Biomedical subjects

G Zanghì

Publications and source records attributed to G Zanghì.

At least 19 recordsLinked to original sources

PubMed2006

[Gastrointestinal stromal tumors: report of three cases and review of the literature].

Gastrointestinal stromal tumours are the most common mesenchimal tumours of the gastrointestinal tract. Diagnosis of these tumours is difficult to establish, because symptoms are vague and traditional diagnostic tests are not specific. Natural history remains poorly defined and many criteria have been correlated with prognosis; for instance, some authors have found that GIST localization influences clinical behavior, that has not been confirmed by other authors; actually, tumour size, mitotic rate and complete resection seem to be the main prognostic factors. Surgical resection is the treatment of choice, with little efficacy reported for irradiation, conventional cytotoxic agents or both. Nevertheless, imatinib mesylate has recently demonstrated significant activity and tolerability in the treatment of malignant unresectable or metastatic GIST. Three cases of GIST, complicated by intestinal bleeding and intestinal obstruction respectively, are presented and a review of the literature is made.

Aged↗

PubMed2006

[Fibrin sealant in tension free hernioplasty: our experience].

The aim of this study was to prove that it is possible to fix mesh sutureless with Tissucol in the Lichtenstein procedure. The mesh fixation with Tissucol was done in 28 patients. Respect the traditional Lichtenstein technique, which was done in the remaining 28 patients, the advantages of using Tissucol are: no surgical trauma, total mesh fixation, no pain, reduced morbidity and reduced costs. Furthermore it is a safe and reproducible method. The results are promising, even if the verification goes more carried out with consisting casuistics and longer follow-up.

Aged↗

PubMed1998

[The role of lymphadenectomy in colorectal neoplasms].

BACKGROUND: The role of lymphadenectomy in the treatment of large bowel cancer is still controversial, not only because it is deemed to be a basic element for a correct postoperative staging, but also because it brings about, according to some authors, an enhancement of survival and of "disease free survival" rates. The difficulty to collect case histories with homogeneous data and the impossibility to identify preoperatively with certainty the lymph nodes involved, makes it difficult to codify the most suitable surgical treatment, even if it is agreed at present, to extend lymph nodes dissection at least as far as Level II nodes. As a matter of fact, despite of slight enhancement of 5-year survival rate (6-8%), a significant increase in morbility occurs, as reported in the literature, particularly in terms of urological and neurological lesions. However, a few authors, perform systematically Level III dessection, reporting a 20% increase in survival. METHODS: Our study, has been carried out on 84 patients affected by large bowel neoplasm and admitted to the Institute of Surgical Pathology I of "Vittorio Emanuele" Hospital of Catania between 1990-1995. RESULTS: This study showed an involvement of Level I lymph nodes in 77% of patients and of Level II in 33%, while Level III nodes were affected only in 4.7% of cases. CONCLUSIONS: On the basis of these data and of those reported in the literature, the conclusion is drawn that the most suitable and responsible attitude is, at present, to perform invariably Level I and Level II dissection, reserving the lymphadenectomy of Level III only to selected cases or when an involvement is documented pre and intraoperatively.

Adult↗

PubMed1993

[Heterologous lyophilized collagen in the secondary healing of pilonidal fistulae].

The authors evaluate heterologous lyophilized collagen efficacy and tolerability in second intention healing of pilonidal sinus fistulae. This therapeutical approach seems to be characterized by a lower relapse incidence. The use of heterologous lyophilized collagen relevantly reduces the prolonged healing time required by such method.

Adult↗

PubMedDate not supplied

[Organizational and surgical-technical aspects of the service of abdominal hernioplasty].

The authors guided by the experience matured from 1/01/94 to 30/06/97 (435 abdominal hernioplasties performed, mainly inguinal and femoral) illustrate the organizational formalities and the technical aspects of a Hernia Surgery Service. In particular, they highlight the advantages of the routine use of local anaesthesia and of tension-free techniques, carried out on a day surgery rule (immediate rehabilitation, greater facilitation to elective surgery, access to the elderly at high anaesthetic risk). Eventually, they emphasize the remarkable reduction of sanitary costs and the outstanding social, practical and didactic value of such Hernia Centers.

Anesthesia, Local↗

PubMedDate not supplied

[Hernia repair with local anesthesia].

The authors report the results of their own personal experience with inguinal and femoral hernioplasties (424 cases) performed under loco-regional anaesthesia. This anaesthetic approach together with the use of prosthetic techniques (tension-free and suture-less) represent the "Gold Standard" in the surgical treatment of hernia. The absence of mortality, the remarkable reduction in terms of postoperative complications, days of hospitalization (one day surgery) represent outstanding advantages. The cooperation of the patient and the stress test at the end of the operation are further advantages of the proposed technique.

