Biomedical subjects

Filippo Taranto

Publications and source records attributed to Filippo Taranto.

7 recordsLinked to original sources

PubMedDate not supplied

Transclavicular access as an adjunct to standard cervical incision in the treatment of mediastinal goitre.

There are cases in which resection of cervico-mediastinal goitres requires additional thoracic access as an adjunct to standard transverse cervicotomy, and typically this takes the form of sternotomy or thoracotomy. The authors propose transclavicular access as an alternative to thoracotomy or sternotomy access for the removal of such goitres. This technical variant is performed by means of resection of the middle third of the clavicle and extraperiosteal disarticulation. They report a case of cervicomediastinal or "plunged" goitre associated with mediastinal metastasis from a follicular thyroid carcinoma in a 77-year-old woman, in whom this technical variant was used. They conclude by stressing the greater effectiveness, ease of execution and relatively limited "aggressiveness" of the technique in comparison with other ways of reaching the mediastinum. The variant proves effective in solving a number of technical, functional and aesthetic problems.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

[Pancreatic echinococcosis. Report of a clinical case and review of the literature].

We report a case of a suppurative hydatid cyst of the pancreas treated surgically (internal drainage on Roux "Y" loop). Follow-up at 6 months revealed no evidence of the cyst. We emphasise the low incidence of the disease in a pancreatic site (02-2% in the literature). This was the first case in our experience despite the fact that Sicily is an area in which the parasite is endemic. We also emphasise the preoperative diagnostic difficulties: ultrasonography and computed tomography yielded very images very similar to those of a pseudocyst or cystic carcinoma. In most cases, in fact, as in the one reported here, the condition is diagnosed during surgery.

Echinococcosis↗

PubMedDate not supplied

[Complications of open prosthetic surgery for large incisional hernias].

The authors examine the complications of open prosthetic surgery for incisional hernias and analyse them from different points of view. The case series includes, over a period of 16 years, 492 hernioplasties for incisional hernias and 160 (32.5%) for large incisional hernias. The authors stress that the best results have been achieved by the retromuscular placement of prostheses. They conclude that while, on the one hand, the successful use of prosthetic material has marked the end of the inoperability of this pathology, such procedures are closely associated with the development of complications, which were unknown in the pre-prosthetic era and are sometimes very serious and linked to the site of the prosthesis and to the kind of material used.

Adult↗

PubMedDate not supplied

[Iatrogenic injuries to the colon].

The authors examine a number of aetiological, diagnostic and therapeutic aspects of iatrogenic injuries to the colon on the basis of an analysis of their own experience and a review of the literature. They highlight the low incidence of this kind of injury, which accounts for only 0.3% of all visceral injuries. Endoscopy and laparoscopic surgery are the most important causes of iatrogenic injuries to the colon. The authors conclude that these injuries are less serious and have a better prognosis than other kinds of colon perforations, because the colon is "clean" and it is possible to obtain an early diagnosis. Exceptions are lesions that occur in the course of a barium enema since these are associated with a high mortality rate which in some series may be as high as 100% of cases owing to the high toxicity of the barium contrast medium.

Colon↗

PubMedDate not supplied

[Haemorrhagic complications in thyroid surgery. Control of bleeding from retroneural vessels using collagen and thrombin gelatine granules].

They conclude that numerous factors contribute towards causing haemorragic complications, such as the technique used for haemostasis, the drainage, and the haemorragic risk factors presented by the individual patient. Prevention of bleeding, however, will depend essentially on the surgeon's experience and the precautions he takes. Of particular interest is the use of FloSeal (collagen and thrombin gelatine) to treat bleeding from retroneural arterial vessels, wich has often been seen to pose a serious problem for the surgeon. The results obtained in the case series described confirm the validity of this haemostatic sealant (arrest of bleeding in 100% of treated patients).

Adult↗

PubMedDate not supplied

[Ileal leiomyosarcoma presenting with an episode of acute massive intestinal bleeding].

The aim of this article was to present a case of gastrointestinal stromal tumour (GIST) presenting with acute intestinal bleeding. The Authors outline the histogenetic, clinical, diagnostic and prognostic profile of this pathology. Technical progress in immuno-histochemical and ultrastructural diagnostics has made possible to go beyond the old definition of gastrointestinal stromal tumours and identify several subgroups of such tumours on the basis of nervous and/or muscular phenotypic differentiation. The histopathological and structural variety of GIST accounts for their different clinical manifestations and variable and unpredictable biological behaviour. Histological criteria are by no means of absolute value: tumours considered benign on the basis of histology may present a malignant behaviour in the course of time, with the development of metastases and recurrences. In this regard, a number of predictive malignancy indices have been identified such as the patient's age, tumour size, presence of haemorrhage and necrotic areas, high mitotic index (> 5 mitoses/50 HFP), and kit-gene mutations. The Authors stress the diagnostic importance of 99m Tc-RBC scintigraphy in the case reported and agree with the literature as to the appropriate therapy, consisting in intestinal resection. The therapy of active GIST is essentially surgical and consists in resection of the intestinal tract affected by the tumour: lymphadenectomy must be performed only in case of need, because GIST metastasis preferably via the blood stream. As far as therapy is concerned, the demonstration of kit-gene mutation, expressed by the more aggressive forms, has made it possible to produce an inhibitor of protein tyrosine kinase Ber-Abl, which causes selective inhibition of cellular proliferation both in vitro and in vivo and induces apoptosis of Ber-Abl positive cell lines.

Female↗

PubMedDate not supplied

[Hemostatic problems in surgery].

In this study the authors analyse hemostatic problems in surgery, with particular reference to the perioperative management of the patient. They examine the numerous factors giving rise to hemorrhagic and thrombotic complications, namely, the hemostatic technique adopted, the use of drainages, patient risk factors, pharmacological prophylaxis, etc. Prevention of bleeding, however, depends essentially on adequate preparation of the patient at surgery and on the surgeon's skill and experience.

Blood Coagulation Disorders↗