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Biomedical subjects

Antonio D'Urso

Publications and source records attributed to Antonio D'Urso.

8 recordsLinked to original sources
PubMed2006

Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma.

HYPOTHESIS: Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival. DESIGN: A consecutive sample clinical study with a mean follow-up of 40 months. SETTING: The surgical department of an academic tertiary center and an affiliated secondary care center. PATIENTS: Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava. INTERVENTIONS: All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases. MAIN OUTCOME MEASURES: Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis. RESULTS: No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years. CONCLUSION: Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.

Adult↗
PubMed2004

Simultaneous repair of abdominal aortic aneurysm and resection of unexpected, associated abdominal malignancies.

BACKGROUND AND OBJECTIVES: The management of unexpected intra-abdominal malignancy, discovered at laparotomy for elective treatment of an abdominal aortic aneurysm (AAA), is controversial. It is still unclear whether both conditions should be treated simultaneously or a staged approach is to be preferred. To contribute in improving treatment guidelines, we retrospectively reviewed the records of patients undergoing laparotomy for elective AAA repair. METHODS: From January 1994 to March 2003, 253 patients underwent elective, trans-peritoneal repair of an AAA. In four patients (1.6%), an associated, unexpected neoplasm was detected at abdominal exploration, consisting of one renal, one gastric, one ileal carcinoid, and one ascending colon tumor. All of them were treated at the same operation, after aortic repair and careful isolation of the prosthetic graft. RESULTS: The whole series' operative mortality was 3.6%. None of the patients simultaneously treated for AAA and tumor resection died in the postoperative period. No graft-related infections were observed. Simultaneous treatment of AAA and tumor did not prolong significantly the mean length of stay in the hospital, compared to standard treatment of AAA alone. CONCLUSIONS: Except for malignancies of organs requiring major surgical resections, simultaneous AAA repair and resection of an associated, unexpected abdominal neoplasm can be safely performed, in most of the patients, sparing the need for a second procedure. Endovascular grafting of the AAA can be a valuable tool in simplifying simultaneous treatment, or in staging the procedures with a very short delay.

Abdominal Neoplasms↗
PubMed2004

Infrascrotal, Perineal, Femorofemoral Bypass for Arterial Graft Infection at the Groin.

HYPOTHESIS: Infrascrotal, perineal, femorofemoral bypass is an acceptable procedure for treating infection of a prosthetic arterial graft limited to a unilateral groin. DESIGN: A consecutive sample clinical study with a mean follow-up of 29 months. SETTING: The surgical department of an academic tertiary care center and an affiliated secondary care center. PATIENTS: Nineteen patients with a mean age of 68 years with prosthetic graft infection at the outflow anastomosis on a femoral artery at the Scarpa triangle underwent an infrascrotal, perineal, femorofemoral bypass, with excision of the graft material limited at the groin. The recipient artery was the profunda femoris artery in 12 cases, the superficial femoral in 5, and the distal common femoral artery in 2. MAIN OUTCOME MEASURES: Cumulative survival, recurrence of sepsis, primary graft patency, and limb salvage rates expressed by standard life-table analysis. RESULTS: Postoperative mortality rate was 5%. Cumulative (SE) survival rate was 65% (11.6%) at 3 years. Cumulative (SE) rate of freedom from recurrent sepsis was 88% (8.6%) at 3 years. Cumulative (SE) primary patency and limb salvage rates were 86% (9.4%) and 91% (7.9%), respectively, at 3 years. CONCLUSION: Femorofemoral bypass with an infrascrotal perineal approach is a valuable procedure for the treatment of femoral arterial graft infection limited at a unilateral groin.

Journal Article↗
PubMed2004

Infrascrotal, perineal, femorofemoral bypass for arterial graft infection at the groin.

