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F P Mattioli

Publications and source records attributed to F P Mattioli.

At least 19 recordsLinked to original sources
PubMed2000

Cervico-mediastinal extension of thyroid cancer.

A surgical series of 30 cervico-mediastinal thyroid cancer patients operated on has been retrospectively reviewed. Results were compared with those obtained in patients operated on for benign cervico-mediastinal goiter and thyroid cancer confined to cervical region. Of 4688 thyroidectomies performed, 30 patients were operated on for thyroid carcinoma with cervico-mediastinal extension. There were 15 males and 15 females. The mean age was 67 years (range, 21-86 years). Patients with cervico-mediastinal cancer were significantly older than patients with benign cervico-mediastinal goiter (P < 0.0001). Time between onset of first symptoms and surgery was significantly longer in patients with cervico-mediastinal cancer than in those with benign cervico-mediastinal goiter (P < 0.0001) and cervical thyroid cancer. Signs and symptoms at the time of surgery were cervical mass in 28 patients (93%), cervical lymphadenopathy in 20 patients (66%), dyspnea in 21 (70%), dysphagia in 9 (30%), dysphonia in 2 (7%), and venous stasis in 1 (3%). None of the patients was asymptomatic. Total thyroidectomy with functional lymphectomy was performed in 16 cases. Seven of these patients were operated on in 2 stages. In 8 cases the operation was a debulking procedure, and in 6 it was a near-total thyroidectomy. Sternotomy was performed in two cases. A differentiated thyroid cancer was found in 21 patients (70%), medullary in 5 (17%) and undifferentiated in 4 (13%). The incidence of medullary carcinoma was significantly higher compared with cervical cancer (P < 0.008). Postoperative complications were higher than those occurring in benign cervico-mediastinal goiter and similar to those occurring in cervical cancer. The actuarial survival was similar to that of cervical cancer matched for age and sex. This analysis shows that the longer clinical history of goiter is related to its endothoracic development and its neoplastic transformation. This finding should further encourage surgeons to treat any cervico-mediastinal goiter as promptly as possible.

Adult↗
PubMed1998

Is euthyroidism the goal of surgical treatment of diffuse toxic goitre?

OBJECTIVE: To find out by studying a homogeneous group of patients whether euthyroidism is achievable by surgical treatment of diffuse toxic goitre. DESIGN: Retrospective study. SETTING: Teaching hospital, Italy. SUBJECTS: 128 of the 152 patients operated on for diffuse toxic goitre during the period January 1971-December 1994 and followed up for a median of 83 months (range 6-289). INTERVENTION. Standard subtotal thyroidectomy. MAIN OUTCOME MEASURES: Operative mortality, recurrence, hypothyroidism and late complications. RESULTS: There were no operative deaths. After 10 years follow up, 11 patients (9%) had developed recurrences and 61 (48%) were euthyroid. In the univariate analysis the risk of hypothyroidism was significantly associated with the year of operation (p = 0.04), the duration of symptoms (p < 0.01), and the degree of lymphocytic infiltration (p < 0.01). The last two were confirmed by multivariate analysis. CONCLUSION: Subtotal thyroidectomy seems to be an effective treatment of diffuse toxic goitre as a stable euthyroid state can be achieved in nearly half the patients after a prolonged follow up.

Adolescent↗
PubMed1998

Mucoepidermoid carcinoma of the thyroid gland arising from a papillary epithelial neoplasm.

We report a case of mucoepidermoid carcinoma of the thyroid gland. The simultaneous association of papillary and mucoepidermoid carcinoma in a Hashimoto's thyroiditis makes the present observation unusual. Surgery was limited due to local extension of the neoplasm. The patient consequently underwent external radiotherapy followed by radiometabolic therapy. The patient survived 11 months after diagnosis. As far as the histogenesis of the neoplasm is concerned, we believe that mucoepidermoid areas correspond to squamous and mucinous metaplasia of a preexisting papillary carcinoma. Transition areas between elements morphologically characteristic of both neoplasms were observed. Histochemical and immunohistochemical studies confirmed the diagnosis of a carcinoma with multiple aspects showing a focal positive reaction for thyroglobulin or keratin antisera. Therefore, this demonstrates different functional activities of the neoplastic cells. There is still debate about adjuvant therapies, the results of which appear for the moment very poor.

Aged↗
PubMed1998

[The role of drainage and antibiotic prophylaxis in thyroid surgery].

