This prospective study, based on 13 patients with single pulmonary nodules of width between 10 and 30 mm, was performed to verify the utility of intrathoracoscopic ultrasound to localize the single pulmonary nodule. In all 13 cases the ultrasound examination was able to localize the position of nodules, but the homogeneous hypoechoic pattern of nodules observed in ten of 13 cases did not prove whether the lesion was benign or malign. In conclusion, we can confirm that intrathoracoscopic ultrasound examination is a safe, risk-free and less expensive method of localizing the single pulmonary nodules.

Adult↗

PubMed2001

Significance of a single pulmonary nodule in patients with previous history of malignancy.

OBJECTIVES: To determine the diagnosis, treatment and follow-up in patients with a solitary lung nodule and a previous primary extrapulmonary neoplasm. METHODS: The authors evaluated the charts of 45 patients with an extrapulmonary malignant neoplasm and a solitary pulmonary nodule. The histologic characteristics of the nodule were correlated with those of the extrapulmonary neoplasm. RESULTS: The histology of the nodule was not known preoperatively in 43 cases (93.5%); in the remaining three cases cytologic examination had shown the presence of atypical cells. The majority of pulmonary lesions (73.9%) were found during the follow-up of the previous tumour, but a significant percentage of nodules (17.4%) were found incidentally. Pre- or intraoperative localisation of the nodule was done in 19 cases (41.3%), and was successful in nine cases (47.4%). Thoracoscopy was performed in 44 patients (95.6%). The coincidence between the pathology of the previous tumour and that of the nodule was 41.3% (19/46). The coincidence rate was 100% for the tumours of ovary, prostate, and sarcomas. CONCLUSIONS: The advent of minimally invasive surgical techniques has made a definitive diagnosis likely, providing also therapy with a less painful engagement for the patient and a less cost for the community.

Adult↗

PubMed1996

Peritoneal cystic mesothelioma treated with minimally invasive approach.

A case of peritoneal cystic mesothelioma in a young woman was treated with a minimally invasive approach. The technique and a review of the literature are presented.

Adult↗

PubMed1996

[Emergency laparoscopic surgery].

The acute abdomen continues to be a large part of the general surgeon's workload. The continuing advances in laparoscopic surgery have already permitted many emergency procedures to be performed by this route. Since 1993 the Authors perform an explorative laparoscopy in patients with acute abdomen. Once the diagnosis is verified, the endoscopic view suggests to continue the intervention laparoscopically or to convert the procedure. 70 acute cholecystitis, 57 acute appendicitis, 15 perforated peptic ulcers, 6 gynaecological emergencies, 8 intestinal occlusions and 2 splenic traumas were treated according to this approach. The results obtained testify that laparoscopy is a valuable diagnostic tool for the surgeon in case of acute abdomen and an interesting therapeutic alternative in selected cases. However, it requires extensive experience in laparoscopic techniques.

Abdomen, Acute↗

PubMed1996

[Experimental study of postoperative lavage: standardization of the method].

Postoperative infections are an outstanding problem in a surgical department. We have been studying them from a clinical and experimental point of view has a long time. In this study we present a method standardisation of postoperative peritoneal lavage as prevention of surgical infections. Winstar mice, infected with intra peritoneal E. coli cultures, underwent peritoneal lavage with saline solution or sterile water. The results showed the right amount of solution and the exact administration of lavage according to grade of infection. Encouraged by this result we are going to test the efficacy of anti microbial agents for the postoperative peritoneal lavage.

Animals↗

PubMed1995

[Video-assisted mediastinoscopy: clinical uses].

The experience with video-assisted mediastinoscopy in 16 cases examined, is reported. Initially the classic mediastinoscopic device with the aid of an operative thoracoscopy was used. Starting from April 1994 the Authors used the video-assisted mediastinoscopy which, enlarging the surgical field, allows to improve the operative performance and may be a good aid for multiple teaching.

Humans↗

PubMed1995

[Pleural drainage vs video-assisted minimally invasive surgery in the treatment of spontaneous pneumothorax. A retrospective study].

