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Biomedical subjects

E Marana

Publications and source records attributed to E Marana.

At least 19 recordsLinked to original sources
PubMed2001

Systematic pelvic and aortic lymphadenectomy in elderly gynecologic oncologic patients.

BACKGROUND: Retroperitoneal lymph node dissection is a fundamental step in the surgical management of patients with pelvic gynecologic malignancies, but its applicability to geriatric patients is controversial. The objective of this study was to evaluate whether pelvic and aortic lymphadenectomy in elderly patients with gynecologic malignancies can be a safe procedure in terms of morbidity and mortality. METHODS: In a retrospective case-control study, the authors compared morbidity, mortality, and surgical data in a series of elderly patients (age > 70 years) with endometrial and ovarian carcinoma who underwent surgery. Patients were divided into two groups: Cases were 36 elderly patients who underwent surgery and pelvic and/or aortic lymphadenectomy and were matched with 72 controls, who were patients who underwent surgery without lymphadenectomy. RESULTS: Cases showed a significantly longer median operative time than controls (median, 162 minutes [range, 85-330 minutes] vs. median, 100 minutes [range 20-310 minutes], respectively; P = 0.003). No significant difference between the two groups in terms of blood loss, blood transfusions, intraoperative complications, duration of ileus, reintervention required, or postoperative hospital stay were observed. One patient in the control group died. The type and frequency of severe postoperative complications in the two groups were not substantially different. CONCLUSIONS: Pelvic and aortic lymphadenectomy was performed safely in elderly patients age > or = 70 years with endometrial and ovarian carcinoma without an increase in morbidity and mortality. Advanced chronologic age alone should not be considered a contraindication to full surgical treatment in these patients.

Age Factors↗
PubMed2001

Current practical application of office endoscopy.

Outpatient hysteroscopy has shown good correlation of findings compared with inpatient hysteroscopy, but one limitation is pain and discomfort in some women, and vasovagal reaction. Various forms of local anaesthesia have been evaluated in the past year, with controversial results, and a narrow 3.5 mm sheath hysteroscope has been introduced. Transvaginal hydrolaparoscopy as an outpatient procedure has been further investigated.

Ambulatory Care↗
PubMed2000

Stress responses to endoscopic surgery.

Growing evidence in the literature suggests that laparoscopic surgery should be performed instead of laparotomy for the treatment of pelvic benign diseases whenever feasible, as it results in a lower stress response on the part of the patient and possibly a shorter recovery time.

Endoscopy↗
PubMed1996

Evaluation of stress-related hormones after surgery by laparoscopy or laparotomy.

STUDY OBJECTIVE: To evaluate the stress hormone response after pelvic surgery performed by laparoscopy versus laparotomy. DESIGN: Prospective study. SETTING: A tertiary care university hospital. PATIENTS: Ten women were scheduled to undergo laparoscopic surgery and 10 laparotomy for either tubal disease or endometriosis. INTERVENTIONS: Surgical procedures were performed by laparoscopy or laparotomy for stage III-IV endometriosis, pelvic adhesions, or distal tubal occlusion. The following hormones were measured before the induction of anesthesia in the ward, 60 minutes after the beginning of surgery, at the end of surgery after extubation, and 2 hours and 6 hours after the end of the operation: norepinephrine (NE), epinephrine (E), dopamine (D), adrenocorticotropic hormone (ACTH), cortisol, prolactin (PRL), and GH. MEASUREMENTS AND MAIN RESULTS: The mean duration of surgery was not significantly different between the two groups. Surgery-related adrenergic activation (E, NE, D) appears more pronounced in the laparotomy group (p<0.005) during surgery and in the postoperative period. More elevated values for laparotomy were observed also for the other stress hormones (ACTH, cortisol, PRL, GH), even though statistical significance was not always reached. CONCLUSIONS: Compared with laparotomy, activation of stress-related factors during laparoscopy seems to be less intense and of shorter duration.

Adrenocorticotropic Hormone↗
PubMed1985

[Behavior of GH and prolactin during enflurane anesthesia and neuroleptoanesthesia in man].

