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Biomedical subjects

D Tarroni

Publications and source records attributed to D Tarroni.

At least 19 recordsLinked to original sources

[Pelvic abscesses. Treatment modalities and personal experience].

The pelvic abscesses as complication of surgical operations or various pathologies is a delicate clinical situation because of the possible and unexpected evolution into a settic shock with a high risk of death. The authors report their personal experience of 16 cases undergone surgical treatment. They underline the importance of an early diagnosis, of a control of the patient general conditions with a specific antibiotic therapy, of the possibility to treat this pathology in a percutaneous way with the help of radiologic techniques or eventually by surgery.

Abscess↗

Magnetic resonance imaging for primary fistula in ano.

BACKGROUND: This was a prospective study designed to determine the therapeutic impact of magnetic resonance imaging (MRI) in primary fistula in ano, and to assess its effect on outcome. METHODS: Thirty patients with suspected primary fistula in ano underwent preoperative MRI, and the findings were revealed during surgery following examination under anaesthesia (EUA). Any effect on operative approach was noted. Outcome was assessed at a median of 12 months. RESULTS: Two patients had sinuses, one had no sepsis and 27 had fistulas: five superficial, seven intersphincteric, 14 trans-sphincteric and one suprasphincteric. MRI and EUA agreed in 15 patients and MRI findings altered the surgical approach in a further three (10 per cent); two of the latter patients were believed to have a sinus at EUA, which MRI correctly identified as a fistula, allowing definitive treatment. The therapeutic impact of MRI was therefore 10 per cent. Persisting disagreement between MRI and EUA in 12 patients mostly related to minor discrepancies in classification. Only one patient required further unplanned surgery, which was for skin-bridging rather than any new sepsis. CONCLUSION: In experienced hands, MRI has a therapeutic impact of 10 per cent for primary fistula in ano, precipitating surgery that is likely to reduce recurrence in a small, but important, proportion of patients.

Adolescent↗

[Gastrointestinal carcinoids and carcinoid syndrome: classification, diagnosis and therapy].

Historically, carcinoids have long been known as a morphologically distinct class of rare intestinal tumors which behave less aggressively than the more common intestinal adenocarcinomas. In recent decades refined methods in pathology improved our knowledge on the diffuse neuroendocrine system, leading to some confusion in classification and nomenclature of carcinoids. The World Health Organization (WHO) classification of endocrine tumors has cleared the definition of carcinoids. The Authors report on 7 cases of midgut carcinoid tumors and 1 case of carcinoid syndrome focusing on the newer approaches to the diagnosis, localization, and role of surgery and peptide therapy.

Adult↗

Advances in rectal cancer surgery.

PURPOSE: We discuss our experience in radical rectal cancer surgery and critically review the results of the current literature. In particular, the importance of distal clearance, total excision of the mesorectum, and pelvic lymphadenectomy is stressed. METHODS AND RESULTS: The rationale for determining a pelvic lymphadenectomy is identified in the high percentage (20 percent) of lateral endopelvic metastatic nodes demonstrated in cases of extraperitoneal rectal cancers. The results after pelvic lymphadenectomy and the eventual complications are observed. The autonomic nerve-sparing procedure is described and the preliminary results, with a decreased rate of urinary and sexual sequelae, are discussed. CONCLUSIONS: It was concluded that, in cases of an advanced rectal cancer, radical surgery, if associated with the nerve-sparing technique, can improve survival without affecting the incidence of major complications.

Humans↗

[Surgical staplers in colorectal surgery: 10 years of experience].

The Authors dissert on some technical details for a correct use of staplers in colorectal surgery. Surgical skill and technology assure always better results, nevertheless the experience and knowledge of the single surgeon must be a guide for further research.

Anastomosis, Surgical↗

[Digestive reconstruction using mechanical staplers after total gastrectomy].

From 1980 up to nowadays, after total gastrectomy for gastric cancer, the intestinal continuity was assured by oesophago-jejunostomy and oesophago-duodenoplasty using stapling devices. Two patients died for causes not related to the technique, and other two patients developed a stenosis of the oesophago-jejunostomy, which was easily managed by endoscopic dilatation. In one patient a partial dehiscence of the oesophago-jejuno-anastomosis was treated by total parenteral nutrition. The Authors have systematically adopted mechanical sutures after total gastrectomy. However, possible intraoperative accidents and complications should not be underestimated, although most of them may be due to the operator's inexperience or stapler misuse.

Anastomosis, Roux-en-Y↗

[Complicated diverticular disease. Three cases of colovesical fistulas and review of literature].

Colovesical fistulas represent a possible less frequent complication of diverticular disease of colon. They represent a complex condition because of the possible and unexpected evolution into a septic shock with a high risk of death. The Authors report three cases of colovesical fistula as a complication of diverticular disease. They underline the importance of early diagnosis, specific antibiotic therapy and appropriate surgical therapy realized in one or two stages according to general and local conditions of each patient.

Aged↗

[Aneurysm of the popliteal artery: diagnostic and therapeutic considerations].

The authors settle the roles of the most recent diagnostic methodologies useful to frame the popliteal aneurysm pathology namely digital arteriography, N.M.R., and doppler-flowmetry. They emphasize, in an observed case, the adopted therapeutic criteria, that is basically interventional. The thinness of saphenous veins draws toward the employing of "Goretex".

Aged↗

[Mesorectal resection in oncologic surgery].

A surgical technique to "en bloc" resect the mesorectum while performing an anterior resection is here described. The procedure aims at preserving those nerves whose injury is responsible for a series of neurological sequalae, which affect the patient's quality of life. Fifteen dissections were carried out in order to demonstrate the possibility to perform an accurate mesorectal lymphadenectomy while preserving, in most cases, the nervi erigentes and, in some cases, the hypogastric plexus.

Erectile Dysfunction↗