Acute liver failure after subtotal hepatectomy in the rat: failure of testosterone pretreatment and hepatocyte transplantation to improve survival.
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Acute Disease↗
Biomedical subjects
F Meriggi
Publications and source records attributed to F Meriggi.
[Surgical treatment of pulmonary metastases of sarcoma].
Lungs are the most common target of metastases from osteogenic and soft tissue sarcomas. Metastases can be successfully treated by surgery. Only a few patients with non treated pulmonary metastases from sarcomas are alive after 5 years. In fact, without surgery the 1-year mortality is 50%. The number of metastases, the site in one or both lungs, the disease-free period and the tumoral doubling time have important prognostic significance. The authors report two interesting cases successfully treated with surgical therapy.
Breast Neoplasms↗
[Surgical treatment of pulmonary metastases in colorectal carcinoma].
After surgical exeresis of pulmonary metastases from colorectal carcinoma the 5-year survival rate is 30% vs 5% in non treated patients. Postoperative survival is longer for patients with a primary rectal cancer. Single pulmonary metastatic lesions, negative ilar and mediastinal lymph nodes, and Dukes' stages A and B are favourable prognostic criteria. The authors review literature's data and report and analyze their clinical observations.
Adenocarcinoma↗
[Surgical treatment of pulmonary metastases of primary neoplasms of the urogenital tract].
The authors review the literature data concerning the surgical therapy of pulmonary metastases from genital and urinary tumours. In both cases a combined chemo-surgical treatment is able to increase longterm survival. Some personal cases successfully treated are reported. The case is reported also of a young girl operated on for pulmonary metastases from a Wilms tumour. Successively, a heart transplantation was performed. She is alive and well.
Adolescent↗
[An update of Bassini's operation for the treatment of inguinal hernia].
Although the Bassini hernioplasty has been criticized, particularly by North American surgeons because of a high incidence of recurrence, among the techniques used for inguinal hernia repair, the Bassini method, in authors' opinion, is still the best if correctly performed. In fact, the transversalis fascia division is fundamental to obtain a better mobilization of the triple layer (transversalis fascia, transversus abdominis, internal oblique) which can approach the inguinal ligament without tension. Hernia repair is achieved by suturing this layer to the pubic tubercle and inguinal ligament with separated stitches.
Fasciotomy↗
[Surgical treatment of pulmonary metastasis from breast carcinoma. Personal contribution and considerations on the experience in the literature].
Considering a series of twelve patients operated on at the General Surgical Clinic of the University of Pavia, the authors discuss the results of surgical therapy of pulmonary metastases from breast cancer. According to literature data their results are not so good with a 5-year survival rate of 11%. Nevertheless, selected series of patients have been reported with a 5-year survival rate of 43% after pulmonary resection. So, by a careful selection of the indications the possibility of a surgical treatment would not be eliminated. After breast cancer exeresis it is certain that surgery is the best treatment for a solitary pulmonary nodule when there is some doubt about the diagnosis of primary or secondary lung cancer.
Breast Neoplasms↗
[Surgical approach to posthepatitic cirrhotic patient today].
A posthepatitic cirrhotic patient may undergo elective or urgent abdominal operation for an extra-hepatic or hepatic disease. According to the high postoperative morbidity (61%), surgery is indicated only for symptomatic or complicated cholelithiasis. A surgical procedure for refractory ascites has been devised to create a permanent peritoneo-venous shunt by a one way pressure-sensitive valve (Leveen). The procedure is simple and brings a long lasting relief with recovery in strength and nutrition and improved kidney function. Sclerotherapy is widely used to treat acute variceal bleeding while repeated sclerotherapy is used in the long-term management to eradicate varices. When indicated, liver transplantation is the best treatment to prevent variceal bleeding recurrence. Also portosystemic shunts effectively prevent recurrent variceal bleeding. They are, however, major operations with an important morbidity and mortality, particularly in poor risk patients. The most advocated shunts today are the Warren distal splenorenal shunt and the Sarfeh portacaval shunt using a small diameter prosthetic H-graft. The transjugular intrahepatic portosystemic stent-shunt (TIPSS) is a new treatment for portal hypertension and its complications. From a haemodynamic point of view it allows balanced hepatic perfusion. Postoperative mortality is rare; further bleeding and encephalopathy are reasonably acceptable. The most relevant complications concern dislocation of the prosthesis, stenosis and thrombosis of the shunt, which can be corrected by non-invasive dilatation. Encephalopathy is the main complication of surgical portosystemic shunts. It is usually controlled by protein diet restriction, and administration of lactulose or oral antibiotics. In severe forms the patients may be treated by an oesophageal transection with oesophagogastric devascularization, and by a postoperative suppression of the portosystemic shunt using external maneuvers. Posthepatitic liver cirrhosis is frequently complicated by the onset of an hepatocellular carcinoma. Early detection (aFP, DCP, Echography) and curative resection are the best ways to improve long term prognosis. Segmentectomy achieves a good balance between liver function preservation and radical exeresis for tumours less than 5 cm in diameter. Liver transplantation may be considered for the treatment of long-staging cirrhotic patients in whom hepatocarcinoma development has been recognized at an early presymptomatic stage. Hepatic arterial chemoembolization (gelfoam, lipiodol, mitomycin C or doxorubicin) may improve the survival of patients with unresectable malignant disease of the liver. A marked reduction in liver size may occur in the weeks following an effective chemoembolization with objective (CT scan) and subjective improvement (amelioration of specific symptoms). Liver chemoembolization is absolutely contraindicated in the presence of jaundice disordered liver function (Child C) or complete portal venous obstruction. In the last years, the number of patients treated by liver transplantation has greatly increased. Surgical technique, postoperative management, and immunosuppressive therapy account for the dramatic improvement of the results. However, indications for selection of patients and the timing for liver transplantation are still not well defined.
Acute Disease↗
[Primary and secondary pulmonary tumors associated with head and neck carcinoma].
The authors analyze personal and literature results in surgery of primary and secondary lung cancer associated with head and neck malignancies. Eighteen patients with primary lung cancer associated with head and neck cancer were compared with six patients affected by pulmonary metastases from head and neck cancer. In the first group the 3-year postoperative survival rate was 60.5%, in the second group 33%. Differential diagnosis between primary and metastatic lung tumours may be easy when multiple pulmonary nodes are present. When only one pulmonary node is present, diagnosis is more difficult. Thoracotomy is necessary to perform the correct diagnosis and the best postoperative medical treatment.
Carcinoma↗
[The surgery of lung metastases of melanoma].
Melanoma is considered one of the most lethal cancers and surgical therapy of its pulmonary metastases is rarely indicated. The only hope for a successful surgical treatment of secondaries from melanoma is a radical resection. Considering the very frequent multiorgan involvement of melanoma metastases, surgery is usually possible in less than 5% of cases. Nevertheless, in selected cases without lymph nodal involvement a 5-year survival rate of 31% has been reported. In any way, it must be remembered that about 10% of lung tumours thought to be metastases are primary cancers. In this occurrence surgery could be a rescuing solution. So, a pulmonary resection is always imperative when some diagnostic doubt exists.
Humans↗