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G Campanelli

Publications and source records attributed to G Campanelli.

At least 19 recordsLinked to original sources
PubMed2006

Inguinal hernia recurrence: classification and approach.

We reviewed case reports, updated to January 2005, of 2,468 operations for groin hernia in 2,350 patients, including 277 recurrent hernias. The data obtained, following a simple anatomo-clinical classification into three types that could be used to orient surgical strategy, were: type R1--first recurrence of "high" oblique external reducible hernia with small (<2 cm) defect in non-obese patients after pure tissue or mesh repair; type R2--first recurrence of "low" direct reducible hernia with small (<2 cm) defect in non-obese patients after pure tissue or mesh repair; and type R3--all other recurrences, including femoral recurrences, recurrent groin hernia with large defect (inguinal eventration), multi-recurrent hernias, non-reducible contralateral primary or recurrent hernia, and situations compromised by aggravating factors (e.g. obesity) or otherwise not easily included in R1 or R2 after pure tissue or mesh repair.

Female↗
PubMed2004

Spigelian hernia.

UNLABELLED: We report on the evolution in concept and techniques that allowed us to improve the treatment of spigelian hernia, operable in day surgery in 90% of cases and through a preperitoneal and recently a preperitoneal and subfascial prosthetic repair (PHS). BACKGROUND DATA: We propose an innovative use of the PHS mesh for spigelian hernia repair. With this new implementation, we confront the standard surgical technique and its postoperative period. METHODS: From January 1992 to March 2004, we performed 2,500 hernia surgical operations, including 32 spigelian hernia repairs (1.3% of total case series). The first surgical approach used for 20 of these 32 patients (62.5% of total spigelian hernias), all electively operated on, was a classical preperitoneal repair (Wantz), performed when possible by size of defect and weight (Body Mass Index) of the patient, under local anesthesia and on a day-surgery basis. Our new modified technique takes place through the insertion of a PHS large-type mesh, whose bottom underlay portion lies flat in the preperitoneal space with the connector obliterating the hernial orifice and with the overlay portion lying on the internal oblique muscle, covered by the aponeurosis of the external oblique muscle. RESULTS: Our modification to the classical technique consisted only in the application of a product, such as the PHS, in a hernia defect, which presented with an orifice of the size of the connector and, therefore, was easily repairable with the use of the PHS device. This approach is easier than the preperitoneal approach, it's always suitable for local anaesthesia, and it gives a more comfortable postoperative period. The surgical approach may be performed completely in day surgery. CONCLUSIONS: We believe that spigelian hernia surgical repair should always be performed by means of a preperitoneal prosthesis under local anaesthesia when the patient's clinical and physical conditions allow for it, always in day surgery, and using the PHS mesh when the hernia defect size fits with the connector diameter. This last possibility seems to be easier and more comfortable for the patient in the postoperative period.

Follow-Up Studies↗
PubMed2004

Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible?

INTRODUCTION: Prosthetic repair for abdominal wall hernia currently represents the gold standard. However, it is still difficult to identify the correct indication for prosthetic implant in borderline cases. The authors propose evaluating whether a prosthetic implant is absolutely contraindicated in potentially infected operating fields through the review of literature and personal experience. MATERIALS AND METHODS: The authors performed ten prosthetic hernia repairs in potentially contaminated areas, with a preliminary preparation of the retromuscular-preperitoneal space hosting the prosthesis implant, and subsequent performance of the major operation. RESULTS: There were neither major nor minor complications with a 21-month follow-up (mean period). DISCUSSION: It is certain that both in noncomplicated inguinal hernia and in abdominal wall hernia repairs, the use of antibiotics can significantly reduce the number of infections. It is very important to underline that the success of the described procedure can be guaranteed only by an accurate preparation of the preperitoneal space: perfect haemostasis, temporary closure of the space with the insertion of iodine gauzes and suturing the edges, local antibiotic treatment, washing of the cavity, and accurate drainage. CONCLUSIONS: Prosthetic repair is the gold standard for inguinal, incisional, and all abdominal wall hernias and should be used, with the method described, even in potentially contaminated areas. The use of a prosthesis has to be avoided in clearly infected cases.

