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Biomedical subjects

A Maturo

Publications and source records attributed to A Maturo.

At least 19 recordsLinked to original sources
PubMed2005

[Prevention of post-operative pain and haemorrhage in PPH (Procedure for Prolapse and Hemorrhoids) and STARR (Stapled Trans-Anal Rectal Resection). Preliminary results in 261 cases].

Intra- and early (first week) post-operative haemorrhages are the most common complications in stapled hemorrhoidectomy PPH (Procedure for Prolapse and Hemorrhoids) and in circumferential resection of the rectal prolapse STARR (Stapled Trans Anal Rectal Resection). Performing PPH and STARR we employed a gelatin based haemostatic sealant with thrombin component (FloSeal) to control intra-operative bleeding and to reduce post-operative bleeding avoiding haemostatic stitches on suture line. We report the preliminary results on 197 PPH and 64 STARR; 44 PPH (22.4%) and 27 STARR (42.2%) were treated by FloSeal. No major post-operative bleeding was observed in all patients treated by FloSeal, compared to 1.3% and 2.7% of hemorrhage respectively in PPH and STARR patients treated without sealant. Post-operative pain was less severe in patients treated by FloSeal, without a difference statistically significant. The data are preliminary and must be confirmed in prospective randomized trials in larger series.

Adult↗
PubMed2005

[Strangulated abdominal herniation by Ladd's band].

A case of a 64-year-old man with abdominal pain since three days, with vomiting and ileus and without previous surgery is reported. Faecal material was aspirated by a nasogastric tube; TC showed dilatation of the small bowel with the walls of the loops thickened. The patient was submitted to emergency surgery with diagnosis of intestinal infarction. At laparotomy an extensive necrosis (two meters) of small bowel was present, caused by visceral herniation by a Ladd's band. Intestinal resection was performed with latero-lateral stapled anastomosis. The postoperative course was uneventful and the patient was transferred in VII p.o. day to an hospital of his Country.

Abdominal Pain↗
PubMed2001

Lateral pelvic lymphadenectomy and total nerve sparing for locally advanced rectal cancer in Western patients.

BACKGROUND: In an attempt to improve the results of locally advanced rectal cancer treatment, we performed an extended surgical technique consisting of total mesorectal excision (TME), lateral pelvic lymphadenectomy (LPL) and total nerve sparing (NS). Resection of the autonomic nerves was realized only when these fibres were involved by the tumour. METHODS: Nine cases (9.2%) of a personal series of 98 western patients with rectal carcinoma operated on between January 1992 and December 1997 at Third Department of Surgery, University La Sapienza, Rome, underwent TME, LPL and NS procedures for locally advanced extraperitoneal disease. RESULTS: Two out of seven patients in stage II/III suffered postoperatively from urinary retention with mild irregular flow as tested on urodynamics, but no long-term urinary disturbances persisted. Retrograde ejaculation occurred postoperatively in one of two patients who experienced urinary disturbances. Another patient had erection dysfunctions. These sexual dysfunctions did not improve during the long-term follow-up. Seven patients with stage II or stage III disease achieved a 5-year survival rate of 80.0% and a 5-year disease-free survival rate of 68.6% after a mean follow-up period of 64.7 months. None of them experienced local recurrence, but one patient died of diffuse metastatic disease 50 months after surgery. Two patients with stage IV rectal carcinoma died of local and distant disease 13 months and 35 months after operation. One patient underwent liver resection for solitary metastasis 25 months after primary operation. CONCLUSIONS: TME, LPL, and NS with resection of autonomic nerves only when these fibres are involved by the disease can achieve satisfactory results in terms of survival and functional outcome in selected western patients with locally advanced rectal cancer.

Adult↗
PubMed2000

Evaluation of anal function after surgery for rectal cancer.

