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Biomedical subjects

B Lasagna

Publications and source records attributed to B Lasagna.

17 recordsLinked to original sources
PubMed1995

Biliary lithiasis: retrospective analysis of a case series.

The paper analyses a series of biliary lithiasis cases encountered in 1983-92 in which cholelithiasis accounted for 79.3%, cholecystocholedochic calculosis for 16.6%, chronic stenotic papillitis for 2.1%, residual/recurring calculosis of the main biliary way after cholecystectomy for 1.7% and intrahepatic calculosis for 0.3%. Among the cases involving the main biliary way, the highest percentage (35/50 cases or 70%) of transduodenal papillosphincterostomies was performed in the first five years, while endoscopic papillosphincterotomy prevailed (28/42 or 66.7%) in the second five years. The endoscopic technique was initially considered elective for residual/recurring biliary calculosis after cholecystectomy and for cholecystocholedochic calculosis in patients who were elderly and/or at risk. Thereafter its use was gradually extended as technological developments allowed its use as a complementary technique in cases of giant stones. The advent of minimally invasive surgery has given a further boost to the use of endoscopic clean-up procedures in cases of biliary calculosis prior to laparoscopic cholecystectomy. The laparoscopic treatment of gallstones is a more recent development.

Adolescent↗
PubMed1994

Subtotal thyroidectomy, the preferred option for eu- and hyperthyroid goitre.

A series of 268 patients operated on for benign thyroid diseases is presented. Totally 168 subtotal thyroidectomies and 100 hemithyroidectomies have been performed, with no mortality and 0.74% morbidity. Postoperative thyroid function was assessed in 135 patients; this demonstrated that many patients do not need postoperative hormone supplementation and that subtotal thyroidectomy must be considered the intervention of choice, even in uninodular forms.

Adolescent↗
PubMed1993

[Palliative treatment of pancreatic carcinoma. Comparison between 2 successive observation periods].

Explorative laparotomies and palliative surgery for pancreatic carcinoma have been reduced due to improved diagnostic tools, the spread of laparoscopic techniques and the growing use of external biliary drainage and endoprostheses. By comparing two successive observation periods the authors point out that, owing to the good results obtained, mini-invasive surgery is more frequently used in the management of obstructive jaundice than biliodigestive surgical derivations. Of these, hepatico-jejunostomy is preferable to duodenal anastomosis due to the latter's frequent involvement by the primary tumour. The authors also consider it inappropriate to increase operative morbidity through the systematic association of gastroenteric with biliodigestive derivation, except in cases of symptomatic or radiologically or endoscopically ascertained duodenal stenosis and when the objective finding of visceral involvement leads to the supposition of its imminent obliteration. The indications for surgical splannicectomy have also been reduced with the spread of percutaneous alcoholization of the celiac plexy in cases which resist analgesic treatment using a parenteral route.

Aged↗
PubMed1993

[Repair of large laparoceles].

The authors report a series of 100 incisional hernias operated on and consider general and local problems in repair of wide hernias. They underline some rules in order to obtain a strong reconstruction, with minimal relapse risk and to avoid adverse systemic effects produced by the intervention itself. Now they consider synthetic meshes to be apt for the treatment of the largest hernias, in order to reinforce or to repair the fascial defect, as meshes are strong, easy to use and are well tolerated by tissues and have a good resistance to infection.

Adult↗
PubMed1993

[Extension of thyroidectomy in the treatment of benign nodular thyroid diseases].

A series of 268 benign nodular goitres, operated on in a 10-year period, is presented. Subtotal thyroidectomy was the chosen operation; however, during the first period of our experience, when the goitre was obviously limited to one lobe we performed unilateral lobectomy in some cases. After surgery no patient received hormone therapy without previous evaluation of thyroid function. Thyroid function was evaluated after surgery and alterations were corrected. As recurrent goitre was a rare occurrence and complications of subtotal thyroidectomy are low, we do not support total thyroidectomy for nodular goitre. In order to avoid recurrences hemithyroidectomy no longer must be performed: the surgical treatment of nodular goitre is carried out by subtotal thyroidectomy, leaving little residual thyroid, to spare parathyroids and inferior laryngeal nerves, which is usually enough for adequate hormone production; in the case of TSH raising, thyroxine must be given.

Adolescent↗
PubMed1993

[Abdominal desmoid tumor].

Two cases of desmoid tumor of the abdominal wall are reported, together with some considerations and a review of the literature; desmoid tumor is an unusual neoplasm which affects women in prevalence. This is an histologically benign neoplasm with no metastatic capacity; however it is highly invasive in the site where it arose, so its treatment can become very difficult. The treatment is by surgical excision that must be as wide as possible, in order to obviate the great incidence of recurrence. The role of radiotherapy, hormone and chemotherapy has not been completely assessed so far.

Abdominal Muscles↗
PubMed1992

[Endoscopic and intraoperative ultrasonography in staging of stomach neoplasms].

In Japan a better prognosis of gastric cancer has been achieved by early diagnosis and wide, careful lymphectomy. This is not true in western countries. Thus the Authors believe that rational surgical strategy and the careful use of advanced diagnostic tools would produce a better outcome. The Authors report the new diagnostic methods that they adopt in every case of gastric neoplasm: endoscopic ultrasonography, which also proved useful in submucosal tumors, like lymphomas; parenteral nutrition, immune status assessment for a possible use of immune response modulators, single-dose antimicrobial prophylaxis, antithrombotic prophylaxis, autologous blood storage, in order to reduce transfusion-linked risks. Surgical strategy is also reported, which includes wide resection with adequate margins, R2 lymphectomy and intraoperative assessment of disease extension by ultrasonography.

