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Biomedical subjects

A Terrizzi

Publications and source records attributed to A Terrizzi.

At least 19 recordsLinked to original sources

[Surgery for complicated colonic diverticulitis. Our experience].

During the last two decades were observed 422 symptomatic patients with various degree of diverticular disease of the colon. 51 patients underwent surgery: 29 for stenosis (24) or occlusion (5), 4 for fistulas, 18 for perforation. The operations (26 emergencies, 25 elective) included: 21 cases of one-stage resection and anastomosis without protective colostomy, 16 with colostomy, 8 Hartmann's procedures, 7 Mikulicz's operations, 1 suturing of the diverticulum with colostomy. The incidence of complications was 17.6% (9 cases, 7 following emergency surgery and 2 after elective procedures). The intraoperative mortality was zero, while postoperative 5.8% (3 cases, 2 after emergency procedures and 1 following elective surgery). The best results (lowest morbidity and mortality rates) occurred with the radical procedures, especially the resection-anastomosis with or without colostomy, which allowed the removal of the septic focus from the peritoneal cavity and thus a shorter recovery in a high number of cases.

Adult↗

[Richter's hernia: a clinical case and the clinico-therapeutic considerations].

The authors report a case of Richter's hernia. They underline main clinical and therapeutic patterns, emphasizing the need of an early diagnosis and surgery. This is a hernia of abdominal wall with partial entrapment of bowel wall (antimesenteric site) through a small ring. The incidence increased in the last years because of diffusion of laparoscopic techniques. Richter's hernia could be asymptomatic for a long time or show vanish sign. Sometimes this hernia can be diagnosed during surgery. The clinical signs are conclamated if hernia is complicated by strangulation. High mortality is justified by performing too late diagnosis and operation.

Aged↗

[Adenocarcinoid of the appendix: a case report and anatomo-pathological and clinico-therapeutic considerations].

The Authors underline the most important pathological, clinical and therapeutic aspects of appendiceal adenocarcinoid. Appendiceal adenocarcinoid is quite a rare tumor, presently considered as a single entity; it differs from typical carcinoid of the appendix because of its well definite histology, its aggressive behaviour and its poorer prognosis. There are no precise prognostic and therapeutic criteria to direct the operative choice between appendectomy and hemicolectomy. In particular the tumor diameter is of no use since the tumor often present diffuse rather than nodular growth. According to most Authors appendectomy is not sufficient in the following cases: liver lymph-node or retroperitoneal metastases; cecal meso-appendiceal or peritoneal spreading; histological poorly differentiated tumors, with nuclear atypia and high mitotic count. Some Authors performed hemicolectomy and bilateral oophorectomy in all case with peritoneal involvement since the ovaries are a frequent site of metastases.

Aged↗

[Esophagectomy without thoracotomy: indications and our experience].

In this paper the Authors report their experience of Orringer operation in 12 patients with oesophageal cancer observed from 1978 to 1992, and stress the possibility to extend the indications to Akijama oesophagectomy without thoracotomy for the treatment of malignant tumors of the entire oesophagus.

Aged↗

[Sclerosing adenocarcinomas of the hepatic hilum].

The authors report their series of 7 adenocarcinomas of the hepatic hilum. Five patients with a stage IV tumor underwent palliative surgery while the remaining 2 patients underwent radical surgery. One patient died and 3 reported postoperative complications. Overall survival was 2 years and 6 months: these results can be considered satisfactory taking into account the advanced stage and the bad prognosis of this type of tumor. The aim of a better quality of life may represent a reasonable indication to surgery.

Adenocarcinoma↗

[Role of surgery in the treatment of gastroduodenal ulcer].

Medical approach to gastroduodenal ulcer has dramatically changed with the advent of anti-H2 drugs. There is still a role for surgery, but it has been confined to the treatment of the complications (perforation, stenosis and some cases of haemorrhage). In this paper the Authors collected the data of 43 patients (27 males and 16 females, mean age 45), operated between July 1988 and December 1992; 12 patients were operated for pyloric stenosis, 16 for gastrointestinal bleeding and 15 for perforation. Surgery was accomplished as an emergency procedure in 20 cases, delayed emergency procedure in 4 cases and elective procedure in 19 cases. 39 out of 43 patients were under anti-H2 treatment for a previous diagnosis of peptic ulcer. In conclusion, anti-H2 therapy, even correctly carried on, may not be effective in avoiding possible complications. This goal may be obtained in patients under omeprazole treatment.

Female↗

[Computerized dynamic endothermography of the gastrointestinal mucosa as an indirect index of the state of vascularization of the abdominal organs. A preliminary note].

Computerized Dynamic Endothermy (CDE) has been applied to the evaluation of the gastroenteric microcirculation. This new method enables mucosal temperature changes to be detected in a dynamic and functional way. With preventive induction of a temperature change (cold stimulus), the instrument measures the time required for the establishment of previous mucosal temperature. Computerized data are displayed in the form of a time/temperature curve. Results obtained on rabbits showed, during ischaemic conditions, a greater reduction of gastric layer temperature during cold stimulus than in basal conditions, followed by a slower return to basal temperature during the recovery time.

