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Biomedical subjects

A V Sgroi

Publications and source records attributed to A V Sgroi.

9 recordsLinked to original sources

[Doppler echography in the intraoperative assessment of the liver circulation: an experimental study in swine].

In this experimental study the authors report an experience in the evaluation of hepatic blood flow with intraoperative echo-Doppler during orthotopic liver transplantation and side-to-side or end-to-side portacaval shunt. Doppler ultrasonography studied the flow of portal vein, hepatic artery and inferior vena cava before the recipient hepatectomy, and after reperfusion during liver grafting. Furthermore echo-Doppler of the portal system was performed to confirm portacaval shunt efficacy. Usually intraoperative Doppler ultrasonography may give informations about the patency of the shunt and regarding the development of early hepatic artery thrombosis during liver transplantation, but often unclear is the exact evaluation of the velocity of the blood flow through the liver. Further experimental studies and clinical evaluations need to find safe parameters and markers of vascular alteration using this superior diagnostic procedure.

Animals↗

Porcine orthotopic liver autotransplantation: facilitated technique.

The technique of a liver autograft in the pig has three advantages: (1) It provides an excellent training model of liver transplantation, (2) it provides an experimental model for cancer research, and (3) it is more economical than liver allotransplant. We describe a facilitated technique of liver autograft, which can be employed to develop experimental models without the use of a biopump. Mean blood arterial pressure, heart rate, pH, and lactates were tested during the liver grafting and at the end of the procedure in pigs that underwent autografting of the liver and compared with pigs that underwent an orthotopic liver allotransplantation. The cell damage was assessed in the same two groups of animals by monitoring aspartate aminotransferase (AST) and alanine aminotransferase (ALT) blood levels and with the MEGX test, 15 min after the beginning of reperfusion. The surgical procedure may be divided into three parts: hepatectomy, side-to-side portocaval shunt with passive caval-jugular shunt, and reimplantation. This procedure could have a clinical indication for otherwise unresectable liver tumors.

Animals↗

[Unreliability of the lidocaine test as a prognostic indicator of acute liver failure: an experimental study in swine].

It has been reported, in the recent literature, that fifteen minutes lidocaine-MEGX (monoethylglycinexylidide) test can also be used in case of acute hepatic failure because in these conditions the test allows a rapid evaluation of the hepatic damage, uneffected by te infusion of liquid or fresh plasma which can alter conventional laboratory parameters. The Authors have demonstrated, in a experimental model, the unreliability of the lidocaine-MEGX test as measure of functional hepatic damage in the early stages of an acute liver failure. The slight decrease of the rate of the MEGX test in these animals submitted to one-stage hepatic devascularization suggests that the hepatic failure is not so early detected by this specific liver function test. Accordingly, the 15' MEGX test should not be used as isolated discriminatory measure to detect an early hepatic failure following fulminant hepatitis or an early hepatic insufficiency as a result of extensive liver resection.

Animals↗

[Identification of an experimental model of partial portocaval shunt].

Portacaval shunt with interposition of 6 mm H-graft of PTFE is a real partial shunt. In this experimental study, the operation has been well tolerated and has been compared with 8 mm H-graft and direct "vein to vein" portacaval shunt. Intraoperative data show that 6 mm is the ideal diameter for a portacaval shunt to prompt an experimental model based on partial decompression of portal bed in animals in this size.

Animals↗

Laparoscopic robot-assisted right adrenalectomy and left ovariectomy (case reports).

BACKGROUND: Laparoscopic robot-assisted surgery has been created to reduce the patient risk of inappropriate scope movements by an assistant and to perform operations quicker and with greater ease. The Authors report their experience in laparoscopic robot-assisted right adrenalectomy for Conn's syndrome and right ovariectomy for benign ovarian mass. MATERIAL AND METHODS: Case 1. CT scan: solid right adrenal mass (diam. 2 cm). An anterior transperitoneal approach was used to perform the right adrenalectomy. The surgeon was placed at the ventral side of the patient and robotic-device was placed at the backside. HISTOLOGY: adrenocortical adenoma (diam. 3 x 2.5 x 1.5 cm). Case 2. CT scan: left iliac mass (diam. 3.5 cm) with origin in the left ovary. The patient was positioned in the gynecological position. The surgeon was positioned on right side of the patient and robot-device on left side. Left ovariectomy was performed. HISTOLOGY: ovarian serous cyst. RESULTS: Operating time was 180 min. for the adrenalectomy and 25 min. for the ovariectomy. No blood loss or complications for both operations were encountered. Image was steady and lens cleaning was unnecessary. CONCLUSIONS: The robot device (AESOP 2000) facilitated the procedures by enhancing stability of the image and reducing the need for lens cleaning. We believe that this method is feasible and could be advantageous especially for cholecystectomy, Nissen funduplication or ovariectomy but at the moment there are no comparative studies to establish the real value of this device.

Adrenalectomy↗

Secondary carcinoma of the liver from parotid gland tumor.

Secondary tumors of the liver from primary tumors arising in organs of the head and neck are rarely diagnosed during the patient's lifetime, though they should be suspected. A case of parotid mucoepidermoid carcinoma with liver metastases, treated by liver resection, is described. The clinical features and biological behavior of this secondary tumor are similar to those of the rare primary mucoepidermoid carcinoma of the liver. This case is unique because it is such a very rare occurrence.

Carcinoma, Mucoepidermoid↗

Correlation between cytochrome P-450 system and liver function tests during experimental liver transplantation.

The aims of this investigation are: 1) to assess the function of the hepatocyte in transplanted porcine liver, immediately after reperfusion, by monitoring both LFTs and the MEGX levels; 2) to search for correlation between MEGX and LFTS, in an effort to evaluate the metabolic mechanisms occurring in the early liver transplantation revascularization phase. The MEGX test was found to be less than 50 micrograms/ml in all the recipients and all the LFTS tested have been reported to be out the normal range. Furthermore our data has shown a statistically significant correlationship between the MEGX values and those of alkaline phosphatase and prothrombin and a highly significant correlationship with cholinesterase.

Animals↗

[Rare malignant tumors of the thyroid].

The incidence of rare malignant tumors of the thyroid is about 4 cases/100,000 people and represent only 1.8% of all the thyroid cancers. When we talk about "rare" tumors, obviously, we do not refer to the most frequent cancers (papillary, follicular), or less frequent tumors (medullary, anaplastic), but to some types of thyroid tumors that have been almost always sporadically observed. Mucoepidermoid carcinoma and squamous carcinoma have been described in the literature. They present occasional papillary formation so that, according to some authors, could be considered as variants of the papillary carcinoma. Teratoma is another rare tumor which in the paediatric age is benign, but its prognosis could be unfavourable because it causes an important respiratory distress, while in the adult it presents a very aggressive clinical course like the anaplastic carcinoma. Lymphoma is the most frequent of the "rare" tumors of the thyroid (1-5% of all the thyroid cancers). It arises often in a setting of a long history of goitre and Hashimoto thyroiditis. Fine-needle aspirate is important to make diagnosis and to start a correct treatment which allows a 5-year survival up to 85% in the favourable cases.

Carcinoma, Mucoepidermoid↗

[A facilitated technique for donor hepatectomy: experimental study in the pig].

A facilitated technique of porcine donor hepatectomy is reported underlying the possibility to make an easy procedure without in situ portal perfusion, so other abdominal organs supplied by superior mesenteric system can be harvested at the same time. The viability of those grafts procured without in situ portal perfusion has been compared with an other group of livers harvested with in situ aortic and portal flushing. The evaluation of the histology and early graft function two hours after riperfusion has shown no differences between both groups.

Animals↗