PubMed Health⌕ Search

Biomedical subjects

G Riccipetitoni

Publications and source records attributed to G Riccipetitoni.

18 recordsLinked to original sources
PubMed2002

Italian multicenter survey on laparoscopic treatment of gastro-esophageal reflux disease in children.

BACKGROUND: Skepticism is still present today about the laparoscopic treatment of gastro-esophageal reflux (GER) in children. We present the prospective experience and short-term results of eight Italian pediatric surgical units. METHODS: We included all the children with complicated GER, operated after January 1998 by single surgeons from eight different centers. Diagnostic aspects, type of fundoplication, and complications were considered. All the patients were followed for a minimum period of 6 months in order to detect complications or recurrences. RESULTS: 288 children were prospectively included. Mean age was 4.8 years (3 m-14 y). Nissen fundoplication was done in 25%, floppy Nissen in 63%, Toupet in 1.7%, and anterior procedures (Lortat Jacob, Thal) in 10%. Gastrostomy was associated, if neurological impairment or feeding disorders were present. Mean follow-up was 15 months and reoperation was necessary in 3.8% of cases. CONCLUSIONS: This experience underlines that minimal invasive access surgery in children is safe and that the laparoscopic approach is considered in eight centers the golden standard for surgical repair of gastro-esophageal reflux disease maintaining the same indications and techniques of the open approach.

Adolescent↗
PubMed2000

Features and outcome of neuroblastoma detected before birth.

BACKGROUND/PURPOSE: The growing use of routine ultrasonography during pregnancy is leading to an increasing number of prenatally diagnosed neuroblastomas. Optimal strategy has not yet been defined for these patients, because knowledge on this particular neuroblastoma (NB) population is still limited. However, definite guidelines are needed to avoid inadequate treatment. The authors analyzed the cases of antenatally detected NB (ADNB) reported in the Italian Neuroblastoma Registry during the past 6 years to elucidate the features of this subset of NB. METHODS: The Italian Neuroblastoma Registry was reviewed for the period January 1993 to December 1998 to collect clinical, radiographic, surgical, and histopathological data on ADNB cases. NB stage was evaluated according to INSS criteria. All patients had undergone imaging (computed tomography or magnetic resonance imaging) of the primary tumor and bone marrow biopsy before surgical resection. RESULTS: Seventeen patients were identified. Primary tumour site was adrenal glands in 16 cases and retroperitoneal ganglia in 1. Stage distribution was stage I, 13 cases; stage II-A, 1 case; stage II-B, 1 case; stage IV-S, 2 cases. All cases underwent primary tumour resection. Mean age at surgery was 4 weeks. Resection of primary tumor was radical in 16 cases, partial in 1. All tumors were characterised by favourable histology according to Shimada classification. N-myc gene amplification was studied in 14 patients. N-myc amplification was detected only in a newborn with stage II-A NB, who died of massive bleeding 2 days after tumor resection. DNA index and 1p deletion were studied in 11 and 8 patients, respectively. Both diploidy and deletion of 1p were observed in a newborn who subsequently died of disease progression despite surgery, chemotherapy, and radiation therapy. Fourteen of 17 patients currently are alive and free of disease, and one with IV-S NB and short follow-up is alive with disease. CONCLUSIONS: Our data give evidence that in most cases infants with ADNB represent a subset of patients with excellent outcome. Aggressive treatment may not always be necessary. Infants with ADNB with unfavorable features should undergo early surgical excision, whereas patients with favourable features could be observed awaiting spontaneous regression of the mass, reserving delayed surgery for tumors that increase in size or do not regress.

Adrenal Gland Neoplasms↗
PubMed1993

Treatment of vesicoureteric reflux in the neurogenic bladder.