HYPOTHESIS: Infrascrotal, perineal, femorofemoral bypass is an acceptable procedure for treating infection of a prosthetic arterial graft limited to a unilateral groin. DESIGN: A consecutive sample clinical study with a mean follow-up of 29 months. SETTING: The surgical department of an academic tertiary care center and an affiliated secondary care center. PATIENTS: Nineteen patients with a mean age of 68 years with prosthetic graft infection at the outflow anastomosis on a femoral artery at the Scarpa triangle underwent an infrascrotal, perineal, femorofemoral bypass, with excision of the graft material limited at the groin. The recipient artery was the profunda femoris artery in 12 cases, the superficial femoral in 5, and the distal common femoral artery in 2. MAIN OUTCOME MEASURES: Cumulative survival, recurrence of sepsis, primary graft patency, and limb salvage rates expressed by standard life-table analysis. RESULTS: Postoperative mortality rate was 5%. Cumulative (SE) survival rate was 65% (11.6%) at 3 years. Cumulative (SE) rate of freedom from recurrent sepsis was 88% (8.6%) at 3 years. Cumulative (SE) primary patency and limb salvage rates were 86% (9.4%) and 91% (7.9%), respectively, at 3 years. CONCLUSION: Femorofemoral bypass with an infrascrotal perineal approach is a valuable procedure for the treatment of femoral arterial graft infection limited at a unilateral groin.

Adult↗
PubMed2003

Revascularization of the internal carotid artery for isolated, stenotic, and symptomatic kinking.

HYPOTHESIS: The operation for isolated, stenotic, and symptomatic kinking of the internal carotid artery is safe and effective in preventing stroke and relieving the symptoms of cerebral ischemia. DESIGN: A consecutive sample clinical study with a mean follow-up of 44 months. SETTING: The surgical department of an academic tertiary care center and an affiliated secondary care center. PATIENTS: Fifty-four patients with a mean age of 67 years underwent 55 revascularizations of the internal carotid artery. The surgical procedures consisted of the following: shortening and reimplantation in the common carotid artery in 36 cases, bypass grafting in 15 cases, and transposition into the external carotid artery in 4 cases. MAIN OUTCOME MEASURES: Cumulative survival, primary patency, and stroke-free and neurologic symptom-free rates expressed by standard life-table analysis. RESULTS: No patients died in the postoperative period. The postoperative stroke rate was 1.8%. The cumulative rates (SEs) at 5 years were as follows: survival, 70% (10.2%); primary patency, 89% (7.8%); overall stroke free, 92% (6.8%); ipsilateral stroke free, 96% (5.3%); neurologic symptom free, 90% (7.5%); and ipsilateral symptom free, 93% (6.5%). CONCLUSION: Revascularization of the internal carotid artery for the treatment of isolated, stenotic, and symptomatic kinking is safe and effective in preventing stroke and relieving symptoms of cerebrovascular insufficiency.

Aged↗
PubMedDate not supplied

[Lung resection: predictive value of respiratory function].

The most important preoperative cardiopulmonary variables for identifying patients at increased risk prior to lung resection are: FEV1, FEV1-ppo, DLCO, MVO2, and SO2. The aim of this study was to evaluate the ability and usefulness of predictive postoperative FEV1 (FEV1-ppo) in 80 patients undergoing lung resection. Spirometry was performed before and 6 months after operation; residual respiratory function was calculated using Nakahara's formula, and data analysis calculations were performed using the chi 2 test. It was observed that the resulting predictive values were almost comparable to the values observed 6 months postoperatively in 63.75% of patients and the correlation proved statistically significant (P < 0.005). In view of its simple and rapid execution, we conclude that Nakahara's formula, compared with the others, remains a reliable standard method of assessing high-risk patients and planning appropriate surgery.

Aged↗
PubMedDate not supplied

[Current indications for the surgical treatment of pulmonary tuberculosis].

A marked worldwide increase in the prevalence of pulmonary tuberculosis has occurred over the past 15 years. The reasons for this change include the worldwide epidemic of AIDS, poverty and the unprecedented extent of migration. We selected 47 patients with pulmonary tuberculosis or its sequelae for 51 surgical operations, with a high prevalence of subjects under 50 years of age (48.9%). There were three major non-fatal complications, and three minor complications. One patient died on postoperative day 1 as a result of unrelated causes. At present, surgery for tuberculosis of the lungs is mainly indicated when all medical treatments have proved ineffective or in circumstances where complete control of complications or disease sequelae is necessary, provided there is a correct indication and a flawless execution.

Adolescent↗