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F Agresta

Publications and source records attributed to F Agresta.

24 records · Page 2Linked to original sources
PubMedDate not supplied

[The rationale of laparoscopic treatment in acute appendiceal disease].

Notwithstanding its widely perceived advantages, laparoscopic appendectomy has not yet met with universal acceptance. The aim of the present work was to illustrate retrospectively the results of a case-control study of laparoscopic vs open appendectomy carried out at our institution. From Jan. 1993 to Dec. 1999 a total of 457 patients (M:F = 210:247; mean age 25.2 +/- 15 years) underwent emergency and/or urgent appendectomy. Among them, 254 (55.5%) were operated on laparoscopically, while 203 (44.5%) were treated by conventional surgery The choice of technique depended upon the availability or otherwise of a team expert in minimally invasive surgery. The laparoscopic technique conversion rate was 3.9% and was mainly due to the presence of dense intraabdominal adhesions. The major intraoperative complication rates were 0.39% and 0% in the laparoscopic and laparotomy groups, respectively (P = ns). Major postoperative complications occurred in 2 and 1%, respectively (P = ns). The postoperative mortality rates were 0.4% and 0.5% in the laparoscopy and laparotomy groups, respectively (P = ns). The reoperation rate was 1.1% in the laparoscopic group as against 0% in the open surgery group (P = ns). Minor postoperative complications were observed in 0.8% and 7.5% of patients in the laparoscopy and open surgery groups, respectively (P = 0.001) and consisted mainly of wound infections. Resumption of bowel function was significantly more rapid and the hospital stay significantly shorter in the laparoscopically treated patients. The greater diagnostic accuracy of laparoscopy allowed concurrent diseases to be diagnosed in 9% of laparoscopically treated patients with histologically proven appendicitis as against 1.5% of those treated by conventional surgery (P = 0.001). Similarly, among those patients with no evidence of gross and/or microscopic appendicitis, concurrent diseases were detected in 58.4% of the laparoscopic cases as against only 6% of the laparotomy cases (P = 0.0001). Despite the limitations of a retrospective investigation, on the basis of our experience we believe that laparoscopic appendectomy is as safe and effective as conventional surgery, presents a higher degree of diagnostic accuracy and makes for less trauma and a more rapid postoperative recovery. Such features make its use mandatory in female patients of child-bearing age referred for urgent abdominal and/or pelvic surgery.

Acute Disease↗
PubMedDate not supplied

[Laparoscopic approach to inguinal hernia pathology].

Laparoscopic hernia repair has already become as accepted a technique as the conventional ones and is routinely used in those centres where this kind of surgery is normally performed. The two most commonly used laparoscopic techniques (transabdominal and total extraperitoneal) have been shown to produce good results in terms of post-operative course and recurrence rates, but still present the disadvantages of high cost and the need for general anaesthesia. We report here a retrospective analysis of our early experience with laparoscopic treatment of inguino-crural hernias. The positive results achieved (no cases of conversion to an open technique; no recurrences to date; 4.7% major morbidity) allow us to consider this approach a valid alternative to the traditional ones in selected, well-informed patients.

Female↗