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Biomedical subjects

F Comotti

Publications and source records attributed to F Comotti.

At least 19 recordsLinked to original sources
PubMed1994

[The functional and manometric results of 2 surgical methods of posterior abdominal rectopexy].

Functional changes after posterior abdominal rectopexy for the treatment of rectal prolapse are not fully understood. We studied the effects of Wells' or Ripstein's rectopexy on functional characteristics as related to anal sphincter function, rectal volume and sensory function in 31 patients with complete or internal rectal prolapse. We have observed an improvement of continence over 70% in both groups. However, an absent or a decreased call to stool, constipation and evacuation difficulties are the aftermath of Wells' rectopexy, while these complaints appear basically unaffected by Ripstein's technique. Maximal squeeze pressure was slightly increased after Ripstein's rectopexy, whereas no significant effects were found on anal pressures. Postoperatively the rectal capacity was reduced by Well's procedure (p < 0.05), while no significant changes were observed with Ripstein's operation. After the Wells procedure patients developed at the threshold for the relaxation of the internal sphincter progressively lower rectal volumes, reaching one year after rectopexy the statistical significance. Sensory thresholds for sense of filling and urge were significantly raised after Wells' rectopexy even one year after operation, whereas after Ripstein's operation sense of filling was not significantly affected and while sense of urge was increased early postoperatively, it was not significantly changed at one hear postoperative control. In conclusion, when fecal incontinence appears associated to a rectal prolapse has good chances to improve postoperatively. Preoperative evacuation difficulties seem to be unaffected by a posterior abdominal rectopexy, Wells or Ripstein, but an extensive dissection of the rectum with the division of the lateral stalks, as it is performed in Wells' operation, seems to be a procedure that can create a further burden of problems the the patient and it seems coupled to a manovolumetric elevation of rectal sensory thresholds.

Adult↗
PubMed1994

[Diagnostic-operative laparoscopy. Our experience].

Diagnostic laparoscopy has been an integral part of our surgical practice for over 4 years. Between 1988-1992, 100 diagnostic laparoscopies have been performed in this institution without mortality. We have found the procedure to be particularly useful in the following situation: 1) Hepatobiliary disease where it is used in conjunction with targeted liver biopsy. 2) Acute emergency cases. These include the diagnosis of acute peritonitis, abdominal trauma and in patients with suspected mesenteric ischaemia. 3) In the staging of intra-abdominal malignancy especially gastric, oesophageal, colonic, peritoneal and pancreatic neoplasms.

Abdomen↗
PubMed1994

[2 cases of deep fibromatosis].

The authors make clear the importance of extrabdominal fibromatosis as a rare pathology that interests many people in Italy. The pathology is of relatively easy diagnosis with the common investigations, required a radical surgical removed to avoid the frequent local recidivists.

Abdominal Muscles↗
PubMed1992

Management of postoperative bile leakage with endoscopic sphincterotomy (EST) and a naso-biliary drain (NBD).

Between July 1987 and December 1990, 13 patients with postoperative bile leakage were treated with endoscopic sphincterotomy and a naso-biliary drain. All the leaks healed in two weeks, except for one (intrahepatic) that needed two months to heal in association with percutaneous management. The non-surgical treatment of bile leakage is the preferred approach on account of the superior safety, efficacy and cost-effectiveness as compared with surgical repair, which is associated with significant morbidity, mortality and costs. The treatment of choice has to be endoscopic, which is much easier and safer than the transhepatic approach, especially in the non-dilated duct, while another advantage over radiology includes the possibility for rapid definitive treatment of distal obstruction (e.g. residual stones). A leak from an extrahepatic duct heals rapidly, while a leak from an intrahepatic duct takes longer to heal and sometimes needs associated percutaneous drainage. Finally, the authors propose treating an extrahepatic bile leak merely with naso-biliary drainage without cutting the papilla, and an intrahepatic bile leak with endoscopic sphincterotomy, nasobiliary drainage and a bilio-duodenal endoprosthesis.

Bile Duct Diseases↗
PubMedDate not supplied

[Rectal prolapse and fecal incontinence. A prospective manometric study].

In the present work we have studied two consecutive series of patients who underwent a posterior abdominal rectopexy according to Wells or Ripstein. During the year of follow up no recurrences were observed. Functional results, evaluated according to a protocol, by history of the patient and manovolumetry, shoved an improvement of fecal continence in more than half of the incontinents in both series. However, constipation increased after Wells' rectopexy, while no major changes were observed after Ripstein's rectopexy. We conclude that the first surgical technique may offers worse functional results.

Adult↗
PubMedDate not supplied

[Total thyroidectomy in recurrent goiters (anatomicosurgical observations with the operating microscope)].

The relapses of the multinodular goitre, often linked with an insufficient surgical treatment of primitive lesions, make serious problems about the operating technique. The current guidance of surgeons is directed towards the complete thyroidectomy which profits, during the operating time, by the use of microscope to identify and to protect the recurrent nerves. This equipment has to be used by those equipped which know how to use it. In our work we report the results obtained with this technique and it's underlined how the complete thyroidectomy for the benign relapsing goitre could be considered curative towards those cases which present hidden microcarcinoma.

Goiter, Nodular↗
PubMedDate not supplied

[Malignant peritoneal mesothelioma: its evolution and outlook].

