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Biomedical subjects

G Fegiz

Publications and source records attributed to G Fegiz.

At least 37 records · Page 2Linked to original sources
PubMed1988

Delayed bilateral ureteral fistula following abdominoperineal resection: a case report.

A case of delayed bilateral ischemic necrosis of the pelvic ureter in a 66-year-old woman submitted to abdominal perineal resection and hysterectomy for advanced rectal cancer, is reported. Five days after the operation urine was observed in the perineal cavity. External urine diversion was carried out by catheterizing the ureteral stumps through the perineal cavity. The reconstructive procedure was performed at a later date by bilateral ureteroileocystoplasty with a defunctionalized loop. The vascular anatomy of the ureter is discussed to highlight the essential technical details useful for prevention of ischemic injury.

Abdomen↗
PubMed1987

[Manual suture versus/or mechanical suture (from the Italian viewpoint)].

Mechanical suturing has become widespread in Italy in recent years, especially for anastomoses between the large intestines and the rectum and between the esophagus and the stomach or small intestine; many chest surgeons also use this type of suture. Basically, mechanical suturing is preferred for anastomoses for which the manual technique has proved difficult, for example those low in the pelvis or high up in the chest. Few surgeons use mechanical suturing at sites where it is easy to suture by hand. Overall, experience with mechanical suturing has been positive, mainly because the number of conservative resections performed for rectal carcinoma has increased while the frequency of the so-called Miles operation has declined in recent years. Our own experience with mechanical suturing has been collected in the construction of colorectal (235 with mechanical suturing out of a total of 592), ileorectal and ileoanal anastomoses (45 ileorectal and 12 ileoanal anastomoses with mechanical suturing out of a total of 155 surgical operations).

Gastrointestinal Diseases↗
PubMed1987

Hydatid hepatothoracic fistulas. A report of 30 cases.

A retrospective study was carried out on 30 patients with hepatothoracic transdiaphragmatic fistulas, classified as hepatopleural (5 cases), hepatopulmonary (11 cases), biliopleural (1 case) and biliobronchial (13 cases). Investigations included chest X-rays, bronchography, plain abdominal films, cholecystocholangiography, liver scanning, ultrasonography and CT scanning. Twenty-nine patients were submitted to 32 operations: two were performed in 1 case and three in another. Thoracotomy was performed in 20 cases, laparotomy in 7 and thoracophrenolaparotomy in 5. Surgical procedures for the treatment of endothoracic lesions included pleurectomy, middle lobectomy, lower lobectomy and wedge resections. Liver cysts were treated by cystectomy and pericystectomy. The postoperative course was uneventful in 21 patients. Complications developed in 3 patients. Operative mortality was 10.3%.

Adolescent↗
PubMed1986

Total gastrectomy in the treatment of adenocarcinoma of the cardia. Review of the results in 73 resected patients.

Between January 1, 1971, and December 31, 1978, 73 patients with adenocarcinoma of the cardia were treated by total gastrectomy with distal esophagectomy. The continuity of the alimentary tract was restored by esophagojejunostomy using a Roux-Y procedure in 32 patients and jejunal loop interposition in 41 patients. The early postoperative mortality rate was 18 percent. The overall 5 year survival rate was 26.7 percent, and the 5 year survival rate for stage I and II disease was 91.6 percent and 25 percent, respectively, whereas none of the stage III and IV patients survived more than 4 years. Fifty-eight percent of the patients without nodal involvement lived more than 5 years. The 5 year survival rate was only 9.3 percent in the presence of nodal metastases. Our 5 year survival rates suggest the value of elective total gastrectomy for stage I or II adenocarcinoma of the cardia. Jejunal loop interposition is a time-consuming but functionally superior procedure in comparison to other reconstructive procedures after total gastrectomy.

Adenocarcinoma↗
PubMed1986

Frequencies and cyclical pattern of the human sphincter of Oddi phasic activity.

Basal frequency of sphincter of Oddi phasic contractility has been repeatedly measured during endoscopic manometry and reported to range, in control subjects, from (M +/- SE) 3.0 +/- 0.6 to 7.5 +/- 0.7 c/min. Recently, high frequency (greater than 8 c/min) phasic contractions or absence of phasic activity were recorded in patients with postcholecystectomy or pancreatic complaints, possibly suggesting a sphincter of Oddi dysfunction. In the present study, sphincter of Oddi (biliary tract) phasic contractility was measured by perendoscopic manometry in 13 subjects without specific clinical symptoms of biliopancreatic disease and with a normal common bile and pancreatic duct at ERCP. Four T-tube patients with no evidence of common bile duct stones or papillary stenosis were studied for comparison (transductal sphincter of Oddi manometry). Basal frequency was found to range from 0 to 7 c/min (M +/- SE: 2.99 +/- 0.46) in perendoscopic manometry (85 min of recording time) and from 0 to 12 c/min (2.0 +/- 0.3) in transductal manometry (2546 min of recording time). Long lasting transductal recordings also showed that frequency of activity derived from the sphincter area varied cyclically in close relation with the duodenal migrating motor complex. It is concluded that the sphincter of Oddi in man is likely to participate in the interdigestive gastrointestinal motor activity and that short perendoscopic recordings may not be representative of the overall sphincter of Oddi activity.

