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Biomedical subjects

C M Fronticelli

Publications and source records attributed to C M Fronticelli.

At least 19 recordsLinked to original sources

[Cicatricial stenosis of colorectal anastomosis. Transanal treatment with circular stapler].

Anastomotic strictures complicating colorectal anastomoses can be difficult to treat. This condition must not be considered as an uncommon complication. In 20% of patients it may be a serious state that may require a therapy. Two patients treated successfully without complication with the transanal use of an CEEA stapler are presented. The staple cutter is safe and easy to use, and except for a conventional anoscope, no special equipment, including fluoroscope, is needed. On the basis of the successful results obtained, the procedure using staple cutter is recommended for the treatment of anastomotic stricture of the rectum.

Adenocarcinoma↗

Primary adenocarcinoma of the angle of Treitz. Case report and review of the literature.

We describe a 54-year-old man who was referred with the diagnosis of adenocarcinoma of the angle of Treitz and treated with the use of a duodenojejunal segmentary resection. After a review of the literature, we emphasize the difficulty of making an early diagnosis and discuss the most appropriate surgical treatment of tumors of the angle of Treitz. The better prognosis of these neoplasms compared with those of the proximal duodenum can be supported by some embryological findings observed from a different research project currently in progress.

Adenocarcinoma↗

Complicated jejunal diverticulosis: report of a case.

The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. Endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60-70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.

Aged↗

[Gallbladder carcinoma. Our experience].

The authors report their experience of 18 patients with primary cancer of the gallbladder. On 10 patients at stage IV, 9 had a preoperative diagnosis, while at stage 0-1 and 2 the diagnosis was intraoperative or histologic. Every patient had a cholelithiasis at the same time. The authors discuss prophylactic cholecystectomy, even without specific symptoms, and emphasize the need for a better morphological and radiomorphological classification. In the light of the new microinvasive surgical techniques, they briefly discuss laparoscopic cholecystectomy and histologic diagnosis of carcinoma of the gallbladder.

Adenocarcinoma↗

Surgery of the incidentally discovered mass of the adrenal gland (incidentaloma).

The authors present their experience about surgery in adrenal gland incidentaloma, during a period of 12 years (1982-1993), at the VI Division of General Surgery, University of Turin. In 17 patients, of 70 who underwent adrenalectomy, the adrenal neoplasm was located thanks to a diagnostic investigation (ECI or CT) executed for other reasons. In ten cases was diagnosed adenoma, in five cases carcinoma, in two cases cysts. In the diagnostic approach to adrenal incidentaloma we did not search for possible hormonal activity, since the patients had been previously selected from specialized endocrinological centres. At present, biological markers not being certain or absolute radiological significance so as to detect benignant from malignant forms. In accordance with international Literature the size of the neoplasm is the discriminant element for adrenalectomy. We have removed the incidentaloma in all cases, be it clinically or subclinically functional and the silent forms > 4 cm as we have observed a statistically significant difference (p < 0.0002) between the benign and malignant lesions, particularly those measuring more than 4 cm in diameter. We suggest a screening with CT scan every three months in lesions < 4 cm, silent and those > 4 cm in patients over sixty years with a morphological aspect of the bening form.

Adenoma↗

Modifications of the trophism of intestinal mucosa after intestinal and bilio-pancreatic diversion in the rat.

Morphofunctional alterations to the intestinal mucosa are influenced by three main factors: food, bilio-pancreatic secretions, intestinal hormones. In order to assess the importance of each one, histological and histochemical tests were performed on different segments of intestine taken from rats which were sacrificed one month after the following procedure: gastrojejunal anastomosis on a Roux loop (Model I); same procedure plus biliopancreatic bypass into the jejunum (Model II). When compared to the controls, Model I duodenum samples revealed hypertrophy of the entire wall with "bundles" of villi, while Model II samples showed a clear hypotrophy and reduction in the number of duodenal villi. To such modifications of the duodenum correspond longer, thinner villi in the other bowel segments, particularly in the jejunum and distal ileum. These results suggest that the predominant trophic effect derives from contact with biliopancreatic secretions at a proximal level. The modifications of the duodenal mucosa appear to regulate the trophism of the distal segments probably by the secretion of distant acting enterohormones.

Adaptation, Physiological↗

[Suspensory elements of the anal canal. Anatomo-surgical considerations].

Continence depends not only on correct muscular function but also on the integrity of the suspensory structures of the anal canal, the latter being the subject of this study performed on embryological and adult specimens. The role of the perineal body as an insertion tendon common to all the striated muscles (pubo-coc-cygeus, superficial striated sphincter) which anchor the anal canal to the surrounding structures is pointed out. The characteristic behaviour of the longitudinal muscle that links the striated musculature to the visceral cylinder is also described.

Anal Canal↗

[Wirsung-septoplasty during interventions on Vater's ampulla].

After a short survey of pathogenetic hypotheses for pancreatitis during papillary lithiasis, stress is laid on the importance of the use of the microscope in peroperative diagnosis of infundibulo-papillar pathology and in the surgery of distal Wirsung.

Ampulla of Vater↗

Telescopic anastomosis of the common bile duct in the rat.

A telescopic technique for the end-to-end anastomosis of the common bile duct in the rat is proposed as a way of reducing the number of sutures without prejudicing the impermeability of the union. Serial histological examinations of the scar process after 10, 20, and 30 days showed that patency was maintained.

Animals↗

[Pelviperineal recurrences in surgery of rectal carcinoma].

A series of pelviperineal recurrences after perineal-abdominal amputation of the rectum and after anterior resection is examined. Involvement of the rectal wall, the biological behaviour of the tumour, and lymphatic diffusion represent the main causes of recurrence. In some instances, the choice of anterior resection in the treatment of middle rectum carcinoma may constitute a risk factor.

Aged↗

[Surgical treatment of postoperative peptic ulcer].

The literature on postoperative peptic ulcer is reviewed and cases observed in the Department of Surgical Anatomy and Operations Course of Turin University in the period 1-I-1968 - 31-III-1975 are presented. 183 operations for primary gastro-duodenal ulcer were carried out. A variety of techniques was employed, including 138 gastric resections using a modified Billroth II technique, with a recurrence of 1.3% encountered only in patients in the specified group. 15 reoperations for postoperative peptic ulcer were performed with the following result: very good in 7 cases, good in 6, and 2 postoperative deaths. The two deaths concerned a simple gastric reconversion and a gastric re-resection with gastro-jejuno-anastomosis. The personal series confirms the statistics presented by numerous foreign workers.

Adult↗