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Biomedical subjects

A Trucchi

Publications and source records attributed to A Trucchi.

31 records · Page 2Linked to original sources
PubMed1997

Ureteral injuries during gynecologic procedures.

The reported incidence of iatrogenic ureteral injuries ranges from 0.05 to 30%. These injuries are particularly secondary to gynecologic surgical procedures. Simple abdominal hysterectomy has proved to be the most common procedure leading to such injures. Because some ureteral injuries may be symptomless, leading to silent kidney loss, the incidence may be too low, and a figure of up to 2.5% after gynecologic operations has been suggested. The incidence continues to be about ten cases during abdominal surgery for one case during vaginal surgery. Different risk factors may influence the ureteral injuries rate. An operation at the pelvic brim, distorted anatomy, removal of the adnexa or of ovarian neoplasm, may facilitate the occurrence of an ureteral trauma. The management of ureteral trauma is positively influenced by an early recognition of the trauma. Conventional technique or ureteroneocystostomy or end to end anastomosis with ureteral stent to treat the injury proved successful. Extensive reconstruction draws upon the entire therapeutic armamentarium of the urologist. Surgical options mainly include creation of bladder tubes and autotransplantation. The most important factor influencing the management of ureteral injury is the presence of associated complications. Blandy et al. sustained to attempt repair of these complicated iatrogenic injuries as soon the diagnosis has been made.

Female↗
PubMed1996

Neonatal intestinal obstruction: reducing short-term complications by surgical refinements.

Over the last ten years advances in neonatal intensive care, such as the advent of parenteral nutrition, have led to a significant decrease in the mortality rates of neonates with intestinal obstruction. Nevertheless, surgical short-term complications associated with the intestinal anastomosis performed, such as stenosis or leakage, and long-term nutritional complications due to extensive resections are still responsible for mortality and for a high morbidity rate. 39 newborns referred to our hospital in the past 3 years for intestinal obstruction were retrospectively evaluated with particular attention to the surgical management, surgical techniques and subsequent complications. Age on admission was from 1 hour to 24 days; weight from 1.4 to 3.8 kg; 41% of newborns had a prenatal diagnosis. 57 surgical procedures were performed: among them 44 intestinal anastomoses. Short-term surgical complications, namely perforation and stenosis, were observed in 18.1% of anastomoses. The complication rate after simple end-to-end anastomosis was as high as 30%. However, certain technical refinements such as tailoring the dilated upper pouch, positioning a transanastomotic feeding tube and an intubated lateral stoma resulted in a much lower complication rate (3.7%). Thus, in our experience these technical refinements are effective in reducing the incidence of short-term surgical complications.

Anastomosis, Surgical↗
PubMed1995

Changes in pressure-flow parameters in patients treated with transurethral microwave thermotherapy.

PURPOSE: We document changes in pressure-flow study parameters in patients treated by transurethral microwave thermotherapy. MATERIALS AND METHODS: Pressure-flow study tracings before and after therapy from 75 patients with benign prostatic hyperplasia were analyzed. Patients were stratified according to the predominant type of obstruction at screening (constrictive or obstructive). RESULTS: An improvement in Madsen score and flow rates was noted at 6 months in both groups. In contrast to compressive obstruction patients, however, those with constrictive obstruction also showed significant changes in pressure-flow study parameters, including detrusor pressure at maximum flow, maximum flow rate and urethral resistance factor. CONCLUSIONS: Patients with predominantly constrictive obstruction are the best candidates for microwave thermotherapy.

Humans↗
PubMed1995

The prediction of clinical outcome from transurethral microwave thermotherapy by pressure-flow analysis: a European multicenter study.

A total of 100 patients treated with a single session of microwave thermotherapy at 4 European centers was stratified according to 2 different types of obstruction (constrictive and compressive) and compared to clinical outcome at 6 months. Patients had a Madsen-Iversen score of 8 or more, maximum flow rate of 15 ml. per second or less and residual urine volume of 300 ml. or less at entry. The change in Madsen-Iversen score was the same in the 2 groups. Maximum flow rate increased from 8.71 +/- 2.62 to 14.73 +/- 4.04 ml. per second in the constrictive group, and from 8.54 +/- 2.26 to 10.41 +/- 4.52 in the compressive group (p < or = 0.0001). Residual urine decreased from 96.00 +/- 72.85 to 40.34 +/- 56.33 ml. in the constrictive group and from 109.86 +/- 67.09 to 84.65 +/- 81.45 ml. in the compressive group (p < or = 0.0001). Success, as defined by an increase of 50% or more in maximum flow rate and Madsen-Iversen score, was noted in 68% of the constrictive but only 15% of the compressive groups (p < or = 0.0001 chi-square test for trend). Selection by pressure-flow criteria for patients being considered for thermotherapy should improve the overall clinical results.

Diathermy↗
PubMed1993

Transurethral microwave thermotherapy in the treatment of symptomatic benign prostatic hyperplasia.

