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Biomedical subjects

C Garrone

Publications and source records attributed to C Garrone.

At least 19 recordsLinked to original sources
PubMed1997

Preoperative pneumatic dilatation represents a risk factor for laparoscopic Heller myotomy.

BACKGROUND: The development of minimally invasive surgery has renewed interest in the surgical therapy of achalasia. METHODS: 21 patients with esophageal achalasia underwent Heller's laparoscopic myotomy with anterior fundoplication between August 1991 and March 1996. RESULTS: There were two intraoperative perforations of the mucosa sutured laparoscopically with no postoperative sequelae; both complications occurred in patients previously treated with pneumatic dilatation; no perforations occurred in the 14 patients who had not been submitted to pneumatic dilatation (28% vs 0%). There were no surgical mortalities and no postoperative morbidities. Complete relief of dysphagia and modifications of radiological and manometric patterns were achieved in all patients. All patients remain asymptomatic at follow-ups ranging from 3 to 55 months after surgery. CONCLUSIONS: Laparoscopic Heller's myotomy is as effective as traditional surgery in treating symptoms and has all the advantages of pneumatic dilatation in terms of short hospital stay, quick recovery, and low cost; preoperative pneumatic dilatation is a risk factor for intraoperative mucosal perforation.

Adult↗
PubMed1997

[Uric acid and pre-eclampsia].

The cause of hypertensive disorders of pregnancy remains unknown. More than 100 clinical, biophysical and biochemical tests have been recommended to predict the development of hypertensive disorders in pregnancy. The findings of numerous studies have been inconsistent. The purpose of this review is to assess the serum uric acid currently proposed for predicting the development of preeclampsia. Hyperuricaemia (> 6 mg/100 ml) correlates with the severity of the preeclamptic lesion, as well as the poor fetal outcome.

Female↗
PubMed1997

[Good rules for cervical cytologic sampling].

There are still many little problems concerning methods about cervical cytology sampling. Are there some risks of teaching Papanicolaou smear technique? In which day of the cycle is it better to do sampling? How long in advance is it better to avoid sexual relations, and do not use any vaginal douching? Is it better to remove in advance cervical mucus? When should the sampling be done if the colposcopy is made in the same time? How should you behave if the cervix is not exposed? How many slides have to be spreaded? Which is better, the fixation with alcohol or aerosol? Where should the sampling be repeated? Is the patient anamnesis reliable? What should it mean the presence of some parasites and some foreign bodies manifested on the slide? Different answers have been given to reply to these questions and to some others. Smear's collecting is a simple method, but it needs an exact manual skill and an adherence to some precise rules. A relevant part of the final result depends how sampling has be done. Improvements must be done in every link of chain events.

Colposcopy↗
PubMed1996

[Laparoscopic treatment of non parasitic liver cysts].

Various surgical treatments have been proposed for highly symptomatic hepatic cysts: enucleation, fenestration, hepatic resection and liver transplantation. The advent of laparoscopic surgery has provided new opportunities but, at the same time, has increased the uncertainties concerning the correct management of these patients. This study evaluates the results and defines the indications for laparoscopic fenestration of symptomatic nonparasitic hepatic cysts, either solitary or diffuse. 31 patients were observed between November 1990 and October 1995: 15 with solitary cysts and 16 with policystic liver disease (PLD). After a careful review of the symptoms, 8 patients (5 with a solitary cyst and 3 with a PLD) were excluded from surgical treatment and 23 were treated by laparoscopic fenestration. There was no mortality. Ten of the 23 patients had a solitary cyst with a median diameter of 11.6 cm (range 6-20 cm). No conversion to laparotomy was necessary. There were no complications and complete regression of symptoms was obtained in all patients. No recurrences were observed. In the PLD group (13 patients), two patients had to be converted to open fenestration (15%). There were no deaths and the surgical morbidity was limited to two cases of postoperative persistent ascites. Symptomatic relief was obtained in 64% of patients, but symptoms recurred in 36%. A subgroup of PLD at high risk for recurrence was identified and a classification of PLD is proposed: PLD type I characterized by large cysts mainly located in the anterior hepatic segments, and PLD type II characterized by numerous small cysts through the liver which do not represent a good indication for laparoscopic fenestration.

Adult↗
PubMed1996

[The use of intraoperative topical bupivacaine in the control of postoperative pain following laparoscopic cholecystectomy].

Taking the starting point of a trial conducted on female patients who had undergone laparoscopic gynaecologic operations, which shows a good control of the postoperative pain through intraperitoneal infusion of local anaesthetic during the operation, the authors have proposed to reproduce the study on patients undergoing a laparoscopic cholecystectomy. The trial was conducted on two groups, a 50 patients each, undergoing an intraperitoneal infusion of local anaesthetic (bupivacaine) and placebo (physiologic solution) respectively. The results regarding the rate of patients who had felt postoperative pain (88% in the first group, 96% in the second group) and the different places of it, the pain in the right shoulder particularly (28% in the first group, 22% in the second), the intensity in the time and the different requests of analgesics new recorded. The results don't show statistically significant differences and they are different from the gynaecologic ones. The authors suggest, as reasons for these differences, the various moments of the liquid inoculation (at the beginning of the operation in gynaecology, at the end of it in cholecystectomy) and the Trendelemburg position of patients during the gynaecologic operation, on the contrary of cholecystectomy operations. They suggest, in the end, that the trials esecutions on numerically larger groups could bring more significant results.