Adult↗

PubMedDate not supplied

Spontaneous rupture of a giant hemangioma of the liver.

Hemangiomas are frequent benign tumors of the liver. Symptoms (abdominal pain and fullness) are mostly seen in giant lesions. Rupture is the most severe complication, can occur spontaneously, with intraperitoneal bleeding, in 1-4% of hemangiomas and has been described in about 30 cases in the international literature with a high mortality (about 60%). This complication is the principal indication for surgery. Although spiral CAT scan and MR are actually the most efficacious imaging methods for study of liver hemangiomas, after Echography, emergency techniques that allows a simultaneous therapeutic approach--as is angiography--are preferable. Trans-arterial embolization (TAE) is in fact useful to stop bleeding and then to perform a safer surgery. A successful embolization can delay the surgical resection of the hemangioma for the time necessary to recover from the hemodynamic distress. Aside from the success of angiographic approach, surgery remains mandatory, effective in stopping the bleeding and in preventing re-bleeding or other complications of TAE such as abscess, fever, etc.. Intraoperative echography currently is the best method to identify vasculo- biliary anatomy and to perform a correct resection. The absence of risk factors for spontaneous rupture of liver hemangiomas, makes this event unpredictable. The best treatment for non-ruptured hemangiomas is still controversial but surgery is usually limited to symptomatic tumors larger than 10 cm.

Adult↗

PubMedDate not supplied

[Surgical treatment of bleeding peptic lesions: our experience].

The authors report their experience on surgical treatment of peptic bleeding lesions. From January 1994 till April 1999 they observed and surgically treated 35 patients (mean age 65) suffering from bleeding gastroduodenal ulcer. Complications linked to surgical treatment had an incidence of 17.5%, while those ones linked to the patient's general conditions of 21%; mortality was 20%. Surgery has been gradually substituted by endoscopy which represent the principal examination for diagnosis of bleeding gastroduodenal ulcer with the aid of different hemostatic techniques, so that surgery has been relegated to the last place in uncontrollable bleeding treatment. Observed results, following those ones of other authors, show the unfavourable prognosis linked to patient's different conditions when surgeon operates.

Adult↗

PubMedDate not supplied

[Ambulatory surgical treatment of primary hernia: our experience].

The authors report their personal experience (169 pz.) of the primary inguinal hernia repair in day surgery treated in local anaesthesia and by applying prosthesis according to latest "Tension-free and Suture-less" techniques. Results surely confirmed the validity of the method and the utility in creating centres concerning this type of surgery so that we are able to grant to the patient the best comfort that is to say a relevant reduction of the recurrence and a faster reintegration of patient's activities daily living.

Adult↗

PubMedDate not supplied

[Dual mesh-plus for wall reconstruction in incisional and umbilical hernia in the aged].

The article reports the author's experience about the use of Gore-Tex Dual Mesh Biomaterial in large incisional hernia operations in patients over seventy. From January 1996 at present day we operated on 23 patients for treatment of abdominal wall defect. In all patients we used a Dual Mesh. Overall mortality was O. Morbility was 9.5%. Follow-up is too short for definitive considerations about the incidence of recurrences but our initial experience with this material encourages us to use it again for replacement of abdominal wall defects especially in the old patient.

Age Factors↗

PubMedDate not supplied

[Surgical treatment of mucosal hemorrhoidal prolapse using a circular stapler].

We present a retrospective clinical study concerning our personal experience with the circular stapler in the treatment of hemorrhoids; the aim of this study was to evaluate the results of this surgical procedure, in terms of operative time, postoperative pain and rate of both short and long-term complications. Twenty-seven patients with grade 3 or 4 hemorrhoids, from January 1999 to June 2001, were included in the study. The main technical details of this procedure, requiring only a short learning period, are described and both short-term complications (such as severe postoperative pain, bleeding, urinary and fecal retention) and long-term ones (such as persistent or recurrent haemorrhoidal prolapse, anal stenosis) are analyzed. The reported results show that, in the presence of appropriate local anatomic conditions, this procedure is able to reduce the operative time, is almost painless and is characterized by low rate of complications.

Adult↗

PubMedDate not supplied

[Sentinel-node biopsy for breast cancer: our experience].

The method of sentinel lymphnode is a new procedure, suitable for the cases of early diagnosed breast cancers: identifying the first lymphatic station of the cancer, it can avoid the axillary lymphadenectomy in those women with primitive invasive and unifocal neoplasis of not more than 1.5 cm in diameter and without lymphnodal invasion. So it is reduced the frequency of postoperative troubles (sensitive and motor diseases, lymphedema). In our study, we have researched and identified, using radioactive isotopes, the sentinel lymphnode in 20 women suffering from subclinic breast cancer. We have obtained a percentage of 5% of false negatives. The optimal level of identification of the sentinel lymphnode and the good level of predictivity about the axillary lymphatic status, that we have obtained, represent a further confirmation of the surety and validity of this method.

