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Biomedical subjects

E Triggiani

Publications and source records attributed to E Triggiani.

At least 19 recordsLinked to original sources

[Extended total gastrectomy: indications in the 3rd millennium].

BACKGROUND: Total extended gastrectomy (TEG) is indicated in the treatment of gastric cancer for necessity or to achieve an oncologic radicality. By this surgical treatment the stomach and other organs or a part of them involved by primitive tumor are removed. METHODS: The authors report a study about 15 patients, out of 116 cases of gastric cancer, operated by TEG between 1990-1998. The middle-age of this patients was 63 years (range 45-76) and their general conditions were good in 9 cases and not-good in 6. The postoperative total parenteral nutrition (TPN) was carried out in all the patients, while preoperatively only in the most compromised patients. The surgical treatments were: 2 TG (total gastrectomy)+splenecomy; 3 TG+splenectomy+pancreatic resection; 4 TG+splenectomy+pancreatic resection+distal esophageal resection; 1 TG+distal esophageal resection; 2 TG+atypic hepatic resection; 1 TG+ atypic hepatic resection+duodenum resection; 2 TG+large intestine resection. While 10 patients were operated on to obtain radicality, 5 patients had a palliative treatment. RESULTS: There was not perioperative mortality, but we have observed: one dehiscence of the duodenal stump and one pancreatic fistula treated with conservative therapy; one left subfrenic abscess treated with surgical therapy. The survival has been higher in the patients treated with radicality. On the basis of these cases, the authors consider: 1) the possibility to obtain radicality by TEG; 2) the gastric localizations more often associated to extravisceral neoplastic localization; 3) the role of extensive lymph node resection (III and IV level) to obtain oncological radicality or neoplastic reduction. CONCLUSIONS. On the basis of their personal experience and related literature, the authors conclude that TEG is indicated to: 1) obtain a better lymphadenectomy; 2) obtain an oncologic radicality; 3) reduce the neoplastic mass in order to facilitate adjuvant therapy; 4) avoid or treat neoplastic complications; 5) improve the quality of life.

Aged↗

[Role of ultrasonography in the control of patients receiving perioperative total parenteral nutrition].

BACKGROUND: On the basis of personal experience and literature, this study has been carried out in order to clarify the impact of ultrasonography on the diagnosis and prevention of hepatobiliary complications Total Parenteral Nutrition (TPN)-related. METHODS: Between April 1995-April 1997 in the Department of General Surgery-University of Catanzaro, 18 adult patients submitted to major thoracic or abdominal surgery, underwent to TPN for perioperative time (range: 9-55 days). In these patients ultrasonography was performed at pre-established days in pre- and postoperative time in order to diagnose precociously the possibility of hepatobiliary complications. RESULTS: Ultrasonography showed: 3 cases of hepatic steatosis, 5 cases of steatosis and gallbladder biliary sludge, 2 cases of gallbladder biliary sludge alone, 1 case of gallbladder biliary sludge with microlithiasis, 1 case of acute acalculous cholecystitis. The other 6 patients presented only little laboratory tests alterations, but normal ultrasonographic findings. CONCLUSIONS: Therefore it is underlined the importance of systematic ultrasonographic follow-up of patients on TPN as a non invasive method in the early diagnosis of hepatobiliary complications TPN-related. The good compliance of the patients to this instrumental investigation and the not excessive increase of their management's costs are also underlined.

Adult↗

Tracheal rupture secondary to orotracheal intubation.

A case of tracheal rupture due to orotracheal intubation performed for anaesthesiological procedures is described. It is very likely that this rare complication was favoured by some anatomical factors, which were responsible for a difficult intubation. Tracheal rupture was diagnosed by endoscopy and treated by a decompressive tracheostomy.

Female↗

[Meigs' syndrome. A case report].

The authors report on a case of Meigs' syndrome in a patient admitted with vomiting, abdominal pain, peritoneal and right pleural effusion, increased serum levels of CA 125. Surgical excision was successful.

Aged↗

[Rational and mini-invasive approach to the therapy in varicose syndrome: the C.H.I.V.A. treatment].

The principles of the C.H.I.V.A. (Ambulatory conservative and haemodynamic therapy of venous insufficiency) procedure are reported. According to the Authors a careful haemodynamic evaluation of the venous system strictly correlates to the clinical and functional results. In their experience, in fact, results showed no variceal recurrence and a very low rate of complications. Therefore, the C.H.I.V.A. procedure is recommended for most of the patients with lower limb varices.

Adult↗

[Carcinoma of the gastroesophageal junction. General principles of surgical therapy].

On the basis of histo-pathological examinations of postoperative samples following gastrectomy for adenocarcinomas of the esophageal gastric junction, the usefulness of the abdominal approach for this kind of surgical treatment is questioned. Assessment is expressed with other authors about the need for an anatomo-surgical classification of the cardial region, and the need to standardise the different surgical approaches in relation to exeresis location and extent as well as for reconstructive procedures is stressed.

Adenocarcinoma↗

[The use of Mersilene mesh in the treatment of giant laparoceles].

The paper reports on experience with the use of Mersilene mesh in 6 patients with giant laparoceles. Besides being physiologically compatible, Mersilene mesh is recommended when traditional techniques fail. The Rives technique was used, placing the prostheses between the posterior sheath and the rectus muscle; in one case it was inserted under the peritoneum. A good local and general preparation for the operation is recommended. Even though the introduction of prosthetic materials into the body is not always non-injurious, the use of Mersilene mesh is advised because of its easy positioning and the low incidence of complications.

Adult↗

Oesophageal trauma: incidence, diagnosis, and management.

The clinical manifestations, diagnosis, and surgical treatment of 110 cases of oesophageal trauma, admitted under the care of one surgical team between 1949 and 1973, are reviewed. The importance of early diagnosis and an aggressive surgical approach in the management of a potentially lethal situation are stressed. In our opinion, spontaneous rupture of the oesophagus, instrumental perforation, open and closed traumatic lesions, and postoperative anastomotic leaks are, as far as diagnosis and management are concerned, different aspects of the same desperate surgical problem. Oesophageal trauma is accompanied by a high morbidity and mortality rate if diagnosis and treatment are delayed. Perforations of the cervical oesophagus may be treated conservatively. Intrathoracic perforations demand an aggressive surgical appraoch; only exteriorisation followed by reconstruction at a later date offers a reasonable chance to save the life of the patient and ultimately restore continuity.

Adult↗