PubMed Health⌕ Search

Biomedical subjects

Gabriele Valenti

Publications and source records attributed to Gabriele Valenti.

10 recordsLinked to original sources
PubMed2006

Vas deferens obstruction due to fibrosis after plug hernioplasty.

The positioning of mesh and plug is routinely performed in hernioplasty, but knowledge about the long-term side effects of plug-induced fibrosis on the vas is incomplete. This is the first case of a documented fibrotic vas deferens obstruction resulting from compression of the plug that was in direct contact with the vas. During subsequent repair for a recurrent hernia, the cord and the plug appeared enveloped in dense fibrous tissue. Microscopy confirmed gross surgical findings. To reduce this morbidity, we suggest a cremaster sparing surgery, avoiding the positioning of bioprosthesis in direct contact with the vas deferens. We also found that positioning of a flat mesh over the transversalis fascia will avoid the unnecessary contact between mesh and bare vas below the transversalis fascia.

Constriction, Pathologic↗
PubMed2006

Dynamic self-regulating prosthesis (protesi autoregolantesi dinamica): the long-term results in the treatment of primary inguinal hernias.

The dynamic self-regulating prosthesis (protesi autoregolantesi dinamica, PAD) is a double-layered prosthesi, in use since 1992 in inguinal hernia repair. In 1999, we published the short-term results on 500 patients and herein we report the long-term follow-up. Five hundred eighty-five PAD procedures were performed on 500 adult male, unselected patients. Hernias were unilateral in 415 patients, were bilateral in 85 patients, were direct in 197 patients (33.7%), were indirect in 269 patients (46.0%), and were combined in 119 patients (20.3%). Four hundred sixty-four patients were alive at the follow-up period of minimum 5 years, whereas 36 died (7.2%) of causes unrelated to the hernia. No information was available on 73 patients (14.6%). Therefore, the follow-up was consisted of 391 patients (78.2%) with 469 hernias. The recurrence and testicular atrophy rates were nil. Three patients (0.77%) presented chronic pain and 18 (4.6%) suffered persistent discomfort or paresthesia. A hydrocoele was observed in one patient (0.2%). The long-term data confirm the efficacy of the dynamic self-regulating posthesis hernioplasty. We propose it as a standard of care in all cases of primary inguinal hernia in adult males, retaining it as a definitive and comfortable solution.

Adult↗
PubMed2005

A case of massive gastric necrosis in a young girl with Rett Syndrome.

This is the unusual case of a 17-year-old girl affected by Rett Syndrome (RS) who suffered acute abdominal distension and constipation for a week. Laparotomy showed massive gastric dilatation, with total necrosis and perforation. Total gastrectomy and Y-Roux esophagojejunostomy were performed. We believe the clinical status was caused by the mechanism of air swallowing, present in our patient and typical in RS. In fact, as reported, massive air bloat may result in a decrease of the intramural blood flow with consequential ischemia of the gastric wall. We stress the importance of early detection of the gastroenterological symptoms in these patients, with timely positioning of nasogastric tube and gastrostomy, to prevent serious complications potentially life-threatening as massive gastric necrosis.

Adolescent↗
PubMed2005

The Marcy repair modified using cremaster muscle sparing. A new and effective method for performing prosthetic hernioplasty.

PURPOSE: The integrity of the internal inguinal ring (IIR) is essential to prevent the occurrence of indirect noncongenital inguinal hernia. Marcy first considered the importance of the IIR and proposed the use of annuloplasty to repair indirect primitive hernias. His procedure involved the resection of the cremaster muscle. We modified Marcy's annuloplasty by sparing the cremaster muscle and herein review our experience. METHODS: We retrospectively reviewed a group of 213 male adult patients who were treated with annuloplasty of IIR for sliding or large indirect hernias, which was performed under local anesthesia as day cases. The median follow-up was 4.7 years (range 2-7 years). RESULTS: There were no complications due to annuloplasty and the overall recurrence rate at follow-up was zero. CONCLUSION: In our hernioplasty we prefer an anterior approach to avoid contamination with prosthetic materials of the zone under the transversalis fascia. The transversalis fascia remains an important anatomical barrier and the cremaster a natural diaphragm between the mesh and funicular structures. We believe that annuloplasty is effective in all types of hernias where a sliding or large indirect hernia is observed.

Adult↗