PubMed Health⌕ Search

Biomedical subjects

C Crosta

Publications and source records attributed to C Crosta.

At least 19 recordsLinked to original sources
PubMed2006

Metal stent placement in acute malignant colorectal obstruction.

BACKGROUND: Obstruction is a common complication of advanced colorectal cancer. Stent insertion can reduce the need for emergency surgery and allows chemotherapy to begin immediately. AIMS: To evaluate the technical and clinical success and long-term outcome of stent placement in the management of acute malignant colorectal obstruction. METHODS: From July 2002 to April 2005, 29 self-expanding metal stents were placed in 24 patients (13 men, mean age 67 years, range 36-83). Stents were inserted under endoscopic and fluoroscopic control. Patients were clinically and endoscopically followed up. RESULTS: Twenty-eight out of 29 stents were successfully placed (96.5%) in 23 out of 24 patients with 25 strictures. The clinical success rate was 95.8% (23/24). Two early stent migrations were observed in two patients (8.3%). Late complications developed in eight patients (33.3%) after a median of 3.8 months (range <1-8.6): two migrations and six occlusions. The median survival was 9.8 months (range <1-27). Eleven patients (45.8%) died from progressive disease without any clinical evidence of recurrent obstruction. CONCLUSION: Stent placement is safe and effective. Stent complications are frequent but not life-threatening, and are easy to manage. An improvement in stent design and well-scheduled follow-up are needed in order to prevent such complications.

Acute Disease↗
PubMed2005

Is colonoscopy a suitable investigation in the preoperative staging of ovarian cancer patients?

BACKGROUND: During ovarian cancer surgery, colorectal resection may be required. In our institution, preoperative colonoscopy is performed in order to assess visceral involvement. AIMS: The aim of this study was to evaluate the utility of preoperative colonoscopy in ovarian cancer patients and the prevalence of adenomas in this population. PATIENTS: This retrospective study involved 144 consecutive patients with a supposed primary ovarian cancer. METHODS: Mucosal infiltration, bowel wall elasticity and bowel fixation were used to predict colorectal infiltration. Endoscopic and pathological findings were compared. All the polyps observed were removed. RESULTS: Six patients (4.2%) were excluded because of a misdiagnosed colorectal cancer metastatic to the ovary. Eight (6%) patients were considered, at endoscopy, to have a bowel infiltration and eight (6%), an uncertain infiltration. In 116 (88%), no signs of bowel infiltration were observed. The pathological analysis showed that colonoscopy had a low sensitivity (44%) in identifying bowel infiltration. Specificity was 100%, positive predictive value 100% and negative predictive value 92%. The overall accuracy was about 90%. Thirty-six adenomas were removed in 26 (20%) women. CONCLUSIONS: Colonoscopy identifies a not insignificant number of ovarian cancer patients requiring colorectal surgery. An increased prevalence of adenomas was not observed in this population.

Adenoma↗
PubMed2001

Endoscopic argon plasma coagulation for palliative treatment of malignant airway obstructions: early results in 47 cases.

Argon plasma coagulation (APC) is a new method of non-contact electrocoagulation, using high frequency current by means of ionized argon gas (argon plasma). Recently, this technique has become available for flexible endoscopic delivery through special probes. Aim of this study is to evaluate the efficacy, indications and the possible side effects of APC use in the palliative treatment of malignant airway obstructions and/or bleeding. Over a 24-month period, 47 patients underwent APC treatment for malignant neoplasms of the tracheobronchial system causing obstruction and/or recurrent bleeding. Immediate airway patency and haemostasis were obtained in 91.5% of cases (43/47). No complications or side effects caused by the treatment were observed. In two patients, the treatment allowed a radical surgical approach after induction chemotherapy. In all cases, APC proved to be highly effective and easy to perform. In our experience, APC has proven to be easy to perform, rapidly effective, safe and well tolerated by the patient, even after repeated application. This study highlights the value of endoscopic APC in the palliative management of tracheobronchial neoplasms.

Adult↗
PubMed2001

Complications of diagnostic and therapeutic ERCP: a prospective multicenter study.