One hundred and forty-four patients with symptomatic benign prostatic hyperplasia were treated by transurethral microwave thermotherapy between January and December 1991. Before entering the study, all patients had a Boyarsky symptom score > or = 8, peak flow rate < or = 15 ml/s and postvoiding residual urine < or = 200 ml. Transurethral thermotherapy with the Prostatron (Technomed) was carried out as a single session (60 min) without any analgesia or sedation. Acute urinary retention occurred in 19.4% of the patients after treatment requiring catheterization for 2-3 weeks; morbidity rate was 5.5%. Six months after treatment, Boyarsky symptom score decreased from 11.73 +/- 4.97 to 4.40 +/- 3.21 (mean values +/- SD); peak flow rate increased on average from 8.97 +/- 4.18 to 13.07 +/- 4.87 ml/s and postvoiding residual urine decreased from 135 +/- 17.9 to 63 +/- 34.7 ml. Slight further improvement was shown, in a few patients, at the 1-year follow-up visit.

Catheterization↗
PubMed1993

[Transurethral thermotherapy by microwaves in patients with benign obstructive prostatic hypertrophy].

The effect of transurethral microwave thermotherapy (TUMT) with Prostatron in patients with benign prostatic hypertrophy was investigated. Two hundred and one patients were treated between January 1991 and June 1992 after informed consent was signed. The following examinations were carried out at screening: interview (including symptoms score evaluation), physical examination (including digital rectal examination), haematology and blood chemistry (including prostate specific antigen), ECG, chest Xray, kidney, bladder and prostate (transrectal) ultrasound sonography (USS) and uroflowmetry; pressure-flow study was performed in a selected group of patients. All enrolled patients had Madsen symptom score > or = 8; peak flow rate < or = 15 ml/s and post void residual urine < or = 200 ml. Patients with obstructive middle lobe of the prostate, any BPH complication or any suspicion of prostatic carcinoma were excluded from the study. Microwave thermotherapy with Prostatron was carried out according to software generation 2.0 (Prostasoft 2.0), the c10 (black) catheter was used in all patients. Follow-up visits were scheduled at 1 week, 1, 3, 6, 12, 18 months after microwave thermotherapy. Overall short- and long-term morbidity rates were 6.09 and 2.73 per cent, respectively. At 12 months, Madsen score was found to be reduced from 11.7 +/- 4.78 to 4.43 +/- 3.30; maximum flow rate (Qmax) was increased from 8.91 +/- 4.20 to 13.20 +/- 4.86; post void residual urine (PVRU) was reduced from 131 +/- 17.6 to 67.40 +/- 34.50.(ABSTRACT TRUNCATED AT 250 WORDS)

Follow-Up Studies↗
PubMed1992

Prenatal diagnosis and clinical outcome of ovarian cysts.

Technical refinements of ultrasound (US) have greatly affected the antenatal diagnosis and treatment of ovarian cysts. From 1985 to 1990 25 consecutive fetuses with ovarian cysts were followed-up by US both during pregnancy and postnatally. All cases were diagnosed between the 28th and 39th weeks of gestation. Deliveries were all at term; cesarean section was required only for obstetric complications. Eight fetuses (32%) showed US patterns of cyst torsion, a finding confirmed at surgery in all. In five patients US patterns suggested complications postnatally that were also confirmed at operation. In six cases cysts increased or remained unchanged in size after 15 days of life: in 50% of these surgery showed ovarian torsion. In the remaining six cases spontaneous resolution occurred within 1 to 4 months. One patient required intrauterine needle aspiration. There were two cases of intestinal obstruction. To date, more than 60% of newborns with ovarian cysts require oophorectomy; however, different treatments (cystectomy, needle aspiration, uncapping) combined with a close US follow-up are likely to reduce this percentage.

Female↗
PubMed1989

[Association of leiomyosarcoma and bladder papillomatosis].

The authors report one case of leiomyosarcoma associated with the papillomatosis of the bladder. After reviewing the literature, in which the exceptional nature of such tumoral associations is underlined, as are the infrequency and marked malignancy of leiomyosarcomas of the bladder, the authors illustrate the pathological and clinical characteristics of this neoplastic disease and discuss the pathogenic theories concerning this association.

Female↗
PubMed1988

[Malignant non-functioning adrenal cortex carcinoma. Apropos of a case].

A rare case of non-functional carcinoma of adrenal cortex is reported. After a review of the relevant literature, clinical characteristics and diagnostic methods are discussed and surgical treatment and chemotherapy prescribed in this case outlined. Based on personal experience, limitations of diagnostic imaging technics are presented and the importance of conventional radiologic investigations (urography and selective arteriography) re-evaluated, while emphasizing the reciprocal complementarity of all these methods for exploration of retroperitoneal lesions.

Adrenal Cortex Neoplasms↗
PubMed1984

[A rare cause of bladder neck obstruction: cervico-trigonal cysts. Report of 2 clinical cases].

Two rare cases of cervico-urethral obstructive lesions are described, illustrating two typical examples of the twofold pathogenic possibilities of the affection. The first patient had a probably congenital cervico-trigonal cyst due to a ureteral bud in the bladder wall. The second case presented different symptoms and signs, and this together with histology findings suggested an acquired nature of the lesion from cystic transformation of an infected glandular structure. The published literature is reviewed and diagnostic difficulties are emphasized, particularly differentiation from a prostate median lobe lesion.

Adult↗