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Biomedical subjects

F Gossetti

Publications and source records attributed to F Gossetti.

At least 19 recordsLinked to original sources
PubMed1999

Routine use of open laparoscopy: 1,006 consecutive cases.

Blind insertion of the Veress needle and of the first trocar is a significant cause of laparoscopic surgery complications. Despite this risk, the closed technique is still more popular than the open one. The authors retrospectively evaluated 1006 consecutive laparoscopic operations in which Hasson's technique was routinely performed. The overall complication rate was 2.2%, but the vast majority of complications occurred during the first 50 cases (6% vs. 1.9%). They conclude that after a learning phase of about 50 cases, Hasson's technique is a quick and safe procedure.

Humans↗
PubMed1996

Double synchronous occluding tumors of the large bowel: a report of three cases.

The development of acute large bowel obstruction secondary to colorectal cancer is very common and, while right hemicolectomy with a primary anastomosis is the accepted procedure for right-sided obstructing tumors, the different strategies performed for left-sided tumors, including staged procedures, Hartmann's procedure, and resection with anastomosis, remain a subject of controversy. We present herein the case reports of three patients who developed two synchronous occlusive tumors of the large bowel. Complete exploration of the entire colon is highly recommended to assess the most feasible therapeutic option in such cases, as the second occlusive tumor, often hidden within the bowel segments, can cause failure of limited resection or intestinal decompression.

Acute Disease↗
PubMed1995

Senior versus proctored young and resident surgeons' experience in laparoscopic cholecystectomy: is there any need of previous exposure to open biliary surgery?

Since its introduction in 1987 laparoscopic cholecystectomy (LC) has gained rapid acceptance as the preferred management of symptomatic cholelithiasis. In our department, during the past 3 years, the number of open cholecystectomies (OCs) has dramatically decreased. The impact of the introduction of LC as a part of the overall surgical procedures performed by residents is analyzed. To date junior-level residents have already more experience in LC than in OC. Indeed in our teaching unit junior-level residents performed only 5% of biliary surgical procedures in open surgery. Residents participated in the "surgeon's" position in 47.9% of the LCs and as either surgeon or first assistant in 100%. We analyzed both the cases where residents acted as surgeons and where they did not. It appeared that there was no difference in the complication and conversion rates. More intraoperative cholangiographies (IOCs) were performed by residents. This was probably due to the anxiety of making a mistake because of their lack of experience. This report suggests that the decrease in the number of OCs is not a drawback and that it is possible to acquire an adequate knowledge of biliary anatomy and surgery from LC training, if strict proctoring criteria are respected.

Cholangiography↗
PubMed1995

Laparoscopic management of volvulated Meckel's diverticulum.

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of the acute abdomen. In our institution, after a sequential work-out that includes physical examination, laboratory data, plain abdominal roentgenograms and ultrasonography, diagnostic laparoscopy is advocated. We present the laparoscopic treatment of an intestinal obstruction caused by a volvulus around Meckel's diverticulum. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedures in the emergency setting are discussed.

Adolescent↗
PubMed1994

The effect of L-carnitine, administered through intravenous infusion of glucose, on both glucose and insulin levels in healthy subjects.

The goal of the present study was to evaluate the effect of L-carnitine on plasma glucose and insulin levels. Two parallel studies were set-up, of 40 and 20 healthy volunteers, respectively. Each group received 500 cc of 10% glucose or 5% glucose, to which were randomly added 4 g or 2 g of L-carnitine and administered a week apart. Results showed that L-carnitine was able to reduce the increase in glucose plasma levels induced by infusion of the glucose solution. This finding was not dependent on an insulin-dependent mechanism.

Adult↗
PubMed1994

[Laparoscopic diverticulectomy for ileal volvulus on Meckel's diverticulum].

Laparoscopy in the emergency setting is a logical extension of this technique. Open laparoscopy is particularly useful in the management of acute abdomen. In fact, after a sequential work-out that includes physical examination, laboratory data, plain abdominal x-rays and ultrasonography, diagnostic laparoscopy is advocated. The Authors herein report a case of intestinal obstruction (volvulus due to Meckel's diverticulum) treated with laparoscopy. The efficacy and safety of the diagnostic and/or therapeutic laparoscopic procedure in the emergency setting are discussed.

Adolescent↗
PubMed1993

[The drug treatment of postoperative pain].

The study, conducted on 40 patients with pain resulting from "minor" general surgery, for the purpose of evaluating the efficacy and tolerability of ST-679 (administered in a single oral dose of 1200 mg in 20 patients) and to compare them with those of paracetamol (administered in a single oral dose of 1000 mg in 20 patients), demonstrated that the new drug was active on all recorded parameters and superior to the reference drug. The evaluation of the evolution of pain, performed using the Scott-Huskisson visual analog scale, evidenced that the maximum analgesic efficacy of ST-679 is reached after 1 hour and 15 minutes from assumption and remains unaltered until the final observation (6 hours). The paracetamol registers maximum analgesic efficacy after 30 minutes, but does not remain constant for the entire observation period. All the other parameters evaluated (variation in pain intensity, peak of analgesic activity and total remission of pain) are significantly favorable to ST-679. The tolerability of ST-679 was very good and better than the reference drug.

Acetaminophen↗
PubMed1992

Low anterior resection versus abdominoperineal excision: a comparison of local recurrence after curative surgery for "very low" rectal cancer.

In the controversy regarding whether sphincter-saving resection (SSR) or abdominoperineal resection (APER) is more appropriate for the treatment of very low rectal cancer, local recurrence rates seem to play a fundamental role in patient outcome. In order to operate an effective patient selection, very low rectal cancer is defined herein as being located within 4.5 to 7.5 cm from the anal verge. This retrospective report investigates the incidence of local recurrence after curative surgery for very low rectal carcinoma in 24 consecutive patients treated by the same surgical team over a 15-year period using the above surgical procedures. In the APER group, the local recurrence rate was 45.5%, occurring in 5 of 11 cases; and in the SSR group 46.1%, occurring in 6 of 13 cases, with no significant difference between the two groups. Recurrence was found within one year of surgical treatment in all except one case. Despite the strict follow-up program, it was only possible to perform reoperation in two recurrent cases, both previously submitted to SSR and diagnosed by means of transanal ultrasonography and macrobiopsy. The high incidence of local recurrence in this series is explained by the advanced stage of disease in the majority of cases. Thus, as the choice between APER and SSR does not seem to affect the incidence of local recurrence, which is related more to tumor size, site, stage, and grading, preservation of the sphincters and restoration of digestive continuity should be achieved whenever technically possible.

Adenocarcinoma↗
PubMed1990

Hydatid cyst: primary diagnosis by fine-needle aspiration biopsy.

Two cases of soft-tissues echinococcosis are presented in which the definitive diagnosis was established by identifying laminated layer remnants on fine-needle aspiration smears. Large polygonal pieces of acellular material with delicate parallel striations were seen, while neither scolices nor hooklets were found. The cases reported most likely represent the occurrence of sterile hydatid cysts. A diagnosis of echinococcosis should be considered when fragments suggestive of laminated layer are identified on smears, even in unusual sites and without evidence of hooklets and/or scolices.

Biopsy, Needle↗
PubMed1990

[Breast metastases of skin melanoma].

Although breast metastases are not frequent, the most common ones are from cutaneous melanoma. In this paper two cases of breast metastases from malignant melanoma are reported. The literature is reviewed and the diagnostic and therapeutic problems related to metastatic mammary neoplasms are analyzed.

Adult↗