional, occurring at a rate of 5% of all cases. Whereas in children a main cause is seldom found, adult intussusception is usually characterised by the presence of a leading intraluminal benign or malignant lesion. The authors report their experience with a clinical case of ileocolic intussusception occurring in an 28-year-old white male. In spite of the patient's age, the clinical presentation was very typical with the classic triad of abdominal pain, blood per rectum and a palpable mass. Diagnostic tools, namely US and TC scan, together with colonoscopy confirmed the physical examination, so that surgery was initiated with a definite diagnosis of intussusception. A large polyp or a lymphoma were considered the possible leading causes. After right hemicolectomy, pathology revealed that there was no organic lesion and the bulging mass was caused only by oedema and haemorrhagic infiltration of the invaginated loop. The patient had been on antipsychotic drugs for several months and the possible explanation of the pathology was linked to altered peristalsis induced by the pharmacological agents he was taking. The authors compare their experience with the data reported in the literature, evaluating in particular the incidence, pathology, clinical presentation, diagnosis and treatment of adult intussusception.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 2","pages":"223-9"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28250674","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

[Magnetic oesophageal sphincter for the treatment of gastro-oesophageal reflux disease: results of a prospective clinical trial]. 磁性食管括约肌治疗胃食管反流病:一项前瞻性临床试验的结果。

Chirurgia italiana Pub Date : 2009-03-01

Marco Nencioni, Emanuele Asti, Greta Saino, Davide Bona, Stefano Pallotta, Letizia Laface, Luigi Bonavina

引用次数: 0

[Spontaneous rupture of the femoral artery after radiotherapy: a case report]. 放射治疗后自发性股动脉破裂1例。

Chirurgia italiana Pub Date : 2009-03-01

Gian Franco Veraldi, Bruno Genco, Maurizio Governa, Eliana Gilioli, Marco Paolo Zecchinelli, Anna Maria Minicozzi, Christian Segattini

引用次数: 0

Laparoscopic reoperative approach after open bariatric surgery. 开放式减肥手术后腹腔镜再手术入路。

Chirurgia italiana Pub Date : 2009-03-01

Paolo Gentileschi, Francesca Lirosi, Domenico Benavoli, Giuseppe Sica, Nicola Di Lorenzo, Marco Venza, Ida Camperchioli, Iviarco D'Eletto, Pierpaolo Sileri, Achille L Gaspari

{"title":"Laparoscopic reoperative approach after open bariatric surgery.","authors":"Paolo Gentileschi, Francesca Lirosi, Domenico Benavoli, Giuseppe Sica, Nicola Di Lorenzo, Marco Venza, Ida Camperchioli, Iviarco D'Eletto, Pierpaolo Sileri, Achille L Gaspari","doi":"","DOIUrl":"","url":null,"abstract":"The aim of the study was to evaluate the laparoscopic approach to reoperative bariatric surgery. From January 2003 to July 2007, 26 obesity surgery patients were referred to our Institution for revision. Nineteen patients previously had an open gastric banding, 3 an open vertical banded gastroplasty, 2 an open jejunoileal by-pass (J-l BP) and 2 an open gastric by-pass. Indications for re-operation were insufficient weight loss in 14 patients, band slippage in 7, band erosion in 3 and severe malabsorptive syndrome in 2. Mean preoperative BMI was 45 kg/m2. Twenty-six laparoscopic re-operative procedures were performed. Three patients required a third operation. Eleven gastric banding patients underwent band removal, 7 gastric banding patients were converted to an open gastric by-pass, 1 band was removed and simultaneously re-placed, the 2 jejuno-ileal by-pass patients underwent an intestinal restoration, 3 vertical banded gastroplasty patients were converted to laparoscopic gastric by-pass, 1 open gastric by-pass patient was converted to a laparoscopic long-limb gastric by-pass and in 1 patient with a gastro-gastric fistula after open gastric by-pass the fistula was resected. Further procedures included 1 laparoscopic gastric banding, 1 laparoscopic gastric bypass and 1 laparoscopic bilio-pancreatic diversion. Conversion to laparotomy was needed in 5 cases (5/29, 17.2%). Early complications included 1 case of pneumothorax and 6 cases of wound infection (24.1%). Mortality was zero. The mean follow-up was 36.2 months. Mean postoperative BMI was 34.3 kg/m2. Laparoscopic reoperative bariatric surgery is feasible, safe and effective after open bariatric surgery.","PeriodicalId":75700,"journal":{"name":"Chirurgia italiana","volume":"61 2","pages":"137-41"},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28252435","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