Animals↗

Use of a thymic factor in the prevention of postoperative infections.

A controlled study was carried out on 60 patients undergoing laparotomy to assess the role of a thymic factor (TP-1 Serono) in the prevention of postoperative infections. All patients entering the study were preoperatively shown to be at risk of sepsis on the basis of the response to skin multitest system for assay of delayed hypersensitivity (Multitest C.M.I. System). The patients were also postoperatively monitored with the same system. The lower incidence of infections in patients treated with the thymic factor with respect to untreated patients (p less than 0.05) and the postoperative response to skin tests have confirmed the efficacy of the thymic factor under study in the prevention of postoperative infections.

Adjuvants, Immunologic↗

Immunosuppressive effect of surgery evaluated by the multitest cell-mediated immunity system.

The immunosuppressive effect of surgery in a series of 100 elective laparotomies was determined by analysing the delayed skin hypersensitivity, the most sensitive in-vivo reflection of cell-mediated immunity. For this purpose, a new method (Multitest cell-mediated immunity system) for simultaneous, multiple, intradermal skin tests was used. This system uses a plastic disposable device for simultaneous intradermal injection of seven immunologically standardized recall antigens, offering the possibility of assessing a patient's immunologic capability in a manner that is painless, rapid, safe, reproducible and quantifiable. Patients were tested preoperatively and on days 1, 3 and 7 after operation. Twenty healthy volunteers, the control group, were similarly tested. Immunosuppression was observed in all patients, reaching a peak on postoperative day 3. Recovery occurred between 7 and 10 days after operation. Immunosuppression was more severe and prolonged in patients with neoplastic disease. By continued immunologic monitoring using the Multitest system, the authors could confirm the suggested immunosuppressive effect of operation and establish that the phenomenon is temporary.

Adolescent↗

[The colonosphincterometrogram (CSMG). An original method of simultaneous study of the motility of the left colon and of the anal sphincters].

Colonsphinctorometrography (CSMG) is a new, original method for the simultaneous investigation of the motility of the descending colon, sigmoid colon, rectosigmoid junction, rectum, and internal and external anal sphincters. A 60 cm open-ended tip sound with an external diameter of 10 mm is used. Three 3 cm long stimulating balloons are located at points 15 cm, 30 cm, and 50 cm along its length. A basal recording is taken for about 15 min with the patient absolutely at rest. The balloons are then inflated to measure the kinetic responses of colon and anal sphincters to stimuli of different volume. In addition to offering a pressure recording for the left colon and internal sphincter, the method also provides an EMG for the external sphincter and a pneumogram.

Anal Canal↗

[Indications, technic and immediate and long-term results of cryosurgery of hemorrhoids. Personal experience].

Haemorrhoid cryosurgery in 528 cases operated since the University of Genoa Colon and Rectum Diseases Centre opened is illustrated. It is shown that the complete success of this technique is dependent on careful preoperative assessment, adoption of a suitable method, and proper post-operative management. An analysis of these three parameters is followed by a description of the immediate and 1-yr follow-up results observed in the reported series. The soundness of the method is asserted. Stress is laid on the fact that cryosurgery offers a valid alternative to conventional surgical methods, provided its indications are strictly adhered to.

Cryosurgery↗

Treatment of esophageal anastomotic leakages after cancer resection. The role of total parenteral nutrition.

A series of 16 cases of esophageal anastomotic leakages after cancer resection observed from 1978 to 1982 is analyzed in a retrospective manner. Eight patients related to the period 1978 to 1980 (series A) were treated with emergency surgery while the remaining eight patients observed from 1980 to 1982 (series B) were treated conservatively with total parenteral nutrition (TPN) and complete fasting. Seven patients from series A eventually died postoperatively and one patient had a good recovery after emergency reintervention. In the series B six patients left the hospital with complete healing of the anastomotic leaks after 27.2 +/- 13.5 days of TPN and complete fasting, while failure of the treatment was observed in two patients who died from septic mediastinitis and acute respiratory failure. Different incidence of positive clinical results in Series A and B was statistically significant (p less than 0.01). The role of TPN and complete fasting will be discussed as the primary approach for the management of this severe complication, taking in consideration the suture line drainage and the control of infection.

Esophageal Neoplasms↗

[Renal hemangiopericytoma. Anatomo-pathologic and clinico-therapeutic considerations. A case report].

The Authors report a case of renal hemangiopericytoma, whose interest is related to the extreme rarity (24 cases reported until today), its insidious growth, the late in diagnosis, its uncertain clinical-biological evolution, not always predictable. Considering chemotherapy and radiotherapy ineffectiveness, an adequate treatment for such a neoplasm requires the surgical therapy, which must be followed by a careful follow-up.

Adult↗