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F Prusciano

Publications and source records attributed to F Prusciano.

7 recordsLinked to original sources
PubMed2006

Video-assisted thoracic surgery in the treatment of pleural empyema.

BACKGROUND: The use of video-assisted thoracic surgery (VATS) in the treatment of pleural empyema has been proposed since the early 1990s, but among surgeons, its use varies considerably, and the results are discordant. This report aims to provide a retrospective assessment of the authors' experience and the literature on VATS in an effort to ascertain rational criteria for the use of this technique. METHODS: Over a period of 12 years, a total of 120 cases of pleural empyema were recorded. The patients were assessed with chest x-ray, computed tomography, ultrasound, and thoracentesis. On the basis of clearly defined clinical and radiographic parameters, 38 patients underwent VATS immediately, whereas the remaining 82 were treated initially by means of tube thoracostomy. The latter was found to be sufficient for only 10 patients. Consequently, for the remaining 72 patients, it was decided to proceed also with VATS. RESULTS: The procedure was performed completely by VATS in 101 patients (91.8%), whereas in 9 patients (8.2%) it was necessary to convert to thoracotomy. The postoperative course was uneventful for 98 of the 110 patients (89%), whereas the remaining 12 patients experienced complications, including one case of persistent empyema (0.9%) treated by thoracotomy. The mean chest tube duration was 6 days (range, 3-25 days). The mean postoperative hospital stay was 7.1 days (range, 5-17 days). Of the 80 patients completing a 6-month follow-up evaluation, the results were considered good for 72, moderately good for 8, and less than satisfactory for 2 patients. CONCLUSIONS: In conclusion, the authors consider VATS to be the technique of first choice for the treatment of pleural empyema when the disease is advanced or tube thoracostomy fails. It provides excellent results with a low level of invasiveness and considerably reduces the need for thoracotomy. These results can be achieved with good videothoracoscopic experience and the use of a very precise technique.

Adolescent↗
PubMed2001

Video-assisted thoracic surgery major pulmonary resections. Present experience.

OBJECTIVE: The purpose of this report is to review our experience of video-assisted thoracic surgery (VATS) major pulmonary resections. METHODS: From January 1993 to December 1999 we proposed VATS, for major pulmonary resections, with these indications: benign lesions and solitary metastases not removable by wedge resection and stage I non-small cell lung cancer (NSCLC). The maximum size of the lesion had to be less than 4 cm. RESULTS: There were 125 patients, 87 men and 38 women with a mean age of 62. We successfully performed VATS procedure in 112 cases (one hamartoma, one tubercoloma, 12 typical carcinoids, 11 metastases and 87 lung cancers), while in another 13 (10.4%) a conversion to open surgery was required. There were 108 lobectomies, three bilobectomies and one pneumonectomy. Out of the first three cases of NSCLC, in all patients mediastinal node sampling or lymphadenectomy was performed. We recorded 13 (11.6%) postoperative complications, one of which required re-operation (bleeding). In the 99 patients without complications, the mean postoperative stay was 5.8 days. In a mean follow-up period of 36 months with patients having lung cancer we achieved a 3-year survival rate of 85+/-9 and 90+/-8% when only the patients in Stage I were considered. CONCLUSIONS: We believe that VATS, in performing pulmonary lobectomy, is a safe and effective approach and it seems to give the same long-term results as open surgery. Now the main problems concern the indications that should be strictly respected and the conversion to thoracotomy which should be undertaken without hesitation when the anatomic or pathologic conditions are not favourable.

Adult↗
PubMed2000

Video-assisted thoracic surgery (VATS) lobectomy for typical bronchopulmonary carcinoid tumors.