The present study was designed to investigate the effects of neuraleptanesthesia (NLA) and enflurane (Ethane) anesthesia on plasma levels of growth hormone (GH) and prolactin (PRL) in man. A total of 18 patients aged between 20 and 65 years scheduled for elective open-heart surgery were divided in two groups. In the first group (9 patients) general anaesthesia was induced with sodium thiopental (TPS) (3-5 mg/kg) and was maintained with enflurane administered with an inspired concentration of 1.5% in nitrous oxide (2 litres/min) and oxygen (2 litres/min). In the second group (9 patients) anaesthesia was induced with dihydrobenzopyridol (BPS) (0.1-0.2 mg/kg), fentanyl (5-8 gamma/kg) and TPS (3-5 mg/kg) and was maintained with fentanyl (0,65 mg in average). The patients had neither hepatic, renal or endocrine disease nor did they have a history of steroid therapy. All subjects received atropine (0.01 mg/kg) and diazepam (0.2 mg/kg) i.m. 2 hours before induction of anaesthesia. Blood samples for GH and PRL was collected before induction of anaesthesia (0) and at 30, 60, 90 and 120 minutes after induction: the 90' sample was taken immediately after sternal incision. The sampling was stopped at the start of the cardiopulmonary by-pass. A significative reduction of GH at 60' and of PRL at 30' was observed in both groups. Surgical stress at 90' does not evoke a significant increase of PRL and GH levels in both groups. In conclusion NLA and enflurane induced a decrease of GH and PRL plasma levels; in both groups the anaesthetic agents, at the dosage used during anaesthesia, blocked the response of these hormones to the surgical stress likely due to a block of the hypothalamic-pituitary response.

Adult↗
PubMed1984

Changes of serum pyruvate and lactate in open-heart surgery.

In 20 patients under extracorporeal bypass, a study was undertaken of the changes in plasma of lactate and pyruvate, the lactate/pyruvate ratio and the lactate excess. A decrease has been found in the pyruvate and an increase in the other values lasting for the first days of the post-operative period. The causes may be many, such as changes in the oxidation potential, blood transfusions and liver function, and these may be manifested in an increase in the serum glutamic oxalacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, and gamma-glutamyl transpeptidase.

Adolescent↗
PubMed1983

Changes of serum magnesium ions in open heart surgery.

The changes of magnesium in the serum were studied in 20 patients undergoing cardiac valve substitution procedures in extracorporeal circulation. The serum magnesium ions were determined before the onset of the anesthesia, at the beginning and at the end of the extracorporeal circulation, at the end of surgery and during the first post-operative day. A slight magnesium ion deficiency was observed even in the initial serum levels, probably due to the pre-operative diuretic therapy. The hypomagnesemia observed during the bypass was related to haemodilution and urinary losses. A limited increase in magnesemia, probably caused by the diffusion of the ion towards the vascular compartment, was observed at the end of the extracorporeal circulation. A new decrease was found during the post-operative stage, perhaps caused by the action of diuretics, which were administered.

Adult↗
PubMed1980

[Use of fazadinium in heart surgery. Clinical contribution].

A new muscle relaxant, fazadinio bromide, has been administered to 10 heart patients awaiting surgery and its induction utility assessed. A constant though non-significant increase in heart frequency, a significant reduction in maximum and a non-significant reduction in minimum arterial pressure were recorded. No arrythmia or changes in effort-induced cardiac index were seen. The short latency period and myoresolution characteristics permitted speedy, atraumatic intubation. While these features and the absence of arrhythmia suggest the drug might have some clinical utility, tachycardia and arterial hypotension limit its use in heart patients.

Adult↗
PubMed1979

Rheological and biochemical changes in open heart surgery with extracorporeal circulation and moderate hypothermia.

The plasma enzymes, glucose, urea nitrogen, total and conjugated bilirubin, osmolality, acid--base balance and rheological data have been studied in a group of patients who underwent open heart surgery to replace the stenotic or insufficient aortic valve. The aim of this study was to assess our operative conditions and to compare results with those obtained by other authors.

Acid-Base Equilibrium↗
PubMed1979

[Risk and choice of anesthetics for patients with previous malignant hyperthermia syndrome].

Two cases of m.h. are reported. Various parameters--age of patients, predisposing situation and diseases, family history and enzyme changes, use of certain anaesthetics and myorelaxant--are examined and evaluated. Alternative anaesthesia techniques are suggested for patients presenting a family history of m.h. or who have manifested the syndrome on other occasions and who have to undergo further surgery.

Adult↗