The most frequent cause of spontaneous pneumothorax is bleb's disease of the lung. Considering that, pnx s. has a remarkable bent for relapsing, we think that it's necessary an aggressive treatment to resolve it. That's because pleural drainage is useful for a symptomatic resolution, VATS for an etiologycal one. To value the real efficacy of the treatment of VATS, we have effected a retrospective research between two classes of patients suffering from pnx s. admitted in our Institute from 1987 until 1991, one treated with pleural drainage (class A, 11 patients) and the other with VATS (class B, 13 patients). 1) Patients treated with pleural drainage were nearly double compared to class B. 2) In class A, the mean value of drainages were nearly double compared to class B. 3) Class A had a number of relapses 10 times more compared to B. 4) Considering the period of hospitalization, class A had a value nearly triple compared to B. 5) We've noticed that the mean value of the cost for episode of pnx s. in class A was more than 15% compared to class B and the cost for patient in class A was nearly double than in class B. We can affirm that, for the treatment of pnx s., the method of VATS rappresents a real success. We're passed from the "symptomatological treatment" of it to an aetiological one, joined to the prophylaxis of the relapse.

Drainage↗

PubMed1995

[Video-assisted atypical resection of peripheral lung nodules localized using CT-guided wires. First clinical experiences].

One of the reasons for the rapidly expanding use of thoracoscopic surgery as an alternative to thoracotomy, is the excision of peripheral lung nodules. Nodules judged too small or too far from the pleural surface to be seen during thoracoscopy, must be localized beforehand. The aim of this study was to evaluate the feasibility and effectiveness of percutaneous placement of needle hook-wires to locate such nodules before surgery. Under Ct guidance 5 nodules were pre-operatively identified in 4 patients. The thoracoscopic resection of the lesions was done without complication, in 1 patient the operation had to be converted into an open one to dislodge of the wire. CT-guided hook-wire localization is easily and safely performed and permits thoracoscopic resection of lung nodules, which otherwise might be impossible.

Aged↗

PubMed1994

[Treatment with immunomodulating drugs of patients with operated cancer. Long-term results].

The authors produce a new course of study in order to verify the efficacy of immunomodulatory treatment in cancer-operated patients. In the General Surgical Clinic and Surgical Therapy Institute of University of Ferrara, from July '86 to June '92, 582 cancer-operated patients were treated by immunomodulatory drugs, making use of standard of absolute random. A group (100 patients) was subjected to peroperative anticontagious immunoprophylaxis; B group (482 patients) to postoperative cyclic immunomodulation; in this last group, were codified C group (166 patients) and D group (63 patients), controlled in follow-up, making use of 3 parameters: survival, clinical-oncological restage, performance status. The results obtained confirm the efficacy of the proposed immunomodulatory treatment: a reduction of incidence both early infections and late infections, an increase of survival, falls in clinical-oncological stage to less advanced levels and, above all, an improvement of performance status.

Adjuvants, Immunologic↗

PubMed1994

[Postoperative lavage. Experimental study of the use of antiseptic solutions].

The authors report their experience of surgical infections and particularly peritoneal intraoperative lavage. In a previous study they have standardized the technique. In this study they report on the lavage adding antiseptic substances in the solution. The experimental, controlled study, was carried out on Wistar rat stock, which were submitted to median laparotomy through which was injected a standard bacterial dose composed of 5 bn E. Coli. The peritoneal cavity was washed out after a few minutes with physiological solution with clorhexidine or PVPI dissolved. The main results were an increase of aderential syndrome and a less survival percent age (physiological solution = 100%, clorhexidine = 60%, iodophors = 23%). The authors concluded by pointing out that the use of antiseptic peritoneal lavage solution is a method that should be proscribed from operating rooms because it is unnecessary and detrimental to health.

Animals↗

PubMed1994

[Video-assisted mediastinoscopy. A new application of television technology in surgery].

Since 1959, when mediastinoscopy was introduced by Carlens, the practice has been technically unchanged. The authors suggest how the new video technologies could be very helpful to this procedure leading to an ergonomic position for the operator and a faster performance. Initial experience is reported.

Ergonomics↗