[Relations between the colpocytologic pattern and estriol in urine in the third trimester of pregnancy].
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Biomedical subjects
Publications and source records attributed to F Santi.
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Four hundred out of 422 patients with primary gastric cancer seen from 1965 to 1979 underwent surgical treatment and were studied retrospectively. Fifty-eight percent underwent curative procedures. The five year survival rate was 19.14%. Subtotal and total gastrectomy gave survival rates of 35.8% and 9% respectively (p less than 0.05). Postoperative mortality (24.2%) was influenced by both the type of procedure performed (p less than 0.001) and the stage of the neoplasis (p less than 0.001). This study confirms the influence of staging on short, intermediate and long term survival and demonstrates the importance of the early diagnosis of gastric cancer in carrying out effective surgical treatment.
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The results of management of perforated large bowel diverticulitis were retrospectively studied over a 7-year period. 38 patients underwent operation, 20 for generalized peritonitis, 12 for local peritonitis, 5 for colovesical fistula and 1 for colovaginal fistula. The mean age of patients was 63 years (range 30-85 years). Depending on the symptoms, the spreading of the peritonitis and associated cardiovascular and pulmonary disease and diabetes mellitus, 4 types of operation were performed: primary left hemicolectomy and anastomosis with and without defunctioning colostomy, Hartmann procedure, suture and drainage with diverting colostomy. The overall mortality was 10.5%: resection and primary anastomosis entailed 3.8% mortality (1 case), while 3 deaths were observed in the 8 patients group having underwent an Hartmann procedure (37.5%). Drainage and/or diverting colostomy performed in 5 patients entailed no hospital mortality, but was followed by a 80% complication rate, requiring reoperation and several hospital admissions. The low mortality and morbidity rates obtained in the group having primary resection and anastomosis encourage wider application of this operation for perforated acute diverticulitis. Even the Hartmann procedure allows removal of the diseased colon but in a great proportion of cases reconstitution of continuity is not performed; nevertheless staged operation entailing major mortality and morbidity, expose these aged patients to remarkable hazard. Prerequisite of safe primary excision and anastomosis is vigorous intraperitoneal lavage and drainage, by the case associated to on table large bowel irrigation if concomitant obstruction is present.
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The authors starting from two observed cases of gallstone ileus, describe of these, the pathogenesis, the diagnostic difficulty, and they express their opinion with regard to surgical treatment to execute, related to the data reported by the authors and from their own experience.