Biomedical subjects
Publications and source records attributed to D Piccinelli.
The authors report on a case of leiomyosarcoma with intussusception of the large bowel. They stress the importance of the clinical suspicion in targeting preoperative instrumental instrumental investigations.
The authors report on a study population of extended operations for locally spread colon-rectum cancer in the Verona Surgical Clinic over the period from 1971 to 1987 (114 surgical demolitions for colon-rectum cancer out of a total of 1294 operations). They report an overall 5-year survival rate of 41% and a 3-year survival rate of 59% with a perioperative mortality rate of 1.75%. A number of aspects of such extended operations are discussed, and, in accord with most other reports in the literature, the authors confirm the validity of the choice of this type of surgery.
Manometry is an important approach to anorectal function. In the haemorrhoids the evaluation of the anal resting tone, of the squeeze and of the sphincterial length is very useful to realize the best surgical treatment. Anorectal manometry is neither invasive nor expensive; it can be ready repeated and the results are reproducible. This examination must be considerated as essential part of the diagnostic routine of the anorectal diseases.
Indications and procedure of submucosal reconstructive hemorrhoidectomy (A.G. Parks hemorrhoidectomy) are described and discussed. This procedure is more difficult and time consuming than other techniques, but results are better in high degree hemorrhoids. Authors consider complications and sequelae on 278 patients operated in their Department.
396 patients, treated with hemorrhoidectomy (278 Parks, 118 Milligan-Morgan) were submitted to preoperative manometry, which, in 158 patients (39.9%), revealed high anal resting pressure (TBS), with or without an associated anal fissure; this group was submitted to a regulated lateral sphincterotomy (SILR) in association with the haemorroidectomy. The manometric follow-up, two mounts after the operations showed similar TBS values in both groups of patients. The authors conclude that normal values of TBS after Hemorroidectomy can be reached only by associating sphincterotomy in manometrically selected cases.
A patient was admitted for a suspected appendicitis; occasionally, a roentgenogram of abdomen, an echography and a tomography: confirmed the suspect. At laparotomy a perforated diverticulum of cecum is suddenly reported: a segmentary resection of ascending colon is performed. Authors remark, according to literature, that preoperative diagnosis of perforated cecal diverticulum is difficult even today, in spite of diagnostic procedures.