[Clinical, radiological and manometric study in total esophagoplasties].
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Adult↗
Biomedical subjects
F Francioni
Publications and source records attributed to F Francioni.
Evolving techniques and perspectives in lung transplantation.
Lung transplantation is currently a suitable option for patients with end-stage lung disease. Since the early 1980s the surgical technique and immunosuppressive protocols have been progressively modified to improve results and favor long-term survival. The original heart-lung transplantation under cardiopulmonary bypass is now rarely performed and single or bilateral lung transplantation is the procedure of choice. Bilateral transplantation is performed with two single lung transplants performed in sequence. Extracorporeal support is rarely employed and in most cases it is instituted through the femoral approach. Also, the surgical approach has been modified and the original clam shell incision has been replaced by two small anterior thoracotomies. The use of marginal donors has been increasingly proposed to enlarge the number of organs potentially available for transplantation. Immunosuppressive protocols have evolved to patient-specific regimens that can be quickly modified if required by the clinical status. Induction is now more aggressive and also rescue protocols for obliterative bronchiolitis can contribute to improved outcomes. Overall, lung transplantation is now performed with encouraging long-term results.
Humans↗
Superior pulmonary sulcus tumors: radical resection and palliative treatment.
Between 1963 and 1987, 56 patients with Superior Pulmonary Sulcus Tumors (SPST) were seen at our Institution. Fifteen inoperable patients were treated by radiotherapy. Forty-one patients underwent surgery: 32 received preoperative irradiation and in four of these postoperative radiotherapy was also administered: in nine cases (non radical resection) radiotherapy was administered postoperatively only. Paulson's approach was employed in 30 cases and Dartevelle's procedure in 11. The resection was considered curative in 22 patients (53.7%) achieving complete palliation of pain in 68.2% of cases. In non-resectable patients 2-year survival was 6%. Five-year survival was 11.1% for patients with non radical resection and postoperative irradiation and 34% for patients undergoing preoperative irradiation and radical resection. Four patients underwent pre- and postoperative irradiation and they are alive 23, 20, 15 and six months after operation. Five-year survival for N0, N1 and N2 patients was 38.1%, 14.3% and 0% respectively. In conclusion, SPST can be radically resected, with the appropriate surgical approach and after preoperative radiotherapy, achieving good long-term survival and pain relief. Postoperative irradiation is advisable for prevention of local recurrence and longer pain relief.
Abdominal Muscles↗