BACKGROUND AND OBJECTIVES: Sphincter-saving surgical procedures for rectal cancer have been legitimized if executed respecting the criteria of oncological radicalness. Our objective was to evaluate anal sphincteric continence after rectal cancer surgery. METHODS: A detailed questionnaire regarding continence was administered to 3 groups of patients. Group 1 was composed of 9 patients treated with a higher (>4 cm), stapled colorectal anastomosis; the 9 group 2 patients were treated with a low (< or =4 cm), stapled colorectal anastomosis; the 9 group 3 patients underwent coloanal anastomosis. RESULTS: The results were evaluated about 3 years after surgery. Continence was excellent in group 1 and very good in group 2. However, in group 3, we observed diminished gas/feces discrimination, reduced ability to postpone evacuation, and increased soiling and perianal rash. CONCLUSIONS: Anal sphincteric continence was better after surgery with a high or low colorectal anastomosis than after coloanal anastomosis.

Anal Canal↗
PubMed2000

Local recurrences and primary surgery in rectal carcinoma.

BACKGROUND: The authors analyze retrospectively a consecutive series of rectal carcinomas operated on with different surgical strategies at Third Surgical Department of "La Sapienza" University of Rome, between January 1985 and December 1997, by one expert surgeon (GDM), and report the incidence of the local recurrence correlated to the surgical technique development. METHODS: In most recent groups of patients treated for extraperitoneal neoplasm from January 1992 with curative (R0) total mesorectal excision (TME) and nerve sparing technique (NST) (Group C, n = 47) and with curative TME plus lateral pelvic lymphadenectomy (LPL) and NST (Group D, n = 7), sacrificing the pelvic autonomic nervous system only in case of neoplastic infiltration, the local recurrence was 8.5% (4 cases, with mean interval of 30.5 months) and 0 respectively at mean follow-up of 44.9 and 55 months. RESULTS: In none of the local recurrences of the Group C a re-resection (neither curative nor palliative) was possible and the survival was 50% at 14 months from the diagnosis of relapse. Instead, in local recurrences of rectal carcinoma in patients who underwent a first anterior resection with less extended dissection in other Department (Group E), a re-resection was possible for 3 cases out of 4 (R0, R1 and R2 operations); re-resected patients are now alive at mean follow-up of 33.6 months (82, 12 and 7 months, respectively). In Group A patients, treated between January 1985 and December 1988 with partial mesorectal excision (R0) also for extraperitoneal localization, the incidence of local relapses is 21.9% (9/41 cases) vs 11.2% (11/98 cases) in Group B patients, treated from January 1989 with curative TME for extraperitoneal tumors. CONCLUSIONS: The incidence of local recurrences of extraperitoneal rectal cancer can be reduced by total mesorectal excision. The total sparing of pelvic autonomic nervous system in advanced rectal carcinoma doesn't increase the incidence of local recurrences.

Aged↗
PubMed1999

Giant abdominopelvic epithelioid angiomyolipoma associated with tuberous sclerosis: report of a case.

Tuberous sclerosis is a hereditary autosomal-dominant disease characterized by hamartomas that can develop in any organ. We report herein the case of a 34-year-old female with tuberous sclerosis and a huge abdominopelvic mass that started growing quickly 2 years after its diagnosis. The patient had undergone several previous operations for hydrocephalus and cerebral tubers, and a nephrectomy for right renal angiomyolipoma. On admission, she was in poor general health with renal failure, severe anemia, and weight loss. A laparotomy revealed that the tumor occupied the pelvis, the lower and part of the upper abdomen, and was hypervascularized, with an extremely irregular surface covered in nodules, vegetations, and areas of hemorrhagic necrosis. The development of the mass and the impossibility of recognizing the internal genital organs led us to assume that the formation had originated from these. Frozen-section examination indicated an undifferentiated tumor that had not been completely resected. Her postoperative course was complicated by bronchopneumonia and progressive renal failure. The patient died 10 days after surgery due to cardiorespiratory failure. A histological diagnosis of epithelioid angiomyolipoma was confirmed. Although it is presently impossible to determine whether angiomyolipoma with predominant epithelioid cells is more aggressive than typical angiomyolipoma, it definitively demonstrated local aggressive behavior in this patient.

