PubMed Health⌕ Search

Biomedical subjects

G Flati

Publications and source records attributed to G Flati.

At least 19 recordsLinked to original sources
PubMed2000

An improved technique for temporary diverting ileostomy.

A modification of the Turnbull technique for a temporary diverting ileostomy, which may be also applied to diverting colostomies, is described herein. According to the technical modification described, a totally diverting ileostomy is performed with the help of a Foley catheter secured in the subcutaneous tissue, and pulled upward and to the right like a sling around the efferent loop. This simple modification allows for better protection of distal anastomosis and an optimal diversion of enteric transit. Furthermore, this technique also permits an easier postoperative handling of the stoma, an easier application of the stomal bags and at the same time, it also more efficiently prevents the eventual subcutaneous infiltration with enteric contaminated fluid. In the authors' preliminary experience with ten cases the procedure was shown to offer advantages in reducing local discomfort and also in achieving the objectives of a totally diverting ileostomy.

Colostomy↗
PubMed1998

A simple ultrasonographic test for preoperative haemodynamic evaluation of varicocele.

According to the haemodynamic classification of varicocele type I is caused by renospermatic reflux due to a proximal nutcracker phenomenon or to valvular insufficiency of the left internal spermatic vein. Type II is due to ileospermatic reflux and type III may be characterized by a combination of I and II refluxes. Although this classification proposed by Coolsaet is precious for decision making, it is seldom used in clinical practice being based on a complex angiographic evaluation which is invasive and exposes the patient (often a teenager or with infertility disturbances) to excessive radiations. The aim of the present study was to work up an original ultrasonographic test for preoperative haemodynamic evaluation of varicocele in order to indicate the most appropriate microsurgical treatment. Sixty-three patients underwent a preoperative clinico-echographic dynamic test which allowed to classify 76.9% of the cases as haemodynamic type I, 10.7% as type II and 12.3% as type III. Microsurgical shunts were performed in all cases and evaluation of recurrences was accurately carried out with ultrasonographic measurement of residual varicosities. In 6% of the cases varicosities were consistently reduced in size and in 94% absence of varicosities was demonstrated. Varicocele increased in size or was unchanged in none of the cases. In conclusion the test hereby described was shown to be simple and easily reproducible. It allowed a haemodynamic and objective classification of varicocele offering a unique opportunity for tailoring to the individual patient the most appropriate treatment. Furthermore, ultrasonographic postoperative follow-up is the most reliable and objective method to control the "true" incidence of post-varicocelectomy recurrences.

Humans↗
PubMed1997

Long-term results of microsurgical drainage for idiopathic varicocele.

The long-term results of microsurgical shunts for idiopathic varicocele are reported in the present paper. Sixty-two patients with a total of 65 varicoceles (three were bilateral) were followed up for 1 to 8 years. Pre- and postoperative ultrasonographic evaluation of varicocele size was considered of great importance in order to reduce the bias of subjective clinical diagnosis and to achieve a reliable and objective follow-up. Microsurgical shunts were tailored to the type of reflux: renospermatic (76.9%), iliospermatic (10.8%) or mixed type (12.3%), 94% of patients experienced a complete morphologic disappearance of varicosities, while in 6% of the cases a consistent reduction of size was objectified although varicosities were still detectable at ultrasonographic examination. In patients with severe infertility a significant increase of seminal parameters was observed postoperatively and this improvement showed a higher statistical significance in patients aged < 30 years.

Adolescent↗
PubMed1994

[Massive pseudocysto-jejunal hemorrhage caused by rupture of pseudoaneurysm of the splenic artery].

The authors report a case of massive intestinal hemorrhage caused by rupture of a splenic artery pseudoaneurysm into a pseudocystojejunostomy. The pathologic and clinical features of this unusual complication of pancreatitis are discussed. One hundred and seventy one cases of major bleeding associated with pseudocysts and/or pseudoaneurysms have been reported in the literature during the period 1989-May 1991. Acute and chronic pancreatitis may be the underlying etiologies and the overall mortality rate of this complication is 35.1%. According to the authors experience, angiographic localization of the bleeding sources and steel coil embolization play a key role in the diagnostic and therapeutic approach to what is generally regarded as the most rapidly lethal sequelae of pancreatitis.

Adult↗
PubMed1994

Surgical anatomy of the papilla of Vater and biliopancreatic ducts.