A retrospective co-operative study was conducted among 6 Italian paediatric surgical departments to assess the results of different forms of treatment of vesicoureteric reflux in patients with neurogenic bladder. Between January 1980 and December 1989 we studied 641 neurogenic bladders in children, mainly due to spina bifida; reflux was detected in 199 patients with 263 refluxing ureters. Details of treatment were available for only 170 patients and they were divided into 2 main groups: conservative medical treatment (n = 127) and primary surgical treatment (n = 43). Medical treatment consisted mainly of clean intermittent catheterisation and the administration of appropriate drugs. In the surgical group 36 reimplantations, 6 cystostomies and 1 STING were performed. Fifteen patients underwent surgery as a secondary procedure. The results showed that approximately 50% of patients with reflux were cured by clean intermittent catheterisation and drug therapy. Ureteric reimplantation can be safely performed in patients with neurogenic bladder provided that a normally compliant, non-hyper-reflexic bladder can be achieved by means of drugs or by bladder augmentation with bowel.

Child↗
PubMed1992

Postnatal ultrasound screening of urinary malformations.

We performed routine neonatal ultrasound screening on 3,454 neonates in the first week of life to establish the real incidence of congenital uropathy. Pronounced anomalies were found in 36 cases (1.04%) and mild renal pelvis dilatation in 159 (4.60%). In the population study prenatal ultrasonography showed evidence of severe anomalies in only 7 fetuses (0.2%). Surgical correction was required in 14 cases. Our results indicate that neonatal ultrasound screening has sufficient sensitivity and specificity for the early detection of the vast majority of urinary tract malformations. In 2 cases mild vesicoureteral reflux was not detected until a urinary tract infection was noted. Thus, neonatal sonography appears to be of limited value in detecting mild reflux.

Congenital Abnormalities↗
PubMed1992

[Transplantation of the left lung in a 2-month-old piglet. The Study Group for Lung Transplantation].

Experimental surgery in animals remains an irreplaceable model for the clinical application of a new technique. We performed a single lung allotransplantation in young pigs. The pigs were organized into groups: 1) 6 to assess the surgical anatomy; 2) 10 to receive left transplantation; 3) 3 to study the pathophysiology of the transplanted lung. The preliminary results demonstrated that the surgical model is useful.

Animals↗
PubMed1989

Conservative management of urinary abnormalities detected in utero.

During a 5-year period, we observed 48 fetuses with urinary malformations diagnosed by antenatal sonography. Postnatal investigations confirmed the presence of a urinary tract anomaly in 44 of the 48 fetuses selected by prenatal ultrasound (91%). Accurate antenatal diagnosis was made in 35 of the 48 cases (73%). In 9 fetuses renal disease was detected, but its specific nature was not in accordance with the prenatal diagnosis. In our series the most common anomaly was hydronephrosis secondary to ureteropelvic junction obstruction. This condition was observed in 31 of the 44 patients (70.4%); 7 of the newborns who showed an obstructive pattern were submitted to early surgical repair, while the remaining 24 cases and 1 renal unit of the group undergoing early surgical repair were relegated to expectant observation, with periodic clinical and laboratory controls. A spontaneous recovery was observed in 12 cases; the dilatation remained unchanged in 10 cases, while 3 patients showed a progressive worsening of the condition which led to a surgical correction. Our findings agree with those in recent reports in providing little support for early, indiscriminate surgical repair. Moreover, our experience confirms the possibility of a spontaneous recovery in newborns with hydronephrosis and draws attention to the benefit of a conservative management in properly selected patients.

Female↗
PubMed1985

[The reno-calyceal index. Radiological evaluation of pyelocalyceal distensions in children].

The ratio length of one kidney width of the lower calyx, measured pre and post-operatively, is proposed as an objective index to assess the result of pyeloplasty in surgical treatment of hydronephrosis. Statistical approach on a series of 25 children with unilateral hydronephrosis and normal contralateral kidney has demonstrated the reliability of this index to determine the evaluation of the dilatation in the post-operative period. An increase of the ratio was present in all cases in which the result of surgery, as far as distension was concerned, was satisfactory.

Adolescent↗
PubMed1984

[Sickle cell anemia in surgical patients. Significance and problems].