Adult↗
PubMed1986

Sexual and bladder dysfunctions following surgery for rectal carcinoma.

A series of 475 patients who underwent surgery for rectal carcinoma were followed up and entered this study. Sexual and bladder function before and after surgery with respect to the surgical procedure was considered. 221 patients gave suitable information about their urinary function: bladder dysfunction was observed in 20% of amputated patients as against 13-14% of resected patients. 144 patients (103 males and 41 females) were available for a follow-up study of the sexual function. Sexual intercourse, libido, erection, ejaculation, dyspareunia, vaginal humidification, orgasm were the parameters examined. Almost all of them were more affected after abdominoperineal resection than after low anterior resection with manual or stapled anastomosis, although the difference was not always significant. In a few instances the rates were inverted. It is believed that these dysfunctions are not related to the type of surgery, but to required extent of radicality. Extreme care should be always taken when dissecting the end portion of the rectum to avoid injuries to the hypogastric plexus and the pudendal nerve.

Ejaculation↗
PubMed1986

Preoperative staging of rectal cancer: validity of the abdominopelvic angio-C.T.

The role of preoperative staging in the treatment of rectal cancer is emphasized. To this purpose, the use of abdominopelvic angio-C.T., which was carried out in 14 cases, is examined. Preoperative staging obtained by this method is compared with the postoperative one assessed by UYCC classification, modified by AYCC. Its diagnostic and prognostic role is evaluated in relation to the other methods. The validity of abdominopelvic angio-C.T. for a correct therapeutic approach is confirmed.

Adenocarcinoma↗
PubMed1985

Surgical treatment of liver metastases from colorectal cancer.

The experience with 28 patients undergoing hepatic resection for metastases from colorectal cancer is reported. In 15 cases the metastases were synchronous, in 13 metachronous, appearing 12 to 60 months after surgery of primary cancer. Six patients underwent right lobectomy, 2 left lobectomy, 9 left lateral segmentectomy, 6 right wedge resection and 2 bilateral wedge resection. In 20 cases the lesions were solitary, in 8 multiple. Overall operative mortality was 14.2%. Mean survival for synchronous metastases was 16 months with 3 patients living beyond 12 months, and 26 months for metachronous metastases with 4 patients living beyond 12 months. The obtained results are analyzed on the basis of staging of primary cancer, of the metastatic disease and type of resection, examining the morbidity and cause of long term mortality. It is evidenced that, even if correct pre- and intraoperative staging of metastatic disease is impossible, an aggressive surgical approach is the treatment of choice in surgically resectable liver metastases from colorectal cancer.

Actuarial Analysis↗
PubMed1983

[Assessment of platelet survival before and after latero-lateral portacaval shunt].

On the basis of a group of 175 patients affected by liver cirrhosis and submitted to side-to-side porto-caval shunt, we have examined the presence of hypersplenism in 49.7% and its changes after splenectomy. In order to find out a suitable method to value the changes of the platelets, we observed platelet survival in seven patients either before or after porto-caval shunt. The results obtained encourage in affirming that: 1) Hypersplenism improves after a simple shunt. 2) Hypersplenism is not severe even if it persists with an open shunt. 3) The possible onset of shunt thrombosis worsens hypersplenism. 4) Platelet survival is surely effective in the study of hypersplenism.

Blood Platelets↗
PubMed1983

Elective endoscopy in portal hypertension.

Eighty-four cases of portal hypertension from cirrhosis assessed by oesophagogastroduodenoscopy before elective surgery are reported. The need for evaluation of both the associated gastrointestinal lesions and the varices in patients with cirrhosis is stressed, to avoid inappropriate medical or surgical treatment.

Adult↗
PubMed1983

Intraoperative high-resolution hepatosonography in the detection of occult metastases in colorectal carcinoma.

During surgery of colorectal cancer, real time B-mode high resolution ultrasound scanning was employed intraoperatively in 25 consecutive patients free of metastases at preoperative evaluation, to localize hepatic deposits. Results showed that intraoperative ultrasonography is a safe and simple technique providing the surgeon with accurate informations which may affect surgical technique as for -) extended indications for hepatic resection -) reduction of resections oncologically useless -) a more correct staging of resected colorectal cancer -) reduction of false positives at second look guided by CEA elevation.

Colonic Neoplasms↗
PubMed1983

Intraoperative high-resolution ultrasonography in the localization of occult endocrine pancreatic tumours.

Intraoperative pancraticosonography was employed in six patients to localize suspected endocrine tumours and to study the specific ultrasonic features. The cases included four insulinomas, one case of occult G-cell apudoma and one case of beta-cell microadenomatosis. Endocrine tumours are generally hypoechoeic and well defined with smooth borders. The study confirms that real-time operative high resolution sonography is a reliable technique to assist in the diagnosis of occult endocrine tumours and to guide the surgical approach.

Adenoma↗