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Biomedical subjects

G Silecchia

Publications and source records attributed to G Silecchia.

47 records · Page 3Linked to original sources
PubMed1988

Abdominotransanal approach in the treatment of the low-lying rectal carcinoma.

Seven patients with non advanced cancer of the lower third of the rectum underwent sphincter-saving resection through a combined abdominoperineal approach. In this procedure not only coloanal anastomosis, but also bowel transection were performed through the anus. All the patients had cancer located between 3.5-5.5 centimeters from the anal verge. The main advantages of the technique are precise lines of bowel transection with desired distal clearance of tumor, and easier and safer mobilization of the distal end of the rectum during the abdominal phase of the procedure. No mortality was observed; morbidity was comparable to low anterior resection. The mean follow-up is 8 months and all patients are free of recurrence and continent.

Adenocarcinoma↗
PubMed1985

Clinical value of CA 19-9 (carbohydrate antigen) in gastrointestinal adenocarcinoma.

CA 19-9 and CEA serum levels were determined before and 7 days after surgery in 140 patients with gastrointestinal adenocarcinoma, and in 70 patients with gastrointestinal non neoplastic diseases. CA 19-9 test was shown to be positive in 37.9% of colorectal cancer, in 32.6% of gastric cancer and in 77.8% of pancreatic cancer. CA 19-9 test was also shown to be more sensitive for colonic cancer with respect to rectal cancer (40.9% vs. 23.5%). CA 19-9 test is more sensitive and specific than CEA. In particular, the reported results suggest the clinical value of CA 19-9 test in the diagnosis of pancreatic adenocarcinoma and as a suitable parameter in the follow-up of gastrointestinal cancer.

Adenocarcinoma↗
PubMed1985

Surgical treatment of congenital dilatation of the biliary system.

Over a total of 1612 patients undergoing surgery for biliary diseases, in 6 cases a cystic dilatation of intrahepatic bile-ducts suggestive of Caroli's disease was diagnosed. One patient with multiple dilatation of intrahepatic bile ducts and septic shock was treated by external drainage without improvement and died. Two patients were treated by left hepatectomy. One case was treated by right extended hepatic lobectomy. One patient with liver cirrhosis and bleeding oesophageal varices was treated by a distal splenorenal shunt. The last patient showed the association of a choledochal cyst and cystic dilatation of the left intrahepatic bile ducts. She was treated by resection of the cyst and biliary-jejunal anastomosis. Five patients had satisfactory recovery from the operation. They are leading a normal life, and are symptom-free. The different forms of treatment are discussed confirming that the best surgical technique on patients with partial cystic dilatation of bile ducts is liver resection. When the extrahepatic bile ducts are affected, biliary-jejunal diversion is necessary. If a choledochal cyst is present, the removal of the cyst is the most radical approach. When cirrhosis and portal hypertension with bleeding varices are diagnosed, portosystemic shunt is necessary.

Adult↗
PubMed1985

Surgical management of liver hydatidosis. 10-year experience with 269 patients.

A series of 269 patients with 371 surgically treated hydatid cysts of the liver is reported. Cystopericystectomy was performed in 45.2% of cases, liver resection in 7%, subtotal cystectomy in 26.9%, cystojejunostomy in 1.8% and drainage in 9.7%. Overall mortality and morbility were 2.9% and 31% respectively, with a mean hospital stay of 29 days. The highest mortality (6%) and morbility (45%) were observed in patients undergoing subtotal cystectomy. In the group of patients treated by conservative surgery the overall mortality was 32.5%, while in the group treated by radical surgery it was 27% (p less than 0.05). These data suggest that in the treatment of hydatid disease radical resection is followed by the lowest complication and mortality rates.

Drainage↗
PubMed1984

Resection of suprarenal inferior vena cava and dacron graft replacement without right nephrectomy for echinococcal cyst. Case report and review of the literature.

A case of a hepatic echinococcal cyst of the right lobe (diam. 16 cm.) involving the anterior wall of the retrohepatic inferior vena cava is reported. During surgery, the vein was occasionally damaged and suture of the lesion was not possible. Therefore resection of the retrohepatic vena cava was performed and the segmental continuity was replaced with a dacron graft (1,6 X 5 cm.). The patient had an uneventful recovery. The controls at 6, 12 and 24 months showed excellent permeability of the prosthesis. This report represents the second long-term survival case of the literature. The indications for graft replacement of the inferior vena cava, are discussed.