The present research was aimed at defining the surgical anatomy of the biliopancreatic ducts and of Oddi's sphincter. The numerous anatomic variations of the papilla, the millimetric distribution of its muscle fibres, and any morphological detail of clinical significance have been investigated. An integrated analysis of radiographic, tridimensional (casts), and histologic findings has been carried out in 49 of 64 autoptic bilio-duodenopancreatic specimens. Exact limits of the choledocus and Wirsung sphincters were defined. A consistent accumulation of circular muscle fibres could be seen, on the choledocus duct side, up to a mean distance of 13.6 mm from the papillary pore. However, more rarefied fibres were present up to 20.5 mm. Muscle fibres were seen to stop roughly on the pancreatic duct side at 7.3 mm from the papillary pore. The beginning of the sphincter was observed 2-3 mm above the papillary pore. There was no evidence suggesting the presence of upper, middle, and lower biliary sphincters. Five anatomic diversities of the Wirsung-choledocus confluence were found. The Y type was the most frequent (61.2%), followed by the U type (22.4%), V (14.3%), and II (2.1%). Santorini's duct with a normal papilla was present in 16 per cent of the cases. These data along with other interesting observations on antireflux mechanisms (Santorini's valves) and on the ductal space orientation appear to be useful guidelines for a physiopathological understanding of bilio-pancreatic diseases and for any therapeutic procedure on these structures.

Ampulla of Vater↗
PubMed1994

[Surgical treatment of 4th-stage hemorrhoids: the role of anatomical techniques].

Surgical options for fourth-degree hemorrhoids are still matter of debate. The high incidence of the disease encouraged research and brought to technical improvements able to achieve a painless, reliable, harmless and well tolerated surgical treatment. The Authors report a retrospective study of 193 patients who underwent surgery for fourth-degree hemorrhoids. In these cases the Authors advise anatomic techniques using local anaesthesia with i.v. administration of sedatives, thus allowing a 24-hour hospitalization.

Follow-Up Studies↗
PubMed1993

Circumferential choledochoplasties with autologous venous and arterial grafts.

Circumferential choledochoplasties with vascular grafts have rarely been attempted either experimentally or in clinical practice. In this study, choledochoplasties using autologous venous and arterial grafts were performed in rats. Sixty-four rats were randomly selected into five treatment groups: A) venous interpositional graft replacement of a choledochus gap without a stent; B) venous graft with prolene stent; C) venous graft with polyethylene stent; D) arterial graft; E) a control group with simple resection between ligatures in the choledochus. The operative mortality in treatment groups B, C, D, and E, was 0, and 13% in group A. At 12 weeks follow-up, all the rats in group E had died, whereas, 52.2% (P < .05) of the rats in group A, 30% of the rats in group B, 57% of the rats in group C, and 92.8% of the rats in group D survived treatment. Surviving animals were sacrificed at 3 months for further examination. The morphology and caliber of the common bile duct of these rats were normal in 25% of the rats in group A, 33% of the rats in group B, 25% of the rats in group C, and 84.6% of the rats in group D. Proximal dilations were found in the rats presenting with abnormal morphology. The dilations were less marked in the group treated by arterial choledochoplasties. Laboratory and clinical cholestatic parameters were within normal ranges in the presence of common bile duct dilations less than four times the normal duct caliber.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Microsurgical treatment of varicocele: selecting most appropriate shunt.

Microsurgical drainage of spermatic veins tailored to the hemodynamic type of varicocele was performed in 20 patients. In 14 cases the procedure was indicated as prophylaxis and in 6 cases as treatment of infertility. Complete regression of varicosities was observed in 75 percent as early as six days postoperatively, in 85 percent at two weeks, and in 90 percent at twelve months. In the remaining 10 percent, a consistent reduction of varicocele was found. No patient experienced progression of the disease. Eighty-three percent of the patients with altered seminal parameters showed an improvement of them at a mean follow-up of 9.1 months.

Adult↗
PubMed1990

Beneficial effect of hepatic arterialization on hypogonadism in male rats with portacaval shunt.

The effect of portacaval shunt (PCS) with and without hepatic arterialization (HA) upon the liver morphology, hemodynamics, and in relation to testicular weight, histology, and plasma sex steroid levels has been investigated in male rats. PCS rats showed a significant decrease in hepatic blood flow, body and liver weights, together with signs of severe hypogonadism. In contrast, in HA rats the increment in liver blood flow was associated with higher body and liver weights. In spite of total portal blood shunting, a beneficial effect on testicular morphology and an increase in plasma testosterone level were observed. In respect to plasma estradiol levels the intergroup differences could not be evaluated due to large individual variations. This was probably caused by the presence of cross-reactive plasma component(s) masking the level of endogenous estrogen. It is concluded that portosystemic shunting is not of primary importance in the etiology of PCS-related hypogonadism in the male.

Animals↗
PubMed1988

Acute hyperparathyroidism due to cervicomediastinal adenoma. A case report.

A case of primary hyperparathyroidism presenting with an acute clinical onset is reported. The diagnostic and therapeutic approach to this rare clinical entity are emphasized. Ultrasonography and CT allow a thorough morphologic and topographic preoperative definition of the lesion. Surgery should not be delayed beyond 96 hours from diagnosis and should be preceded by an intensive metabolic resuscitation for a successful result.

Adenoma↗