Biomedical subjects
Publications and source records attributed to A Sortini.
A new surgical technique for peripheral lymphatic-venous anastomosis is presented. It is designed especially for cases of node block, e.g. lymphoedema after mastectomy. The distal ends of the collectors are sectioned downstream from the block and passed through a patch, which also serves to close a phlebotomy on an adjacent vein. An experimental study and preliminary clinical results are discussed.
The enlargement of the indications in the use of the laparoscopic technique puts the surgeon in front of the need to project new techniques and to improve new instruments daily. On one hand, the technique and instruments used to perform a video-laparoscopic cholecystectomy are codified. However, there is still a lot of work to do for the laparoscopic treatment of the common bile duct stones. The aim of the present scientific contribution is the exposition of an original methodology for the positioning of the T-tube in laparoscopy which would be a difficult manoeuvre otherwise.
The Authors report their experience in the thoracoscopic surgical treatment of neurovascular abnormalities of the upper extremities. The experience acquired in the last two years with mini-invasive video-assisted thoracic surgery of the pleura and lung forced the Authors to perform thoracic sympathectomy following the same approach. In this way 4 thoracic sympathectomies were performed in 3 patients. Two of them presented Raynaud's phenomenon, and one was affected by bilateral idiophatic upper limb hyperhidrosis. The operation is performed thanks to 3 12mm Thoracoports that allow the introduction of the telescope and operative instruments. It is easy to recognize and remove the sympathetic gangliar chain from T2 to T3. The short operative time required, the absence of mortality and morbidity, the regression of the symptomatology, the rapid return to work authorize to consider endoscopic transthoracic sympathectomy the gold standard in the treatment of neurovascular abnormalities of the upper extremities.
The authors report a case of acute inveterate right subclavian artery obstruction. The leading role of US vascular investigation and the surgical technique adopted are pointed out. The personal findings are compared with those from the international references.
A series of 186 cases of mediastinoscopy performed in a department of general surgery is reported. The main indications for this procedure are: histological diagnosis of mediastinal masses, definition of bronchopulmonary neoplasms and thoracic esophagus ones with indication for surgery. The results obtained are: sensibility 90.3%, complications 3.7%, mortality rate 0%. The authors believe in the great utility of mediastinoscopy in case of unknown histotype of primary neoplasms and CT N2? involvement.
The Authors describe the results of an epidemiology project on nosocomial infection performed from 1989 through 1991 at the "Arcispedale S. Anna", Ferrara, Italy. Data are considered from 4.183 patients who were hospitalized for surgical treatment and intensive care: 301 patients (7.2%) developed 402 episodes of infection, namely 1.34 infections per patient. 8.2% of the patients who underwent surgery had at least one infection, while 3.9% of the those who did not have surgery showed at least one infection. The majority of infections came out higher among those submitted (11.4%) than among those not submitted (4.4%) to antibiotic prophylaxis. Infections were caused by both Gram+ and Gram- bacteria, and often the infections were polimicrobial.
The Authors report their experience of skin closure using a new device, a surgical "zipper", without applying any sort of sutures. The application of this device, the functional and aesthetic advantages and the results obtained are described.
The spontaneous pneumothorax (pnx. s.) is a type of pathology with a high per cent of relapse so its aetiological treatment can't be done only with a pleural drainage. With the resection of the bubble (that is the cause of it) instead, the problem will be resolved without possibilities of relapses. In the past, this was possible only with a thoracotomy, now with the new techniques of video-thoracoscopy, the therapeutical approach to this pathology has been revolutionized. In fact, this methodology resolves definitively the pulmonary lesion, can avoid the relapses, can guarantee a short stay in hospital and a very good restarting of the working and social activity.
This paper reports the results of a trial, comparing the use of disposable skin staplers with conventional nylon or silk sutures in skin closure. This study began in 1986; 7274 patients undergoing elective and emergency operations were controlled during the postoperative period, 3 and 6 months after surgery. It was shown that skin clips instead of sutures decrease the operative time, produce wound healing with a good cosmetic results, and above all a significant lowering of the wound infection rate.