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Biomedical subjects

E Forni

Publications and source records attributed to E Forni.

At least 19 recordsLinked to original sources
PubMed1992

[The diagnostic elements and therapy principles in thyroid cancer: the Pavia experience 100 years after Bottini].

The diagnostic and operative management of thyroid cancer is controversial as the nature of the disease is heterogeneous in its growth rate, pattern of spread, and histological type. Therefore, surgery must be extensive enough to minimize the chances of recurrence and death. In the period 1962-1989, 159 thyroid cancers were observed. According to the histological type, 61 total thyroidectomies, 34 hemithyroidectomies with isthmusectomy, and 29 subtotal thyroidectomies were performed. Cervical lymph node dissection was performed in 55 patients. The 10-year postoperative survival rate was 70.59% with lymphadenectomy and 65.71% without lymphadenectomy.

Female↗
PubMed1991

Preventing relapses of breast cancer with modified radical mastectomy.

Better prevention and early detection have improved the percentage of early cancers among all the treated breast tumors to about 40%. After the first demonstration in Milan in 1981 that even conservative surgery can effectively prevent tumor relapses, radical and modified radical mastectomy was compared in 136 and 127 women, respectively. The groups were well stratified as regards age, menopause, T- and N-status. No difference was found in 10-yr survival (58.8 and 59.8%, respectively) or local relapses (9.5 and 10%, respectively) or general relapses. The median disease-free survival was 10 yr in both groups. The results suggest that in T1-T2a, N0-N1b M0 unilateral breast cancer relapses are prevented as effectively with modified radical as with radical mastectomy.

Adult↗
PubMed1990

[A modification of the Sweet-Allen simple reconstruction technique after total gastrectomy].

The Authors report their personal modification of Sweet-Allen's esophago-jejunal reconstruction after total gastrectomy. In their opinion, it enables to combine the advantages of the omega-shaped loop (easier and faster surgical technique, reduced postoperative morbidity) with those typical of the Roux-en-Y loop, that is complete elimination of biliary reflux, leading to better long term functional outcome and quality of life for the totally gastrectomized patient.

Anastomosis, Roux-en-Y↗
PubMed1989

The potential malignancy of eccrine spiradenoma.

Eccrine spiradenoma is a rare, usually benign tumor, originating from cutaneous sweat glands. Its clinical and histologic diagnosis can be difficult at times, especially when malignant features are present. Proper management requires radical surgical excision. Two cases of spiradenoma are reported, one of which highly malignant with diffuse pulmonary metastases leading to the patient's death in spite of repeated radical surgery.

Adenoma, Sweat Gland↗
PubMed1987

Cytogenetic findings in a case of anaplastic carcinoma of the pancreas.

A cytogenetic study was performed on a short-term culture of a biopsy from a primary anaplastic carcinoma of the pancreas. The modal chromosome number was 60. Six numerical clonal anomalies involving chromosomes #2, #6, #7, #10, #15, and #16 were found, and marker chromosomes involving #1, #3, #5, #8, #11, #12, #13, #15, #16, #18, #20, #22, and X. Premature chromosome condensation (PCC) was observed with a high frequency. The results are discussed with reference to the scarce literature on chromosome changes in pancreatic cancer.

Carcinoma↗
PubMed1985

Diaphragmatic hernias due to blunt thoracoabdominal trauma.

This nineteen-year retrospective review was designed to evaluate diaphragmatic hernias due to blunt thoracoabdominal trauma in a series of 50 patients. Motor-vehicle accidents were the most frequent cause. The diagnosis was made immediately after injury in 34 patients (acute hernias), but delayed from two months to 30 years in 16 (chronic hernias). Two patients, with multiple associated injuries, died soon after admission and diagnosis was made at necropsy. The nature of injury, the physical findings and the plain chest roentgenograms suggested a traumatic diaphragmatic hernia in most of the remaining acutely injured patients. All patients with chronic hernias had suggestive or suspicious abnormalities on chest roentgenograms; however, appropriate upper gastrointestinal tract and barium enema studies were of utmost importance for the correct diagnosis. Reduction of herniated viscera and repair of diaphragmatic defect were generally accomplished through a laparotomy in acute hernias, whereas thoracotomy was the preferred approach in delayed instances. There were four postoperative deaths, three with severe multiple associated injuries and one with respiratory failure.

Abdominal Injuries↗
PubMed1984

[Results of the treatment of carcinoma of the thoracic esophagus with one-stage resection and esophagogastrostomy].

Between november 1964 and december 1982, 102 patients were operated upon for the treatment of carcinoma thoracic esophagus. The philosophic objectives were to restore promptly the ability to swallow and to achieve a worthwhile survival period. To fulfill these requirements wide excision of the growth and immediate esophagogastrostomy were performed through a combined abdominal and right thoracic approach. In higher thoracic growths the Authors added a cervical phase. The resectability rate was 74% and the overall hospital mortality rate was 19,6%. Anastomotic leaks occurred in 10 patients (9,8%) with fatal outcome in 6. Pre- and postoperative care (particularly hyperalimentation and intensive respiratory therapy) and use of mechanical devices reduced the operative mortality rate to 8,1% between 1976 and 1982 without deaths in the last 16 patients. Very satisfactory palliation was achieved in 80% of the patients who survived the standard esophagogastrectomy. These patients enjoyed uncomplicated oral alimentation for the remainder of their lives. Despite there has been considerable improvement in operability and resectability rates and in survival of resection as compared to past years, long term results of treatment of carcinoma of the esophagus continue to remain disappointingly low. Overall survival rate at 5 years was 10,2% in this report. The stage of the disease influenced significantly survival: curative as opposed to palliative resections demonstrated a marked difference in 5-year survival (28,2% vs 2,8%). Long-term survival of patients with carcinoma of the esophagus will probably not improve until early diagnosis is possible. Therefore esophagogastrectomy should be the treatment of choice until other forms of therapy prove superior to it both in terms of palliation and long-term survival rate.