OBJECTIVES: Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP/ES) can be associated with unforeseeable complications, especially when involving postprocedural pancreatitis. The aim of the study was to investigate risk factors for complications of ERCP/ES in a prospective multicentric study. METHODS: One hundred fifty variables were prospectively collected at time of ERCP/ES and before hospital discharge over 2 years, in consecutive patients undergoing the procedure in nine endoscopic units in the Lombardy region of Italy. More than 150 ERCPs were performed in each center per year by a single operator or by a team of no more than three endoscopists. RESULTS: Two thousand four hundred sixty-two procedures were performed; 18 patients were discharged because the papilla of Vater was not reached (duodenal obstruction, previous gastrectomy, etc.). Two thousand four hundred forty-four procedures were considered in 2103 patients. Overall complications occurred in 121 patients (4.95% of cases): pancreatitis in 44 patients (1.8%), hemorrhage in 30 (1.13%), cholangitis in 14 (0.57%), perforation during ES in 14 (0.57%), and others in 14 (0.57%); deaths occurred in three patients (0.12%). In multivariate analysis, the following were significant risk factors: a) for pancreatitis, age (< or = 60 yr), use of precutting technique, and failed clearing of biliary stones, and b) for hemorrhage, precut sphincterotomy and obstruction of the orifice of the papilla of Vater. CONCLUSIONS: The results of our study further contribute to the assessment of risk factors for complications related to ERCP/ES. It is crucial to identify high risk patients to reduce complications of the procedures.

Acute Disease↗
PubMed1997

Esophageal perforation and caustic injury: emergency management of caustic ingestion.

Diagnosis and treatment of caustic ingestion injuries remain controversial. Based on experience with a wide spectrum of upper gastrointestinal tract injuries from caustic ingestion, prospectively observed in 58 adult patients treated in a teaching hospital in Milan, the authors suggest an early staging of the lesions by endoscopy, followed by resective surgery for high-degree esophagogastric lesions. Ingestion of a large amount of corrosive agent results in a life-threatening condition that requires a much more aggressive diagnostic and therapeutic approach than was formerly recommended. Early surgery plays a fundamental role in the prevention of acute hemorrhagic and perforative complications as well as of development of scar tissue and neoplastic stricture over time. The multidisciplinary approach to the management of these patients is underlined, stressing the need of close cooperation between a number of different specialists.

Adolescent↗
PubMed1991

[Early gastric carcinoma: short and long term results of surgical treatment].

This paper reports Authors' experience in 58 cases of early gastric cancer observed between 1972 and 1990. The diagnosis of E.G.C. was frequently obtained in patients with recent dyspeptic symptoms. The diagnostic importance of endoscopic procedures, upper gastrointestinal X-rays and endoscopic ultrasonography is underlined. The choice of total gastrectomy with the standardized dissection of regional lymph nodes in order to treat multicentric or upper gastric malignancies v.s. distal gastrectomy for antral lesions is discussed. The cumulative survival rate was 84.4%; local recurrence rate was 4.2%.

Adenocarcinoma↗
PubMed1989

[Cancer of the gallbladder].

The Authors report their experience about 20 patients operated on since 1975 for primary carcinoma of the gallbladder. They remark their disappointment because of the poor percentage of preoperative and early diagnosis, that only allows a radical surgical therapy. More attention, therefore, should be payed to this not so rare pathology in the hope the survival of the patients radically operated will increase.

Aged↗
PubMed1987

[Angiodysplasia of the right colon. Angiographic findings in 5 cases].

The authors present five cases of angiodysplasia of the right colon diagnosed by selective arteriography of the superior mesenteric artery. The patients, affected by repeated digestive haemorrhages, underwent angiography after many endoscopic and radiological examinations, all without significative findings. Clinical patterns, methods and angiographic findings are described, together with surgical specimen.

Angiography↗
PubMed1987

Gastric submucosal neoplasms: new diagnostic and therapeutic procedures.

Submucosal neoplasms can be found in the esophagus and stomach during radiologic or endoscopic examination; histological diagnosis, however, is not significant in many cases because sampling is difficult. Endoscopic biopsies usually do not allow to obtain tissue from the submucosal layer nor other techniques prove to be reliable enough. 23 patients, aged between 21 and 76 were studied over a period of 5 years; in 1 male large gastric folds were observed. Of the 22 patients affected by benign submucosal neoplasms, 2 underwent surgical operation; no significant samples were obtained in any of the 11 cases in which biopsy forceps had been used. In the remaining patients an electrosurgical snare for polypectomy was used; this technique proved to be successful in 77.8% of cases. It is often shown to be also a therapeutic method when polypoid neoplasms are found.

Adenocarcinoma↗