Aged↗

PubMedDate not supplied

[Bleeding gastric lymphoma: report of two cases].

We report two cases of bleeding gastric lymphoma. The stomach is the most common site of primary extranodal Non-Hodgkins Lymphomas. The best treatment for primary gastric lymphoma has not yet been defined. For many years the treatment of choice has been the gastric resection. Helicobacter pylori (H. pylori) has been associated with many gastric pathologies, including gastric lymphoma. Eradication of H. pylori is now considered essential for the treatment of this pathology, and usually consists of antibiotic therapy, combined with acid suppression by a proton pump inhibitor. This simple treatment in patients with low grade histology and tumor confined to the stomach can often obviate the need for surgical intervention. Surgery is a necessary treatment, independently of the grading and the staging of lymphoma, in the bleeding complication as the cases we showed.

Aged↗

PubMedDate not supplied

[Day surgery for breast cancer in the elderly].

Early diagnosis of breast cancer and improvement of new technologies for identification and analysis of sentinel node allow more conservative surgical approaches, which guarantee both excellent local control and a good quality of life, also in elderly patients. We have studied a series of 28 women aged 70 years or older and affected by breast cancer. They underwent breast-preserving surgery either alone or in association with axillary lymphadenectomy and all of them had early discharge from hospital. This approach demonstrated to be safe and effective, so we may conclude that day-surgery treatment of breast cancer in these patients is possible in the majority of cases, is associated with low morbidity and is profitable for clinical, social and economic issues.

Aged↗

PubMedDate not supplied

[Inguinal hernioplasty with PHS: our experience].

Three hundred patients underwent inguinal hernia repair from January 2003 to December 2004; 40 patients, randomly selected, received the PHS (Prolene Hernia System) mesh. Surgery was performed under local anesthesia in 80% of cases and under spinal anesthesia in the remaining 20%. There were 29 men and 11 women; mean age was 58,5 years (range 39-78). Postoperative pain was light and morbidity was low; all patients had early return to normal activities. Particularly, there were differences between the self-employed and the employees: the former began work again 2-4 days after surgery in 85% of cases, while the latter began after 15-20 days. Immediate complications were rare and always minor: they included seroma (1%) and ecchymosis (1%). Follow-up examinations did not show any recurrences.

Adult↗

PubMedDate not supplied

[Solitary rectal ulcer (a case report)].

The solitary rectal ulcer is a rare disease localized not only in the rectum but in other colonic tracts. It more frequently appears in female, the age preferred by the disease is the one between twenties and thirties. The 68% of ulcers is localized in the anterior wall of rectum and her length varies from 4 to 15 cm. The S.R.U. is a benign chronic disease that does not pass the muscularis mucosae, originated by an alteration of the mechanism of defecation with a prolapse of mucosa. Nowadays the therapy must by addressed to treat the prolapse and not the ulcer. The Authors report a case recently observed and after a review of the literature, analyze anatomo-clinic, etiopathogenetic and therapeutic aspects of the disease.

Adenocarcinoma↗

PubMedDate not supplied

[Indications for surgical treatment of ulcerative rectocolitis].

The indications to surgical treatment of the ulcerative colitis (RCU) are a discuss argument to date, for etiopathogenetic uncertain still being. The problems of treatment are expressed by A.G. Parks and J.H. Pemberton very well, who said that "... Its treatment, both medical or surgical, is empirical", and "... The patients with chronic ulcerative colitis heal with proctocolectomy". From 1980 to 1992 we observed 65 cases of URC. 21 (32%) of these were treated by surgery. The indications to surgical treatment were: unsuccessful of medical therapy (14 cases), toxic megacolon (3 cases), severe dysplasia (2 cases), perforation (2 cases). We have submitted 5 patients to colectomy with ileostomy, 13 patients to colectomy with ileorecto-anastomosis and 3 to proctocolectomy with definitive ileostomy. Morbidity was 14.2% (anastomotic linkage, bronchopneumonia sepsis, wound sepsis). Mortality was 4.7% for a case of large bowel multiple perforations. The treatment of the URC is a difficult choice for surgeon, because he must decide the surgery timing. To different of the Crohn's disease, that is not heal with surgery, today URC allows more surgical aggressive attitude.

Adult↗

PubMedDate not supplied

[Desmoid tumors of the abdominal wall (clinical cases)].

The authors on the basis of three cases of desmoid tumors observed, examine the etiologic factors, clinical aspects and results of medical and surgical therapy. According with the date learnt from the latest literature authors propose a surgical therapy in first instance by a large excision with clear edges. This approach guarantees the most efficacious prophylaxis of recurrence.

Abdominal Muscles↗