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A Cusumano

Publications and source records attributed to A Cusumano.

15 recordsLinked to original sources
PubMed1992

Push-through intubation: effective palliation in 409 patients with cancer of the esophagus and cardia.

Between 1980 and 1989, 355 patients with cancer of the esophagus and 54 with cancer of the cardia underwent push-through intubation because of advanced tumor stage or medical contraindications to tumor resection. In 36 other patients (8.1%), the attempt at transtumoral intubation failed. The hospital mortality rate after intubation was 3.4%. The following complications were observed: hemorrhage in 2.0% of the patients, esophageal perforation in 4.9%, tube dislodgment in 12.7%, and tube obstruction in 4.4%. Early resumption of semisolid oral feeding was possible in 80% of the discharged patients. The actuarial 1-year survival rate was 7.7% and the median survival, 3.9 months. In conclusion, push-through intubation represents a valid therapeutic choice, which is indicated mainly for patients with a long, infiltrating, and circumferential stricture of the thoracic esophagus or cardia that is inoperable and for patients with an esophagorespiratory or esophagomediastinal fistula.

Adenocarcinoma↗
PubMed1991

Early and long-term results of pneumatic dilation in the treatment of oesophageal achalasia.

Between 1967 and 1989, 60 patients underwent pneumatic dilation of the cardia at our institution. Of these, 33 had not undergone any previous treatment (group 1), whereas 27 presented with recurrent dysphagia after a failure of surgical treatment (group 2). In this series there was no procedure-related mortality and a perforation occurred only in 1 patient who was treated conservatively. The mean follow-up was similar in both groups (44 and 49 months, respectively). The results of pneumatic dilation were either excellent or good in 61% of group 1 patients, and in 76% of group 2 patients. Reflux oesophagitis requiring medical therapy occurred in 1 group 2 patient. We conclude that pneumatic dilation is a safe and relatively effective procedure in patients with achalasia. Patients with a failed Heller myotomy seem to respond better than patients without previous surgery. However, the risk of gastro-oesophageal reflux after pneumatic dilation should not be underestimated.

Catheterization↗
PubMed1991

Is chronic intraocular inflammation after lens implantation of bacterial origin?

In an effort to better understand the cause of chronic intraocular inflammation after intraocular lens (IOL) implantation, both scanning and transmission electron microscopy were used to compare 1 anterior chamber, 1 iris-fixated, and 3 posterior chamber IOLs removed for this condition between 2 and 16 months after implantation with 8 IOLs explanted for other reasons (decentration in 4 cases, bullous keratopathy in 4 cases). Colonization with non-slime-producing, as well as slime-producing bacteria (1 case) in the presence of a thin membranous structure of cellular origin (multinucleated giant cells and macrophage-like cells) was demonstrated on all of the 5 IOLs explanted from inflamed eyes. Neither bacteria nor membranous structures could be identified on the IOLs removed because of dislocation or from eyes with bullous keratopathy. These observations indicate that bacterial colonization and the consequent host response may be characteristic features of many otherwise unexplained cases of intraocular inflammation after IOL implantation.

Aged↗
PubMed1991

Mycotic infection of the capsular bag in postoperative endophthalmitis.

A case of mycotic infection after uncomplicated extracapsular cataract extraction with implantation of a posterior chamber modified C-loop intraocular lens (IOL) is reported. Severe postoperative intraocular inflammation, diagnosed by aqueous cultures as secondary to Staphylococcus aureus endophthalmitis, did not respond to antibiotic therapy. Despite IOL and capsular bag removal and further antibiotic treatment, the inflammation persisted and phthisis followed. Retrospective electron microscopic examination of the explanted material demonstrated the presence of abundant fungal elements in the capsular bag and spores on the IOL surface. Vitreous taps performed at the time of explantation were negative for bacteria and fungi, confirming the localized nature of the mycotic infection. To our knowledge this report represents the first observation of a mycotic infection confined to the capsular bag after cataract surgery with implantation of a posterior chamber IOL.

Aged↗
PubMed1978

[Cavernous hemangioma of the mediastinum].

