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Biomedical subjects

C Huscher

Publications and source records attributed to C Huscher.

12 recordsLinked to original sources
PubMed1996

Laparoscopic colorectal resection. A multicenter Italian study.

BACKGROUND: The aim of the present study was to evaluate retrospectively the experience of six surgical units currently performing laparoscopic colorectal surgery. METHODS: From November 1991 to January 1994, 200 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with locally advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I and IV adenocarcinoma. All surgeons considered obesity a relative contraindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resumption of gastrointestinal function, number of lymph nodes harvested, hospital stay. RESULTS: Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedure (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90-480) for assisted resection and 275 min (54-550) for complete laparoscopic resection. The mortality rate was 1.7%; the overall morbidity was 19.6% (major complications 11.2%). All patients quickly became ambulatory and showed a prompt resumption of gastrointestinal functions, and less postoperative pain if compared with converted cases. The average number of lymph nodes was 12.1 (range 1-32). The mean hospital stay was 8.6 days (range 5-14.5). The mean follow-up was 16 months (range 6-24). The recurrence rate 11.7%. CONCLUSIONS: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-term follow-up is needed to evaluate the efficacy of laparoscopic surgery in the treatment of colorectal cancer.

Adult↗
PubMed1986

A double-blind controlled trial of ranitidine 300 mg nocte and ranitidine 150 mg b.i.d. in the short-term treatment of gastric ulcer.

A multi-center study was carried out to compare the healing rates of ranitidine 300 mg nocte and 150 mg b.i.d. in the short-term treatment of gastric ulcers and to assess the side-effect liability of ranitidine 300 mg given in a single daily dose. Forty-five outpatients suffering from endoscopically and bioptically proven uncomplicated benign gastric ulcer were selected for the study. The patients were treated, for 4 weeks, on the basis of a double-blind randomized design. An endoscopic examination was repeated within 4 days after the end of the treatments. The patients who did not demonstrate complete healing were treated for an additional 4-week period. Clinical controls were performed to evaluate symptoms, antacid consumption, compliance with trial tablet consumption; hematological and biochemical tests were also carried out at the end of the 4 and 8-week periods. No differences were observed between the healing rate induced by 300 mg nocte and 150 mg b.i.d., after 4 weeks of treatment (76% and 79% respectively) and after 8 weeks (100% in both groups). Similar results were obtained as far as symptoms, antacid consumption and compliance are concerned. Neither treatment regimen induced appreciable side-effects.

Adult↗
PubMed1983

Jejunal endoscopic polypectomy in the Peutz-Jeghers syndrome.

The authors describe a transendoscopic wire snare excision of three jejunal polyps in a patient with Peutz-Jeghers syndrome. Two years previously the patient had undergone surgical jejunal segmental resection for invagination caused by several polyps, one of which revealed carcinoma in situ. The procedure was well tolerated, and the subsequent course was uneventful. Endoscopic follow-up of the proximal jejunal polyps in this syndrome is stressed.

Adult↗
PubMedDate not supplied

[Traditional esophagectomy and esophago-gastrectomy vs. laparoscopic surgery. Evaluation and results].

The therapeutical choice in patients affected with esophagus disease depends on patients' conditions, as well as on the benign or malignant nature of the lesion. Actually, the surgical option is strongly conditioned by the state of health, particularly, the surgical therapy of resection, that is a mayor kind of surgery, has to value the heavy engagement to which the patient is submitted, meant as a clinical stress, caused by the clinical situation in which the patient can frequently feel: malnutrition, immunological and hematological conditions. It is in this field that the mininvasive surgery can be considered the most important surgical choice. The target of the treatment of the traditional and mininvasive surgery, to cure the intestinal transit, by means of other internal organs, is the same: that is curative or palliative. In this study we analyzed and compared 8 patients, from July 1999 to March 2003; all of them undergone a therapy of resection in order to cure esophageal lesions (we applicated the same technique of esophagectomy according to Orringer): 5 of them underwent a mininvasive surgery, while the other 3 patients underwent a traditional surgery. As a result we saw the same mortality in both groups, with a minor morbidity in the second one (mininvasive surgery); this fact is very important because we can suppose an increase in the number of patients threatened with a curative or a palliative surgery, thanks to a minor load of the mininvasive surgery compared to the same surgical operation performed with the traditional methodology.

Aged↗
PubMedDate not supplied

[Glypressin and emergency sclerotherapy, deferred emergency shunt (Warren, portacaval, mesocaval): new tactics in the treatment of severe hemorrhage by esophagogastric varices in cirrhotic patients].

Transplenic decompression of esophageal varices by distal splenorenal shunt according to Warren (DSRS) aims to a selective detention of the esophago-gastric varices, also assuring an adequate portal perfusion and hypertensive state of the porto-mesenteric district. The DSRS though, should and must not be performed in emergency as a high mortality rate is registered in all cases of emergency porto-systemic derivations. A mortality risk is reported even during endoscopic sclerosis if performed in emergency compared to the elective procedure. The scope of our study was to test the validity of a new approach of the hemorrhagic cirrhotic patient: the end point was to stop the bleeding with Glypressin and deferred sclerotherapy, associating a selective shunt at 40-60 days. Out of 32 patients with esophago-gastric variceal bleeding, 8 were selected also for derivative surgery. Results show Glypressin as the first and best therapeutic approach. The drug in many cases stops bleeding or at least reduces the blood loss allowing an easier endoscopic sclerosis. Further sclerosis and/or surgical therapy may assure variceal eradication.

Adult↗
PubMedDate not supplied

[An extreme case of Lobstein's osteopsathyrosis: problems of surgical correction].

Those surgeons who have had experience of Sofield's treatment in case of osteogenesis inperfecta would be unanimous in agreeing that this method offers great advantages to these unfortunate children. Although the technic is exact and the results often cancelled out by the growth so that the re-operation is indicated, nevertheless the long fracture-free period gained and the control of deformity confer very worth-while benefits. A case of O.I. is reported; the subject presented fracture sequaele in the lower limbs and bone alterations of extreme seriousness. Sofield's treatment was not possible in the rodding time; the Authors describe a modified treatment which has proved useful in practice. Notes on the specific features, course and treatment are presented; a particular attention is paid to its genetic and etiopathogenetic aspects.

Adolescent↗
PubMedDate not supplied

[Peritonitis caused by the rupture of an amebic abscess of the liver in childhood].

The peritonitis from the rupture of the amebic liver's abscess is a not rare complication of the hepatic amebiasis in the children, with a poor prognosis. The usual treatment is loaded with a high morbility and mortality. The AA show a therapeutic screen based on saucerization with debridment and on the installation of a disposal of peritoneal washing. The above mentioned treatment is looking at the recovery of the organ and consequently at the direct removal of the "primum movens" of the septic shock and generalized peritonitis.

Child, Preschool↗
PubMedDate not supplied

[The laparoscopic treatment of Hirschsprung's disease].

Swenson's procedure, first described in 1948 for Hirschsprung's disease, consists in resection of aganglionic intestine and distal colo-anal anastomosis provided a precise dissection of extra peritoneal rectum. Potential jeopardy of pelvic vessels and nerves stimulated alternative surgical techniques to prevent complications on bladder and genital function. We performed in laparoscopy Swenson's procedure after Toupet, taking advantage from closer view and magnification of this technique, in a 15 months girl. Laparoscopy simplified and made safer pelvic dissection and resulted in a better postoperative period and cosmetic outcome.

Anastomosis, Surgical↗