BACKGROUND: It is our habit to employ an open drainage after thyroid surgery in our department. We have also found a large number of surgical infections in these patients (5.8% vs 2.5). Aim of the study is to evaluate prospectively if contamination happens during surgical procedure or in a later time according to the presence of the open drainage. METHODS: From October 1995 to November 1996, 113 patients who underwent a subtotal thyroidectomy were randomized into two groups: group A with antibiotic prophylaxis (57 patients) and group B without it (56 patients). RESULTS: One case (1.7%) of sepsis among 57 patients of group A and 2 cases (3.4%) among 56 patients of group B were observed. CONCLUSIONS: No statistical difference was found between the two groups despite antibiotic prophylaxis covering surgical procedure. It is personal opinion that sepsis arose after surgical procedure, due to the presence of the open drainage.

Adult↗
PubMed1997

Laparoscopic cholecystectomy and gallbladder cancer: a diagnostic and therapeutic dilemma.

The correct treatment strategy of patients with unsuspected gallbladder cancer undergoing laparoscopy, and the prevention of delayed diagnosis are current issues. We report a case of late diagnosis with umbilical metastasis and poor survival. A policy of careful inspection of the gallbladder and a cautious strategy in the case of gross alteration of its external morphology seems advisable during laparoscopic cholecystectomy. Although no agreement exists concerning the best treatment in the event of delayed diagnosis, the adopted strategy is contingent on patient status, disease stage and the possibility of performing appropriate follow-up.

Aged↗
PubMed1992

[The use of different suture materials in thyroid surgery. A statistical evaluation of the immediate and long-term results].

Six groups of patients for a total of 120 cases were examined for cervical wound suture results. Different synthetic absorbable sutures and different suture techniques were employed. Good aesthetic results were always obtained in long-term follow-up. The patients sutured with Polydioxanone, a monofilament with prolonged breaking strength retention, had a lower incidence of local complications.

Absorption↗
PubMed1991

[Functional evaluation of gastric and jejunal transplant after esophagectomy].

Increased survival rates after esophagectomy for cancer and the significant development of forms of therapy alternate to surgical treatment, today compel surgeons to devote far more attention to the methods will pursue in reconstructing the alimentary tract after removal of the esophagus. Nine patients with esophago-gastro-plasty and 6 with esophago-jejuno-plasty, after esophagectomy for cancer, experienced a study of esophageal function. The study consisted of extended esophago-gastro-intestinal manometry, performed both while at digestive rest after a semi-solid meal, and of scintigraphy, performed to investigate gastric emptying. 24-hours esophago-gastric pH-metry was also executed, along with basal and stimulated acidity metering in, patients with gastroplasty. The fundamental alterations, from the manometric point of view in esophago-gastro-plasty, are the absence of phase III of the IMMC interdigestively and in the absence of a motor response when ingesting the meal. Scintigraphically this coincides with a fundamental alteration of gastric tubule emptying. On the contrary, in jejunoplasty the jejunal loop retains adequate motility, both during the interdigestive phase and following a meal. Such strikingly diverse motor behavior explains the higher quality of life of patients with jejunoplasty versus patients in whom the stomach is used to substitute for the esophagus.

Deglutition↗
PubMed1990

[Gastroduodenal surgery using mechanical staplers: our experience].

Results of 71 operations of the gastroduodenal tract performed with stapling devices are reported (51 for malignant diseases and 20 for benign diseases). 20 total gastrectomies, 21 Billroth II gastrectomies, 17 Roux en-Y-gastrojejunoplasty, 6 Billroth II to Roux-ex-Y-conversion and 7 palliative gastroenteroanastomosis were performed, using TA, GIA and EEA stapling instruments. The analysis of the reported data brought us to some considerations regarding the safety and versatility of mechanical viscerosynthesis, also in relation to some technical aspects.

Anastomosis, Roux-en-Y↗
PubMed1990

[Education (university training in mechanical sutures)].

The advances in surgical sciences and their evolution, besides the increasing number of surgical residents and the low availability of the operating-rooms, have made clear the limits of the usual teaching methods and of the integrative theoretical learning instruments. The teaching of viscero-synthesis, particularly mechanical suture training, emphasizes such problems and encourages the development of additional training programmes, including simulation, before the admittance to operative procedures.

Education, Medical, Graduate↗
PubMed1989

[Sphincter function after low anterior resection of the rectum].

Until a few years ago, surgical technique and the age-old convictions of oncological radicality rejected very low rectal resections for cancer, particularly as the problem of postoperative incontinence did not exist. Currently, on the other hand, with the advent of mechanical staplers, the surgeon attempts increasingly to reconcile the possibility of using new sphincter-saving techniques with adequate oncological radicality, backed by accurate pre- and intraoperative staging. It is underlined that postoperative assessment of sphincter function in all its aspects, both clinical and instrumental, may be useful for the purpose of clarifying what anatomical structures should really be saved, delegated to retaining sphincter sensitivity and reflexes, so improving the functional results of operations. In addition, the almost rare identification of manifest or latent postoperative incontinence would make it possible to intervene in operated patients, for example by functional reeducation techniques as happens in the relatively recent biofeedback techniques.

Anal Canal↗