Gastroscopy↗
PubMed1992

[Isolated neurofibroma of the stomach. Case report and review of the literature].

An uncommon case of gastric neurofibroma is described: it was an incidental finding during assessment for abdominal pain, possibly due to pancreatitis, in a 58 year old man, with no sign of von Recklinghausen's disease. The generic diagnosis of gastric wall neoplasia was made by CT scanning; the neoplasm was resected with wedge resection of gastric wall. Histological and ultrastructural examination revealed a neurofibroma. Gastrointestinal stromal tumors are rare occurrence and usually are of smooth muscle derivation: a small percentage arises from nerve sheet, but such a distinction is never sharp. Neurogenic gastric tumors are usually benign and only 10% of von Recklinghausen associated neurofibromas can undergo malignant transformation. Wide excision of the tumor appears therefore the treatment of choice.

Humans↗
PubMed1991

[Adrenal neuroblastoma in adults: a rare neoplasm of difficult diagnostic interpretation. A case report].

A case of a 25-year old girl, affected by an adrenal neoplasia with bone marrow and splenic metastases, is reported. The site of the neoplasm, that was highly undifferentiated, the presence of rosette-forming cells along with the clinical picture and the rapidity of the final outcome, could suggest the diagnosis of neuroblastoma. However we stress that the diagnosis is very difficult and can only be stated on probability bases in such undifferentiated neoplasms.

Adrenal Gland Neoplasms↗
PubMed1990

[Etiopathogenetic considerations on local recurrence after excision of rectal carcinoma].

A series of 77 cases of rectum carcinoma observed in a six year period, is presented. Sixty-one patients underwent radical operation and 57 of them have been regularly followed up. The incidence of local relapses has been 12.28%, with a majority of perianastomotic forms. It turned out to be proportional to the aboral distance and to primitive neoplasm staging, but not to histologic differentiation degree. Staplers were used and therefore the choice between resection or amputation was determined by the degree of loco-regional infiltration of the neoplasm. The frequency of local relapses turned out not to be related to the type of operation, but the impossibility to the exeresis of perirectal tissues involved by neoplastic process.

Adult↗
PubMed1990

[Diagnostic and prognostic value of CEA and GICA in colo-rectal tumors. A caseload contribution].

The Authors analyse the clinical usefulness of serum levels' determination of Carcinoembryonic Antigen (CEA) and Gastrointestinal Cancer Antigen (GICA) in 152 patients with colorectal cancer, admitted to their Hospital from November 1982 to March 1989. The sensibility for primary diagnosis of each tumor marker is not very high but there is a relationship between the stage and the histological characters of the disease, especially when the markers are considered at the same time. Preoperative serum level determination of CEA and GICA can be considered a good prognostic index: infarct the increase of the levels is generally due to metastatic tissue or local recurrence. This was confirmed during patients follow-up by further tests which revealed recurrence of the disease.

Adenocarcinoma↗
PubMed1989

[Analysis of a series of cases of liver metastasis of colorectal carcinoma].

The Authors present a six years case-report concerning 135 patients operated on colo-rectal carcinoma (82 of them are still followed up). The incidence of hepatic metastases (synchronous and metachronous) has been 30.37% in all. The preoperative ultrasonography has shown an 11% about margin mistake to visualize secondary lesions of liver. They have acknowledged the intraoperative ultrasonography very useful to visualize occult metastases and to guide an exeresis operation. The resectability of hepatic metastases from colo-rectal cancer has been of 12.19%. Synchronous forms have been rarely operable (5.88%) because they are constituted by multiple and disseminated lesions. They have found an higher incidence of operable forms among the metachronous metastases (42.85%), whose average time of appearance from the primary operation has been about 13 months. The operative mortality and the complications following hepatectomy have been null. The average survival time from operation has been over 22 months. Therefore they recognized the importance of a careful follow-up to find precociously operable lesions.

Adult↗
PubMedDate not supplied

[Laparocele: a review of the literature and analysis of case histories].

We analyze a group of 64 laparoceles from which it emerges a per cent distribution in the different regions and a correlation between the dimensions of the lesion and the relative regions in agreement with the data usually given in the literature. Furthermore we point out a clear dependence on pathogenetic factors of general and local order. Is therefore recognized the necessity of preventing their insurgence and reducing the risk of relapses through appropriate laparotomy incisions, with adoption of a suitable surgical technique and the correction of systemic diseases. The voluminous laparoceles are responsible of cardiac, respiratory, coagulative diseases, that must be scrupulously judged for an appropriate therapeutical approach. The surgical treatment, as well as for the cases of bigger dimensions, has mostly availed itself of an elementary technique (simple approach, apposition "en paletot" splitting of the fasciae). In the necessity of strengthening weak parietal tissues or of replacing vast losses of matter, we have limitedly resorted to autologous grafts, while good results have been observed with the lyophilized dura mater.

Adult↗
PubMedDate not supplied

[Actinic lesions of the small intestine requiring surgery. Case reports].

Radiation enteropathy is a disease that seldom requires surgical treatment, in the chronic variety. We report the findings of four cases we operated in an attempt to identify the weak points of surgery involving a high percentage and morbidity of mortality. NPT (total parenteral nutrition) can favour a positive evolution with total rest of the bowel and with reinstatement of normal nutrition.

Adult↗