Biomedical subjects

A Donini

Publications and source records attributed to A Donini.

75 records · Page 5Linked to original sources

PubMedDate not supplied

[Trans-umbilical cholecystectomy: a new laparoscopic cholecystectomy technique. Description of the technique and preliminary results].

The aim of videolaparo-cholecystectomy is to achieve a good results with minimal surgical trauma. Recently there has been an evolution of this technique toward the progressive reduction of trauma with an improvement of the results, also from the aesthetical point of view. In this article we describe our new videolaparo-cholecystectomy technique. Trans-umbilical videolaparo-cholecystectomy represents a variant of the traditional technique. This new method allows the operation to perform with only two trocars positioned in the peritoneum cavity through only one umbilical incision. The technical innovation of this method consists of the substitution of the others trocars, utilized in the traditional technique, with an equal number of trans-parietal suspension wires. Up to now, we have given 95 patients this kind of operation being successful in 67% of the cases. We think that this new technique, requiring as it does only standard laparoscopic instruments, is in accordance with the philosophy of mini-invasive surgery. The suspension wires are responsible for minimal bile spreading which is not an important complication if the surgeon performs an accurate and through cleaning of the abdominal cavity at the end of the surgical procedure. The patient better accepts this technique because of its better aesthetical results. In spite of this there should be more evaluable data about trans-umbilical videolaparo-cholecystectomy especially about the incidence of post-operatory complications.

Cholecystectomy, Laparoscopic↗

PubMedDate not supplied

[Dunbar's syndrome: clinical reality or physiopathologic hypothesis?].

The authors report the cases of two patients presenting a symptomatic intestinal angina caused by median arcuate ligament compression. Arteriography demonstrates severe coeliac artery stenosis in both of them and a retrograde filling of the coeliac axis from the superior mesenteric artery branch collateral vessels. The patients became asymptomatic after surgical release of the celiac trunk by section of the median arcuate ligament of the diaphragm. At 2 and 3 years follow-up, both patients report no further abdominal pain. Dunbar's syndrome is still a questionable subject; how can be a narrowing or an occlusion of the celiac artery semeiotically and clinically important? Some have proposed an ischemic base to explain the abdominal pain: the compression of the celiac trunk could be responsible of a celiac steal which results in shunting of blood from the superior mesenteric artery to the celiac distribution through the collateral system. There are very strong proofs that partial or even complete obstruction of the celiac artery should not lead to visceral ischemia such as: the rich collateral anastomosis of the celiac axis, the surgical ligation of the celiac axis performed without untoward consequences, the finding of asymptomatic celiac stenosis in the 49% of an arteriographic study, impossibility to formulate a consistent and rational for the surgical results. Shearing this view, few authors would prove that a stenotic type of the celiac artery is only a normal anatomic variant, refuting the existence of this syndrome.

Adolescent↗

PubMedDate not supplied

Percutaneous large core needle biopsy versus surgical biopsy in the diagnosis of breast lesions.

OBJECTIVE: To value LCNB accuracy in the determination of morphobiological parameters and as an alternative to the open SB diagnostic procedure of breast lesions. SETTING: University Hospital, Italy. SUBJECTS: From May 1992 to February 1995 196 biopsies have been performed. The diameter of the neoplasms examined varied from 0.6 to 7 cm with an average of 1.9 cm. MAIN OUTCOME MEASURES: The accuracy of the two methods in the evaluation of histological degree, receptor state, protein c-erb B2 and p53 were compared. RESULTS: No inadequate sampling were ever recorded. LCNB has shown values of 97% sensitivity and 100% specificity. The positivity and negativity predicted values obtained were 100% and 89% respectively. Retrospectively 70 sample-cases of carcinoma were selected and the morphobiological parameters evaluated. The correlation coefficients for the data obtained with SB and LCNB in the evaluation of Progesteron and Oestrogen receptor expression, protein c-erb B2 and p53 were excellent. Furthermore it was noted that LCNB allows a saving of at least 1/3 of the cost vs intraoperative SB. CONCLUSIONS: Percutaneous LCNB has high diagnostic accuracy for histological classification. LCNB has the same accuracy as SB for morphobiological parameters. The cost of LCNB is markedly lower than SB.

Adult↗