Biomedical subjects
Publications and source records attributed to G Tugnoli.
The paper reports the Authors' ten year experience on simple ligation in appendicectomy. After having reviewed the various surgical procedures, the Authors report their clinical experience and, considering the good postoperative results with this method, regard this procedure as an alternative to the technique of ligation with inversion of the stump in appendicectomy.
Two cases of acute caecal diverticulitis are reported. The Authors describe the clinical aspects, diagnostic procedures, histological pictures and surgical treatment. Particular emphasis is also placed on problem of a correct preoperative diagnosis.
BACKGROUND: From the first successful splenectomy performed in 1893 the trend, in the management of splenic injuries has been increasingly toward avoiding splenectomy in favor of splenic preservation, either operatively or nonoperatively. The aim of this study is to evaluate our experience in the management of splenic injuries. METHOD: 429 Patients who suffered splenic injuries from 1989 to 2001, were examinated retrospectively. RESULTS: 120 Patients were treated non operatively; 270 were treated with splenectomy and 39 with operative preservation. The mortality rate was 6.8% but no Patient treated nonoperatively or with surgical preservation died. CONCLUSION: The splenic preservation either operatively or nonoperatively is the treatment of choice of splenic injuries in all Patients irrespective of the grade of injury or the age of the Patient.
PURPOSE: To evaluate our 12-year experience in the treatment of complex hepatic injuries with periepatic packing and damage control priciples. METHOD: A retrospective review was conducted of 21 Patients with grade IV-V injuries of the liver and severe haemorrage induced hypothermia and acidosis admitted to the Ospedale Maggiore Trauma Center in Bologna from 1989 to 2001 RESULTS: All the Patients had major blunt trauma. Mean age was 39.6; mean ISS 41.5; mean RTS 4.13; extimated loss of blood was greater than 5300 ml. Packing provide definitive control of bleeding in 16 Patients but 10 had recurrent bleeding or bleeding from different injuries such as bone fractures and required further surgery or arterial embolization. 12 Patients died (57.2%). Survival was strongly associated with the ISS, GCS, the loss of blood and acidosis. CONCLUSION: The authors concluded that in selected circumstances the traditional approach to hepatic injuries is not appropiate. In this situation, alternative and aggressive treatment--damage control--has been recommended as the procedure of choice.
BACKGROUND: To evaluate if combining operative treatment of patients with trauma and general surgery emergencies offers a good operative experience and can be a model for a Trauma Center organization, we compare our surgical experience with that of our general surgeons. METHODS: We reviewed records to determine number of operation, need of intensive care unit care for patients treated, the after hours practice by the trauma and emergency surgeons and general surgeons over a 1-year period at Ospedale Maggiore of Bologna. RESULTS: Emergency and trauma surgeons performed more operations per surgeons (133.7 vs 102.6) and managed more patients in intensive care unit than general surgeons. 51.8% of emergency and trauma operations were after hours. CONCLUSION: The care of trauma and emergency patients resulted in a breadth and scope of practice for trauma and emergency surgeons compared well with that of general surgeons but in a worse lifestyle.
PURPOSE: To evaluate our 2-year experience in the emergency surgical treatment of elderly people (aged > or = 80). METHOD: A retrospective review was conducted of 198 elderly patients admitted to Emergency Surgery Unit of the Ospedale Maggiore in Bologna from 01.07.2001 to 30.06.2003. RESULTS: All the Patients were submitted to emergency operations. Mean age was 84.8 (range 80-96); Female were 152, male 73. Preexisting condition, ASA scores and surgical procedures were recorded. The postoperative mortality was 17.1%. The mean length of stay in our Unit was 9.7 days; 93 patients needed rehabilitation facility at discharge. CONCLUSION: The Authors concluded that emergency surgery entails a high risk to the patients, high cost in hospital resources and rehabilitation facility.
The authors report their experience with the mostly used technique of hernioplasty. They compare the Shouldice hernioplasty, development of the traditional Bassini, with the Trabucco and Lichtenstein techniques in which synthetic prosthesis are used. The two surgical departments participating to this study present 234 patients who underwent hernioplasty with the above mentioned techniques. The authors consider local and general complications during the postoperative time and after a 6-month follow-up. Results indicate that the surgical techniques used are efficient in terms of low complication rates and reduced hospitalization.