Adult↗
PubMedDate not supplied

Acetaminophen-induced fulminant hepatic failure in dogs.

Results concerning morphological and biochemical changes following intravenous administration of different doses of acetaminophen in dogs are reported. Acetaminophen infusion, as a parenteral solution (500 mg per kg per 90 min), produced fulminant hepatitis characterized by a good correlation between Portmann's grade of lesion and percentage of necrosis. All animals died within 76 hr after intoxication. Analysis of biochemical parameters revealed positive correlation between serum bilirubin levels and severity of the hepatic lesion. The experimental model of acetaminophen-induced hepatotoxicity is proposed as a model for evaluation of the therapeutic efficacy of new medical and surgical procedures.

Acetaminophen↗
PubMedDate not supplied

Concomitant radiotherapy with protracted 5-fluorouracil infusion in locally advanced carcinoma of the pancreas: a phase II study.

AIMS AND BACKGROUND: To evaluate the efficacy of combined radiation therapy and continuous infusion of 5-fluorouracil in patients with locally advanced carcinoma of the pancreas. METHODS: Between January 1992 and June 1999, 31 patients with locally advanced adenocarcinoma of the pancreas were treated in our Institute. In 20 patients, the tumor (65%) was located in the head of the pancreas and in 11 (35%) in the body or tail; 13 cases also showed involved nodes. Radiation therapy consisted in a median dose of 63 Gy in 33-36 fractions applied to the tumor and regional lymph nodes. Chemotherapy with 5-fluorouracil in continuous infusion, 250 mg/m2 daily, was administered in the first and fifth week of the radiation therapy. Thereafter, 22 patients received 3-10 cycles of adjuvant chemotherapy with same doses. Median follow-up of the series was 20 months. The toxicity of the treatment was scored according to WHO criteria. All patients underwent nutritional assessment at the time of radiochemotherapy. RESULTS: The median overall survival was 15.2 months (range, 4-42). At restaging, 17 cases (55%) showed no change and 14 (45%) a partial remission. At the end of radiochemotherapy in 8 (26%) of the cases there was indication for pancreatectomy, which was executed in 4 patients. At the time of the study, 2 patients (6.4%) were surgically proven disease free. Eleven of the 13 cases (85%) presenting involved nodes showed that the enlarged lymph nodes had disappeared. Nineteen patients (61%) are alive with clinical evidence of disease anti 2 cases are alive with liver metastases; 8 patients (26%) died for disease. In 74% of cases there was complete pain control. Tolerance to the regimen was good. Nutritional assistance was evaluated and was found to be correlated to survival. CONCLUSIONS: The results of the series confirm a good tolerance with low acute toxicity. Tumor down-staging and resectability rates were high, together with prolonged survival and a good quality of life.

Adenocarcinoma↗
PubMedDate not supplied

[Laparoscopic surgery of the colorectum: analysis of results of the National Registry of the Italian Society of Endoscopic Surgery and New Technologies (S.I.C.E.)].

The aim of this paper was to review the data from the Italian Registry of Laparoscopic Colo-Rectal Surgery sponsored by SICE. The Italian Registry was set up in January 1993 by the merging of two Registries existing since November 1991. Thirty-five centres, up to March 2001, had participated in the Registry, with 2,793 patients recorded (F = 1,409, M = 1,384), 1878 for malignancy and 915 for benign diseases. The median age was 63.7 years. The conversion rate was 10.8%. Mortality was 0.6% (18 cases) and major abdominal complications occurred in 11.1% of patients. The reoperation rate was 5.1%. After a median follow-up of 59 months, 16 patients (0.9%) presented abdominal wall metastases. Relapses occurred in 18.5% of patients after curative resections for rectal cancer, and in 12.7% after curative resections for colon cancer. Laparoscopic colo-rectal surgery has gained widespread acceptance. The reproducibility and safety of all the major laparoscopic colo-rectal procedures has been demonstrated. Nevertheless, the lack of long-term results of randomised trials in terms of oncological efficacy and the technical difficulties of the procedures suggests that laparoscopic colo-rectal surgery should be performed only in referral centres by skilled surgeons.

Adolescent↗