Administration, Topical↗
PubMed1995

Survey on Torino courses. The impact of a two-day practical course on apprenticeship and diffusion of laparoscopic cholecystectomy in Italy.

Since March 1991 a monthly course on laparoscopic cholecystectomy has been organized at the Department of Surgery of the University of Turin. To evaluate the impact of this course and to obtain feedback from surgeons in order to improve the teaching of laparoscopic surgery, detailed questionnaires were sent to the participants of the first 20 courses. The outcome of this survey shows that short-residency "hands on" courses do not represent a completely satisfactory training, either for practicing surgeons or for residents, mainly because of the constraints of time and the lack of proctoring and supervision. Besides, the present study shows a significant difference in the diffusion of laparoscopic surgery in different areas of Italy. However, clinical results reported by this group of surgeons are satisfactory and comparable to the best multicentric series: 2,127 laparoscopic cholecystectomies were performed by 48 surgeons with a conversion rate of 6% and a complication rate of 2.4%.

Cholecystectomy, Laparoscopic↗
PubMed1994

Laparoscopic management of symptomatic nonparasitic cysts of the liver. Indications and results.

OBJECTIVE: This clinical study evaluated the results of and defined the indications for laparoscopic fenestration of symptomatic nonparasitic hepatic cysts, either solitary or diffuse. SUMMARY BACKGROUND DATA: Different surgical treatments have been proposed for highly symptomatic hepatic cysts: enucleation, fenestration, hepatic resection, and liver transplantation. The advent of laparoscopic surgery has given new opportunities but, at the same time, has increased the uncertainties concerning the proper management of these patients. METHODS: Eight patients with solitary cysts and nine with polycystic liver and kidney disease (PLD) were seen during a period of 2 years. After a careful review of the symptoms, 6 patients were excluded from surgical treatment and 11 (4 solitary cysts and 7 PLD) were treated by laparoscopic fenestration. Postoperative morbidity and mortality rates, hospital stay, and clinical early and late results were evaluated. RESULTS: In the solitary cyst group, there was no surgical morbidity or deaths, and a complete regression of symptoms occurred in all patients. No recurrences were observed. In the PLD group, two patients had to be converted to laparotomic fenestration (28%). There were no deaths, and the surgical morbidity was limited to two cases of postoperative ascites. Symptomatic relief was obtained in 80% of patients, but the symptoms recurred in 60%. A subgroup of PLD at high risk for recurrence was identified. CONCLUSIONS: The best indications for laparoscopic fenestration seem to be solitary cyst and PLD characterized by large cysts mainly located on the liver surface (type 1), whereas PLD characterized by numerous small cysts all over the liver (type 2) should be considered a contraindication to laparoscopic fenestration.

Adult↗
PubMed1992

[The diagnosis and treatment of renal oncocytoma. Our experience].

Personal experience of the treatment of renal oncocytoma is compared with reported data. Furthermore the problems relating to the diagnosis and treatment of this tumour, characterised, in many cases, by its lack of symptoms and tricky histopathological classification, are examined in greater depth.

Adenoma↗
PubMed1990

[Insular carcinoma of the thyroid gland. Observation of a clinical case].

We present a case report about a patient affected by an "insular" thyroid carcinoma, a poorly differentiated carcinoma, situated morphologically and biologically in an intermediate position between the well-differentiated (papillary and follicular) and the totally undifferentiated thyroid tumors. We believe that its separation from other types of thyroid cancer will lead to a more accurate estimate of its prognosis and a more aggressive therapeutic approach.

Adenocarcinoma↗
PubMed1989

[Cloacogenic carcinoma of the anus. Description of a clinical case].

A clinical case of cloacogenic anal carcinoma is reported. These neoplasms, deriving from embryonal residuals at different levels of the ano-rectal junction, have a better prognosis than squamous carcinomas; the surgical alternative to abdomino-perineal resection is a simple local exeresis for small tumours that do not invade the muscular layer, with a good radical result as reported by the literature.

Aged↗
PubMed1989

[Effect of somatostatin and salmon calcitonin on carcinoid syndrome. A clinical case].

In carcinoid syndrome, calcitonin administration proved to have an effective action in reducing symptomatology. During the perioperative period, treatment with somatostatin, thanks to the ease of administration of the drug and the reductive action of gastroenteric secretion, demonstrated its usefulness in countering the action of serotonin. In the present case, the data reported in the most recent literature on the use of the two drugs in the carcinoid syndrome are confirmed.

Aged↗