Drepanocytosis, a disease notoriously widespread among blacks, is surprisingly frequent in certain Italian islands. Surgical aspects of the disease are discussed: erythrocyte sequestration attacks, pigmentary cholelithiasis, priapism, malleolar ulcers and vaso-occlusive attacks. A knowledge of such aspects is considered fundamental for the purposes of a reasoned differential diagnosis in the field of paediatric pathologies requiring surgery.

Anemia, Sickle Cell↗
PubMed1983

[Experimental intrauterine surgery. Morphological study of lung development in the sheep fetus with congenital diaphragmatic hernia].

Experimental comparison of the lungs of 7 sheep foetuses with surgically induced CDH and 7 controls permitted an assessment to be made of the changes that take place in lung growth, generally described as hypoplasia, through a study of their morphology and histology, and the lung: lamb weight ratio. Changes increased in gravity in function of the duration of hernia. They included: reduced alveolar expansion, fewer generations of bronchi and alveoli, and septal thickening. An increase in the smooth muscle component of 5th-6th generation arteries (i.e. resistance) may offer an explanation of the hypertension characteristic of CDH, and the non-reactivity of these vessels in response to vasodilators. It is also suggested that damage to the mesenchyma can be regarded as the sole cause of the changes in lung growth observed in CDH. Early treatment before these changes become irreversible is thus advisable.

Animals↗
PubMed1982

[Experimental intrauterine surgery: the creation of a congenital diaphragmatic hernia in a sheep fetus].

Up to 50% of the neonates operated during the first hours of life for a congenital diaphragmatic hernia die. The presence of a severe lung hypoplasia, which is at the origin of hypoxia, acidosis, increased pulmonary vascular resistance and right to left shunt, explains the poor clinical results, in spite of surgical success and intensive therapy. A modern approach to the problem includes treatment with pulmonary vasodilator drugs, whose effects are still discussed. Perhaps the prenatal recognition of the defect could improve prognosis. Lots of experience are needed to know more on the subject. This could be obtained with an experimental approach on newborn animals with a CDH. The article relates authors experience in the creation of a CDH in a foetus of sheep, by means of a surgical intervention during its intrauterine life.

Acidosis↗
PubMed1981

[Hirschsprung's disease in adolescents and adults].

Megacolon must be considered as a diagnosis in any case of intractable constipation also in the adult. Besides the Hirschsprung's disease and the idiopathic megacolon, which have no apparent organic cause, many other pathologic conditions may produce a marked dilatation of the large bowel. The differential diagnosis depends, after a valuation of the clinical and radiologic features, also from enzymatic, histologic and functional tests. The Hirschsprung's disease can be observed after the infancy in: 1) Patients in whom diagnosis is made only in adult age; 2) Patients with a diagnosis made in infancy or childhood, with moderate symptoms, treated with a conservative methods, who are getting worse; 3) Adult relapsers after a previous inadequate operation. Group II also includes the patients who need an emergency operation, because of a perforation or a volvolus of a dilatated loop. We report three cases of adult Hirschsprung's disease and two adult "idiopathic megacolon". The patients with aganglionic megacolon were admitted to our Hospital respectively for an abdominal palpable mass, a volvolus and incontinence. The two patients with idiopathic megacolon showed the same clinical picture of those with Hirschsprung's disease. We choose a surgical therapy in all five patients, with good long-term results.

Adolescent↗
PubMed1979

[Current status in transplantation of the endocrine pancreas in the treatment of diabetes mellitus 2. Transplantation of fetal pancreas].

The latest findings support hypotheses that diabetes complications are secondary to metabolic control which current insulin therapy is unable to render constant. Surgical attempts to transplant the pancreas and Langerhans islets in the treatment of diabetes mellitus are reviewed and special attention paid to the use of the foetal pancreas which has proved particularly suitable in preventing microangiopathic complication. Comments are based on a careful review of the literature, made in the light of personal experience.

Animals↗