The authors present a rare case of cavernous hemangioma of the mediastinum. After a critical review of existing literature on the subject, they discuss the symptoms of this vascular malformation with special emphasis on the difficulties of differential diagnosis versus other space-occupying lesions of the mediastinum. They further discuss the characteristic histopathologic features of cavernous hemangioma, and state that ablative surgery is the only possible therapeutic measure.

Adult↗
PubMed1977

[13 cases of double neoplastic localizations, 1 involving the esophagus].

During the course of nine years 494 patients suffering from oesophageal cancer have come under our observation, including 13 cases characterised by the phenomenon of double neoplastic localisation. In some cases, in view of the histological identity of the two neoplasias, remote endocanicular colonisation may be presumed, while in other cases the rise of the tumour "disease" may be correlated with the action of carcinogenetic agents on sites of lesser resistance in organisms whose immunitary defences have been decreased in relation to neoblastogenesis. This is supported by the increase in the incidence of malignant neoplasias in patients subjected to immuno-suppressive treatment.

Aged↗
PubMed1976

[Retroperitoneal liposarcoma].

The various aspects of this comparatively rare neoplasia are discussed on the basis of two cases of retroperitoneal liposarcoma and an analysis of the literature. Consideration are expressed on the clinical symptoms, the pathological anatomy, its marked tendency to evolve with repeated local relapses and the need to properly localise the mass and the feeding peduncles prior to the operation, so that radical exercise can be performed, since this leads to a more favourable long-term prognosis. The utility of radiotherapy, which leads to a lengthened period of freedom from the disease and to an increased survival time, is also stressed.

Adult↗
PubMed1976

[Usefulness of the early study of intrathoracic digestive anastomoses].

The appearance of a dehiscence after an operation of oesophageal resection and reconstruction with stomach, jejunum or colon, constitutes a highly serious event frequently leading to the patient's death. Early recognition of dehiscence is therefore important for the purpose of starting adequate therapy as quickly as possible and preventing the rise and establishment of those lesions which condition an irreversible trend of the clinical condition. In this note the means today available for early diagnosis fo fistula, with particular reference to early radiological examination, are discussed. Early diagnosis and adequate prompt treatment may, in our opinion, lead to an improvement in the poor results reported by a number of surgical schools.

Colon↗
PubMed1976

[Upward extension of esophago-gastric resection in carcinoma of the cardia: our current trend in the light of experience in 52 cases].

A first lot of patients (18 cases) operated for carcinoma of the cardias, with oesophageal resection performed at a distance of 4-5 cm. from the neoplasia, evidenced high mortality (7 cases) within the first twelve months. In a second lot of patients (17 cases), a study of the oesophageal section was made and showed invasion in 7 cases; this led to the level of the oesophageal resection being extended to a distance of 8-10 cm. from the tumour; in 17 cases thus operated (third lot) only one case of invaded oesophageal section was found. Systematic extension of the oeophageal resection, in cases of cancers of the cardias, to the level of the inferior pulmonary vein is therefore proposed in order to obtain a radical surgical result.

Adenocarcinoma↗
PubMedDate not supplied

Modified surgical technique for repeated epikeratophakia surgery in aphakic eyes.

BACKGROUND: Incomplete epithelial removal from the peripheral keratectomy at the time of repeat epikeratophakia surgery can lead to interface downgrowth and consequent failure, as observed in the case reported herein. We present a modification of the standard surgical technique aimed at avoiding such complication. METHODS: A 69-year-old white female underwent a third aphakic epikeratophakia modified to reduce the risk of epithelial interface downgrowth, which had caused a previous failure. The aphakic tissue lens, 8.5 mm in diameter, was sutured into a corneal pocket obtained at a deeper level, inside the peripheral keratectomy used for the previous two procedures. RESULTS: Useful visual acuity (20/60) was obtained and the refractive outcome remained stable up to 1 year postoperatively. Epithelial interface downgrowth did not recur. CONCLUSIONS: Despite the possible risk of perforation while undermining the recipient cornea at a deeper level, the modified technique might offer a more effective method of preventing epithelial downgrowth after repeat epikeratophakia surgery.

Aged↗