Abdominal Muscles↗
PubMed2003

Difficult hernia repair in the elderly. A particular case.

A particular clinical case personally observed is described. On the basis of this case it is evaluated if it can be correct to implant a mesh in potentially contaminated areas, if preperitoneal repair is the best approach in recurrent or difficult hernia repair and if there are specific contraindications in operating elderly patients.

Adenocarcinoma↗
PubMed1998

Organ culture in 3-dimensional matrix: in vitro model for evaluating biological compliance of synthetic meshes for abdominal wall repair.

A new in vitro method to evaluate the early critical interactions between synthetic prosthetic materials and growing tissues is reported. The correct spatial organization and proper cell to cell interaction required to mimic the in vivo environment was obtained in a 3-dimensional (3-D) embryo organ culture. The clot formed by plasma and chick-embryo extract provided a natural 3-D extracellular matrix that was able to support the growth and differentiation of intestinal tissue dissected from 12-day-old chick embryos. Different materials used for the repair of abdominal wall defects were taken as standards; all the prosthetic materials were devoid of any evident cytotoxic potential over a 10-day culture period, so they did not interfere with the organogenesis process. A polyglactin mesh (Vicryl) was fully incorporated into the growing tissue, but early signs of its degradation were detectable. The biologically inert materials polyethylene terephthalate (Mersilene) and polypropylene (Marlex, Prolene, and Herniamesh) retained their structural integrity when incubated with cultured tissue at 37 degrees C, and they did not hinder cellular proliferation or fibroblast migration. However, the outgrowth behavior was very different while the connective tissue invaded the interstices of the polyethylene terephthalate mesh; the explants and the migrating cells were repelled by hydrophobic polypropylene meshes. These findings are in agreement with other reported results in in vivo studies. Therefore, this method can be considered as reliable and predictable for the evaluation of biopolymers.

Abdominal Muscles↗
PubMed1996

[Recurrent inguinal hernia. Propositions of classification and surgical strategy].

We reviewed 1005 cases of groin hernia in 932 patients including 113 recurrent hernias. Eighty-seven percent of the patients were seen again one year after surgery for an evaluation of technique, results and complications. The data obtained was used to propose a simple anatomoclinical classification into three types which could be used to orient surgical strategy. Type R1 includes first relapse oblique external reducable hernia of less than 2 cm in non-obese patients: the Lichtenstine-gilbert technique is indicated. Type R2 includes inferior, direct reducable first relapse hernia of less than 2 cm in non-obese patients: the Wantz-Trabucco technique is indicated. Type R3 includes all the other forms: the Stoppa technique, or alternatively laparoscopy, is proposed.

Age Factors↗
PubMed1991

[Pyloric stenosis caused by gallstone (Bouveret's syndrome). Presentation of a further case].

The Bouveret's syndrome is a rare complication of a bilio-digestive fistula, where a big stone occludes the pyloro-duodenal region. The clinical symptomatology is atypical, symptoms of the disease are acute and only in fifty per cent of cases it is possible to have a positive anamnesis for biliary lithiasis. The evolution of the occlusion is generally rapid. The clinical case we are in possession of, shows a particularly chronic evolution with a 15 month sub-occlusive symptomatology that caused a massive gastric dilatation. The diagnosis of Bouveret syndrome was set forth during operation, as generally happens in about 50% of cases. The surgical treatment is still the only one capable to solve the obstruction of the alimentary canal and the bilio-digestive fistula at the same time.

Biliary Fistula↗
PubMed1989

[Sensitivity to antibiotic drugs of isolated bacteria in urinary infections in children].