Adult↗
PubMed1984

[Retrosternal gastric bypass in the palliative treatment of advanced carcinoma of the thoracic esophagus].

Palliative substernal gastric bypass was performed in 20 patients with far-advanced, obstructing carcinoma of the thoracic esophagus between the years 1978 and 1982. In 18 patients the thoracic esophagus was bypassed using the stomach brought to the neck by substernal route for anastomosis to the proximal end of the divided cervical esophagus. The thoracic esophagus was completely excluded in 10 patients; the tumor-bearing segment of the esophagus excluded formed a small and asymptomatic mucocele with time. The Kirschner-Ong technique with the additional step of Roux-en-Y jejunal anastomosis to the intra-abdominal esophagus was used to provide drainage of esophageal secretions in 8 patients with tracheoesophageal invasion or impingement, for fear of imminent esophagorespiratory fistula; in three of these patients a radiation therapy was subsequently administered. In two patients an isoperistaltic gastric tube formed from the greater curvature and brought to the neck substernally was used for esophageal bypass. Anastomotic leakage occurred in 3 patients (15%). The thirty day operative mortality was 10 per cent (2/20) and the mean survival time was 10 months. The palliation afforded was excellent in all survivors with restoration of the ability to swallow a normal diet until the time of death. The authors believe that a simple one-stage bypass of the esophagus using the stomach substernally is an effective alternative to esophageal intubation, prolonged radiation therapy or colon bypass in achieving palliation with an acceptable morbidity and mortality in a high risk patient group.

Aged↗
PubMed1984

[Adenocarcinoma of the proximal stomach and cardia: problems of surgical strategy and technics].

In a total of 142 patients with adenocarcinoma of the proximal third of the stomach and cardia, curative resection was carried out in 88 during the period 1960-1980. The patients were divided in two groups. I group included 32 patients with tumor distal to the esophagogastric junction. In II group (54 patients) the tumor involved the esophagogastric junction (adenocarcinoma of the gastric cardia). In I group, when the proximal border of the cancer was well defined and sufficient length was maintained between the proximal tumor border and esophagogastric junction, the abdominal approach was preferred and the operation performed was generally a total gastrectomy combined with splenectomy and celiac node dissection. Distal pancreatectomy was performed as necessary. In most patients of the II group, the operation was performed using separate abdominal and right-sided thoracic incisions. Two principally types of operation were used: extended total gastrectomy and extended proximal subtotal gastrectomy, depending on degree of gastric wall involvement, combined with extensive esophagectomy, splenectomy and regional nodes dissection in both cases. Distal pancreatectomy was not performed routinely but only as necessary. In this group of patients there was no significant difference in the overall cure rate between the extended total gastrectomy and the extended proximal subtotal gastrectomy. Operative morbidity and mortality rates were also comparable.

Adenocarcinoma↗
PubMed1984

[Treatment of esophagotracheal and esophagobronchial fistulas secondary to carcinoma of the esophagus].

An experience with 16 patients with respiratory tract fistula (RTF) related to carcinoma of the esophagus is presented. The malignant fistula was present at the time of initial presentation and/or before any therapeutic intervention in 11 patients, and developed either during or following a course of radiation therapy in 5 patients. Bronchoscopy examination in 8 patients prior to RTF development showed tracheobronchial invasion or impingement in all. The patients were divided in five groups according to the treatment received. One patient received no specific therapy although was fed via nasogastric tube. Three patients had a feeding gastrostomy. Four patients underwent insertion of a Celestin tube. Three patients were submitted to esophageal exclusion with combinations of cervical esophagostomy, feeding gastrostomy and ligation or complete division of the gastroesophageal junction; drainage of the excluded esophagus was provided by a red rubber catheter. Five patients received by-pass operation: four had Kirschner-Ong operation with gastric by-pass placed substernally and distal esophagus anastomosed to a Roux-en-Y jejunal loop; in one patient an isoperistaltic gastric tube brought to the neck substernally was used for esophageal by-pass. These patients had, by far, the best palliative results with complete relief of their respiratory tract symptoms and restoration of the ability to eat and drink. Substernal gastric by-pass of the RTF is therefore advocated if the general conditions of the patient are improved with the institution of parenteral hyperalimentation and antibiotic therapy.

Aged↗
PubMed1984

[Current role of surgery in the treatment of pulmonary metastasis].

During the period between november 1964 and december 1982, 48 patients were operated upon for metastatic lesions of lung from previous or actual carcinomas and sarcomas elsewhere in the body. The most frequent sites of origin of the primary malignancy were colon, testis and breast. The usual approach was through a thoracotomy; bilateral lung metastases were removed with one-stage procedure through a median sternotomy in two patients. The operative mortality was 2%. Overall five-year survival was 26%, which was not influenced by tumor histology, disease-free interval, or extent of pulmonary excision. In view of these findings, conservative pulmonary resection of metastatic lesions is advocated, regardless of the tumor histology or the disease-free interval, when the following criteria are adhered to: primary site controlled or controllable; no extrapulmonary metastases demonstrable; good operative risk; no other effective means of treatment available.

Adolescent↗