BACKGROUND: Indications for the use of video-assisted thoracic surgery (VATS) lobectomy are a controversial matter. This study aims to provide a retrospective evaluation of VATS lobectomy in typical bronchopulmonary carcinoids. METHODS: Patient selection criteria for VATS lobectomy were as follows: (a) typical carcinoids with clear diagnosis; (b) centrally located lung tumors not amenable to bronchial resection with bronchoplastic procedures, or tumors located in peripheral lung tissues; (c) no hilar or mediastinal lymph node enlargement; and (d) normal respiratory function. Between January 1995 and December 1999, 12 patients (eight men and four women with a mean age of 57 years) were treated, seven with a peripheral and five with a centrally located tumor. Preoperative examination included chest roentgenograms, computed tomography (CT) of the chest, bronchoscopy, and spirometry; diagnosis was established by direct bronchoscopy in five cases, transbronchial biopsy in two cases, transthoracic biopsy in two cases, and video thoracoscopic wedge resection in three cases. Eleven VATS lobectomies and one VATS bilobectomy were performed. All patients underwent hilar lymphadenectomy and mediastinal sampling. RESULTS: There were no intraoperative complications. The only postoperative complication, hematothorax (8.3%), required VATS reoperation. Mean postoperative hospital stay was 5.33 days. Pathological examination of the resected specimens confirmed that the procedure was radical in all 12 patients and revealed eight T1N0 and four T2N0. At a mean follow-up of 30 months, no signs of recurrence were recorded. CONCLUSION: VATS lobectomy in the treatment of selected typical carcinoids, both central and peripheral, seems to yield favorable results and is therefore preferable to thoracotomy since it is less invasive.

Adult↗
PubMed2000

[Video thoracoscopic treatment in pleural empyema].

BACKGROUND: To evaluate the possible role and the effectiveness of videothoracoscopy (VATS) in the treatment of pleural empyema. METHODS: Personal experience on 40 cases of pleural empyema treated by (VATS) during 5 years is reported. The underlying diseases were: pneumonia (32), pneumothorax (3), tuberculosis (2), abdominal diseases (2) and lung cancer (1). Before VATS at least one thoracentesis was performed to evaluate the characteristic of the pleural fluid. RESULTS: Due to complications related to thick pleural adhesions, in one case (2.5%) the procedure was converted to open surgery, while in the remaining 39 cases VATS was able to achieve a complete cleaning of the pleural space with re-expansion of the pulmonary parenchyma. The improvement of the clinical symptoms were observed after a mean period of 3.5 days (range: 1-12 days). Chest tube was removed in a mean period of 4.8 days (range: 3-11 days); five patients had prolonged air leak from 6 to 10 days after surgery. CONCLUSIONS: In conclusion we are of the opinion that VATS has to be considered a very important mean for the treatment of pleural empyema; its use in the fibrinopurulent phase of the disease should give very good results, while in the following phase its indications are controversial.

Adolescent↗
PubMed1992

Confirmation of high prevalence of hepatitis C antibodies in hemodialysis patients by second generation immunoblot assay.

Sera from 209 dialysis patients were tested for antibodies to hepatitis C virus (anti-HCV) by a 2nd generation enzyme-linked immunoassay (ELISA 2) using nonstructural and core antigens. Confirmation of reactivity was obtained by a 2nd generation immunoblot assay (RIBA 2) for antibodies to 4 separate antigens (5-1-1, c100-3, c33c, c22-3). ELISA 2 was positive in 99 sera, 95 of which were confirmed by RIBA 2, thus accounting for an anti-HCV prevalence of 45.5%. Anti-HCV positivity was correlated to longer duration of dialysis therapy (p less than 0.001), higher number of transfusions (p less than 0.001), history of kidney transplant (p less than 0.001) and of serum alanine/aspartate aminotransferase (AST/ALT; p less than 0.001) or gamma-glutamyltransferase (GGT) (p less than 0.001) increments. The most frequent RIBA 2 patterns were: reactivity to all 4 antigens (34 patients) and to c33c and c22-3 (45 patients). The former patients, compared to the latter, had higher values of AST (p less than 0.08), ALT (p less than 0.02), GGT (p less than 0.005), IgG (p less than 0.05). It is possible that the reactivity to all 4 antigens of RIBA 2 is a clue of a greater activity of viral hepatic disease.

Adult↗