The need for an early start to antibiotic therapy during infections of the urinary ways in paediatrics, even before knowing the infecting strain and chemosensitivity tests, often makes it difficult to choose the drug to be used. The present study examines all the urine samples reaching the Microbiology Laboratory of Rome University's Paediatrics Clinic between 1986 and 1988, highlighting infecting species and respective chemosensitivity. The samples were also distinguished on the basis of sex and origin (hospitalised patients and out-patients). From the data so examined it was noted that some antibiotics give a broader cover against the species most frequently encountered during urinary way infections.

Adolescent↗
PubMed1986

[Complications of vascular prosthesis].

The main complications deriving from the use of vascular prostheses in the surgical reconstruction of the arteries are thrombosis, infection and the appearance of pseudoaneurysms. Among 233 aorto-femoral b.p., prosthetic thrombosis occurred in 45 patients creating the need for 66 reoperations, 19 early and 47 tardive. In 387 aorto-iliac reconstructions, infection arose early in 11 cases, tardively in 6. Out of 1118 vascular reconstructions there were also 28 pseudoaneurysms (2.5%). After remarks on the aetiopathogenesis of such complications, methods that can be used to prevent them are discussed and personal results of treatment are presented.

Aneurysm↗
PubMedDate not supplied

[Current approaches in the treatment of gastrinoma metastases].

In the last years the therapeutic behaviour with regard to gastrinomas, has deeply changed becoming more and more aggressive. Nowadays, almost all authors recommend, after a serious treatment of the hypersecretion with omeprazole, an explorative laparatomy in all patients affected by gastrinoma even without a preoperative tumor localization. The multiple endocrine syndrome (MEN I) and the metastatic disease are excluded from the above practice. A careful examination of the most recent data available today in literature accompanied with our experience, even if limited, shows that only the surgical treatment allows a better survival also in metastatic disease. The surgical treatment is surely recommended in gastrinoma with pancreatic and duodenal lynphonodal metastasis. For hepatic metastasis all types of hepatic resection, the "wedge resection" included, can be suggested. After the first positive experiences, the hepatic transplantation can find a place among the therapeutic means against this kind of tumors.

Gastrinoma↗
PubMedDate not supplied

Long term results of extra anatomical bypasses.

The authors discuss their own experience with extra anatomical bypasses. It is composed by 214 patients who underwent 224 extra anatomical bypasses: 167 axillofemoral bypasses, 50 femorofemoral bypasses and 7 trans-obturator bypasses. The indications included the presence of infections, or a previously thrombosed aortic prosthesis, or infected aneurysm, in 12.1% of the cases; in 6.2% of the cases the extra anatomical bypass was due to acute ischaemia of limb. In 81.7% it was chosen because of the presence of some general or local contraindication to direct aortoiliac reconstruction. The results are comparable to those reported in the literature. The only unusually high datum is the rate of early infections in femorofemoral bypasses (12%). On the ground of these results, the Authors stress the value of extra-anatomical bypasses as an alternative to direct aortoiliac reconstructions.

Aged↗
PubMedDate not supplied

[Crohn's disease in the elderly].

Primary Crohn's disease in the elderly is a not frequent pathology, which however have distinguished from the reheightening or relapse of an inflammatory illness risen up in juvenile age. The Authors compare the personal experience (6 cases on 120 patients operated for Crohn's disease) with the data of the literature. The more frequent localization stays the ileo-colic one, also if in the elderly present better impact the cases of Crohn's colitis (pancolitis or left colitis), with frequent and- perianal implications. The symptomatology is not pathognomonic and above all in the cases of colitis sets problems of differential diagnosis with other pathologies, among which the diverticular disease, that on the other hand, can also coexist with the inflammatory illness. A pharmacological treatment is desiderable, but frequently doesn't result effective. The surgical conservative therapy is not always possible and could be necessary resort to maiming interventions, like massive ileal resections or a total proctocolectomy. From the prognostic point of view, the course appears from the beginning or very favorable (with low index of relapse) or tumultuous (with acute manifestations, which require an emergency surgery, wighted by a more elevated rates of mortality and morbidity.

Aged↗