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Biomedical subjects

A L Gaspari

Publications and source records attributed to A L Gaspari.

At least 37 records · Page 2Linked to original sources

[Venous grafts in reimplantation of the thumb].

The Authors analyze their experience of 25 thumb reimplantations and revascularizations within 5 years. The importance of the first finger in the functional hand economy as well as the ratio between reimplantation take rate and degree of functional recovery with regard to the type of trauma, technique used, and possible and incidental complications are underlined. The venous autologous grafts are of great importance in this microsurgical area and they are more and more applied. In most cases, indeed, intimal lesions are more extended than their macroscopic appearance and the tract of damaged vessels is always wider than assessed. The graft interposition solves the problem with the further advantage to preserve the maximal bone length and to avoid especially contaminated areas. The results achieved confirm these statements and the Authors conclude for the absolute need of venous grafts in thumb reimplantations, especially after amputation from avulsion or crush traumas, even though a greater skill is necessary in using this technique.

Adolescent↗

[Latissimus dorsi flap in reconstructive surgery of the lower limbs].

The free latissimus dorsi flap has been used to repair 10 complex losses of substance of the lower extremity. The results have shown the great reconstructive potentialities of the microvascular transfer of this muscle, considered by the authors the most versatile of the myocutaneous flaps. Among the advantages there are the extended surface, its thickness, its pedicle with adequate length and diameter as well as the absence of functional involvement, especially by preserving the upper branch of the thoracodorsal nerve. The indications, however, are limited due to a significant rate of complications which prevent its extended use.

Adolescent↗

[Microsurgery in gynecology. 8 years' clinical activity].

A series of 110 patients given surgical treatment for "mechanical infertility of varying origin in 1980-88 is examined". The classification system proposed for the microsurgical procedures available is based both on personal experience and on the classification of the causes of mechanical infertility in women according to aetiopathogenesis. Clinical results are judged in terms of pregnancies achieved and suggest that while adhesiotomy, salpyngostomy, t-t tubal anastomosis and cornual reimplantation are all useful, fimbrioplasty is less likely to give good results, particularly in the long term. Finally the links between gynaecological microsurgery and F.I.V.E.T. and G.I.F.T. are analysed.

Female↗

Reversal of sterilization by microsurgical technique.

Tubal sterilization techniques that spare the fimbriae and cause the least amount of tubal destruction offer the best chance for reversal of sterilization. Patients seeking reversal of sterilization should be carefully selected. Surgical technique and equipment are important factors in reversal procedures; microsurgical techniques are shown to be more effective than macroscopic techniques.

Anastomosis, Surgical↗

[Cystadenolymphoma of the salivary glands: is there a familial role?].

The authors present two patients (mother and son) affected by cystadenolymphoma (Warthin's tumor) of the salivary glands, both surgically treated. A thorough review of the literature is conducted and the authors suggest that echographic screening of these neoplasia in first-degree relatives could be of value.

Adenolymphoma↗

[Retrospective analysis of the use of prophylactic drainage of the pelvis after anterior resection of the rectum].

Although the use of drains is common in clinical practice, its real role in the prophylaxis and therapy of postoperative complications is still not clear. In the literature we can find both supporters of drains, and many opponents who consider their use unnecessary and sometimes even dangerous. In fact, during new experimental and clinical studies, it was impossible to determine the usefulness of prophylactic abdominal drain, at least in the case of colo-rectal anastomosis, it has been demonstrated that use of drains limits the risks of an anastomotic leakage but, in some cases, the same drains could be the cause of some of the complications that should be avoided. Although there is a considerable theoretical and practical evidences in favour of drainage, the dispute about "to drain or not to drain" the peritoneal cavity after elective colo-rectal surgery remains open. This retrospective study made on 150 patients operated on elective surgery for rectal cancer demonstrates that prophylactic drain does not significantly influence the general rate of leakage (3.15% for group A and 5.45% for group B, p > 0.1); in two of the three fistulas in patients with drains, the drains have permitted the diagnosis, but have not permitted the reduction of the number of operations for fistulas.

Adult↗