Abdominal Neoplasms↗
PubMed1997

[Current trends in therapeutic indications in gallstones].

In the last 3 years, 300 consecutive patients (110 men, 190 women) were treated for gallstone disease using either traditional open surgery or the video laparoscopic approach. The relative clinical data and results were compared and analysed. The Authors conclude that video laparoscopy presents a number of advantages such as minor costs, reduced pain, quick return to work, compared to traditional surgery, especially when correctly indicated.

Cholangiography↗
PubMed1997

[Cholecystosis: anatomo-clinical profile and therapeutic considerations].

In the last 5 years 16 patients with cholecystosis were observed. In this period the most recent diagnostic and therapeutic techniques were used including ultrasound which allowed to diagnose 60% of adenomyomatosis, 33.3% of cholecystosis and 6.7% of gallbladder polyposis. In 6 cases a traditional open surgery cholecystectomy was performed, while the videolaparascopic approach was used in other 6 cases. Histologic examination always confirmed the preoperative diagnosis, however in one case a gallbladder cancer was histologically found; this case had been clinically diagnosed 9 years previously as adenomyomatosis. Therefore, our experience suggest, in agreement with others, that cholecystosis should be considered as a precancerous lesion.

Adenomyoma↗
PubMed1997

[Gastrointestinal carcinoids and carcinoid syndrome: classification, diagnosis and therapy].

Historically, carcinoids have long been known as a morphologically distinct class of rare intestinal tumors which behave less aggressively than the more common intestinal adenocarcinomas. In recent decades refined methods in pathology improved our knowledge on the diffuse neuroendocrine system, leading to some confusion in classification and nomenclature of carcinoids. The World Health Organization (WHO) classification of endocrine tumors has cleared the definition of carcinoids. The Authors report on 7 cases of midgut carcinoid tumors and 1 case of carcinoid syndrome focusing on the newer approaches to the diagnosis, localization, and role of surgery and peptide therapy.

Adult↗
PubMed1997

[Ampullary and periampullary tumors].

Ninety-eight consecutive patients with ampullary and periampullary carcinoma diagnosed between 1983-1993 were studied retrospectively. Among these patients, 66 had a carcinoma of the head of the pancreas, 10 a carcinoma of the papilla of Vater, 8 a carcinoma of the duodenum, and 14 a carcinoma of the distal common bile duct. Resectability rate ranged from 12% to 90% according to the tumor location and histologic type. Palliative procedures such as laparotomy, biopsy and bilio-digestive bypasses were performed in 27 patients. Curative resections were performed in 24 cases: 20 pancreatoduodenectomies, 2 total pancreatectomies, 1 duodenectomy, 1 common bile duct resection. The results of the surgical treatment as well as mortality and morbidity rates were compared with those of different and larger series.

Adult↗
PubMed1997

[Artificial nutrition in acute pancreatitis].

Nutritional support for acute pancreatitis is a matter of debate, clear guidelines based on objective data do not exist. We report our experience in patients with severe disease. Parenteral nutrition appears to be a safe initial therapy, but the enteral route has many practical and theoretical advantages and should be started as soon as possible.

Acute Disease↗
PubMed1992

[Malignant fibrous histiocytoma of the pancreas].

The authors report a case of pancreatic malignant fibrous histiocytoma (approximately 22 cm). Clinical and instrumental approach for preoperative diagnosis is discussed and the anatomopathological features of the lesion, which is rarely localized in the pancreatic gland, are stressed. Surgical treatment is outlined as well.

Female↗
PubMed1989

[Cavernous hemangioma of the small intestine].

The Authors report an uncommon cavernous hemangioma of the small bowel. Pathological and clinical features are compared with those of the literature. Considering the difficulty of diagnosis, they remark the importance of histological exam as the only reliable diagnostic tool and surgery as the only therapy.

Aged↗