Mesotheliomas are mesenchymal neoplasms which originate in the lining membrane of various serous cavities: pleural, pericardial and peritoneal. Peritoneal mesotheliomas are extremely rare. They are usually seen to middle to old age, predominate in men. We report a case and show the most recent concepts about histology, pathology, diagnosis and medical-surgical therapy of these diseases.

Adult↗
PubMedDate not supplied

[The functional and manometric-volumetric results following abdominal rectopexy for total rectal prolapse].

Functional changes after the posterior abdominal rectopexy for the treatment of rectal prolapse are not fully understood. We studied the effects of Wells' or Ripstein's rectopexy on functional characteristics as related to anal sphincter function, rectal volume and sensory function in 21 patients with complete rectal prolapse. We have observed an improvement of continence over 70 per cent in both groups. However, an absent or a decreased call to stool, constipation and evacuation difficulties are the aftermath of Wells' rectopexy, while these complaints appear basically unaffected by Ripstein's technique. Sensory thresholds for sense of filling and urge were significantly raised after Wells' rectopexy even one year after operation, whereas after Ripstein's operation sense of filling was not significantly affected and while sense of urge was increased early postoperatively, it was not significantly changed at one year postoperative control. In conclusion, when fecal incontinence appears associated to a complete rectal prolapse has good chances to improve postoperatively. Preoperative evacuation difficulties seems to be unaffected by a posterior abdominal rectopexy, Wells or Ripstein, but an extensive dissection of the rectum with the division of the lateral stalks, as it is performed in Wells' operation, seems to be a procedure that can create a further burden of problems to the patient and it seems coupled to a manovolumetric elevation of rectal sensory thresholds.

Adult↗
PubMedDate not supplied

[Phlebographic study of venous incontinence in varicose veins].

Phlebography is a test known for a long time: although by this time it is supported and, in a way, substituted by some substantial and not surgical methods like the doppler test, doppler echography, plethysmography and the duplex scanner. This test makes it possible for us to achieve precise diagnosis rapidly and in an unequivocal way, especially in those cases in which the mentioned methods don't give final results. Nowadays phlebography has to be optimized and adapted to clinical request, in order to provide a through diagnostic result. The purpose of this work is to evaluate the effectiveness of this methodology using a group of selected patients for the test.

Adult↗
PubMedDate not supplied

[Usefulness of preoperative biliary drainage: comparison of therapeutic strategies].

This work shows the results obtained by the comparison between a period in which obstructive icterus was treated only surgically and a mixed period, based on endoscopic or endoscopic surgical treatment. In a period of 9 years (1979-87), 186 patients suffering from obstructive icterus were admitted into the 1st Division of General Surgery at Ospedale Maria Vittoria, Turin. In the first five years (1979-83) all the patients (78) were indistinctly operated after the usual diagnostic controls. In the following four years (1983-87) 62 out of 108 patients, considered as high-risk ones, underwent drainage by endoscopic way. In the high-risk patients, both neoplastic and not, morbidity rate, death rate and average stay in hospital were evidently lower after endoscopic or endoscopic-surgical treatment than after surgery alone. In conclusion, endoscopic pre-operating drainage in selected and/or high-risk patients greatly reduces perioperative complications and mortality.

Aged↗
PubMedDate not supplied

[Treatment of large laparoceles: review and personal experience].

Surgical correction of laparocele is still today a problem for the surgeon. Physiopathological aspects, preparation to surgery and most of all the indications to the use of synthetic prosthesis are reviewed. Easy application and lesser evidence of recurrency and complications suggest a wider field of indications of these procedures. Attention should be payed to the rules of a careful operative technique involving the use of foreign bodies.

Adult↗
PubMedDate not supplied

[Bleeding gastroduodenal ulcer: indications for surgical intervention].

The best chance for a patient with a bleeding gastroduodenal ulcer is: "a diligent doctor and a reluctant surgeon". It is necessary to evaluate clinical and endoscopic elements and to check haemodynamic and general conditions of the patient. A better prognosis is ensured by prompt initiation of therapy. All patients with a bleeding since 12 hours or rebleeding must be selected for urgent surgery. The success of surgical intervention is the result of an exact indication and the most correct surgical procedure. Selection of patients for surgery must ensure careful local haemostasis and control of hyperchlorhydria.

Duodenal Ulcer↗
PubMedDate not supplied

[Diagnosis and therapy of splenic injuries].

The purpose of this work is a critical revision of spleen traumatism treatment. We have examined 46 patients which we treated by total splenectomy. We examined the recent literature on spleen functions and we tried to punctualize the newest methods for conservative treatment of the spleen.

Adolescent↗
PubMedDate not supplied

[Surgical therapy of recurrent varicocele].

In the surgical treatment of recidivous varicocele, has been adopted in eight patients a personal technique that varies in some points from the Ivanissevich's one. Large dissection and resection of the spermatic vein in peritoneum back zone for 6-8 cm. length, prier ligature of all possible collaterals. In four cases has been applied the microsurgical technique, anastomosing the veins of the spermatic plexus to the saphena vein. Checks performed at distance of time haven't shown any relapsing case. The microsurgical technique should give the more immediate normalization of spermatogenesis.

Humans↗