Ultrasonographic findings of isolated torsion of the epididymis.
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Adolescent↗
Biomedical subjects
Giovanni Serafini
Publications and source records attributed to Giovanni Serafini.
Laparoscopic treatment of Morgagni-Larrey hernia: technical details and report of a series.
Three patients with Morgagni-Larrey hernia were admitted to the surgical department between August 2000 and September 2003 with slight chest pain and dyspnea. Laparoscopic repair of the diaphragmatic hernia was performed using a tension-free closure of the defects with either Vicryl-Prolene or dual facing mesh fixed by Prolene extracorporeal knots and Endostitch devices. The patients were discharged on postoperative day 5 without complications. Mean follow-up has been 23 months (range, 15-36 months) and no recurrence or morbidity related to the procedure has been seen. Laparoscopic repair of Morgagni-Larrey hernia represents an attractive alternative to open surgery. The benefits are gentle and easy manipulation of the content of the sac, reduced surgical trauma, and rapid and uneventful recovery.
Adult↗
Radiofrequency-assisted liver resection.
Radiofrequency (RF)-assisted thermal ablation has been used with increasing frequency for unresectable hepatic tumors. This new approach employs RF energy to coagulate the liver at the hepatic resection line after which hepatic resection is performed with the use of a common scalpel. This procedure was used in three patients with hepatocellular carcinoma and in five patients with colorectal metastasis to the liver. These eight patients underwent a total of two left bisegmentectomies, three segmentectomies, and seven wedge resections. Mean operative time was 220 minutes. A mean of 78 sessions of RF-assisted ablation were required for these resections. Mean blood loss was 46 ml; no device other than RF ablation was required to obtain hemostasis. None of the patients needed a blood transfusion. Preoperative hemoglobin was 12.8 gm/dl and postoperative hemoglobin was 11.3 gm/dl. There were no perioperative deaths. Postoperative complications occurred in two patients: a liver abscess in one and heart failure in the other. The mean hospital stay was 9.4 days. This new approach, integrated with other techniques, reduces blood loss and coagulates the margins of resection during liver surgery. This new technique has two limitations: (1) it cannot be applied near main portal pedicles, and (2) it requires a long operative time. The best indication for this technique is when segmentectomy is required in patients with cirrhosis. Its role in major hepatic resections has yet to be determined. Further progress in the development of thermal ablation techniques and experience gained during the learning curve should help reduce the operative time, thereby improving the safety and efficacy of this procedure.
Aged↗
Color Doppler US of the postoperative penis: anatomy and surgical complications.
A number of surgical procedures that significantly change the penile anatomy and vasculature can be used to manage pathologic conditions of the penis (eg, congenital and acquired deformities, erectile dysfunction, priapism). Phallic reconstruction surgery can be used for sex reassignment and after penile amputation or for correction of congenital malformations. Color Doppler ultrasonography (US) clearly depicts the normal penile anatomy and postoperative changes (eg, changes of the tunica albuginea, extraalbugineal pathologic fluid collections, cavernosal tissue changes produced by scars and fibrosis). It is also effective in evaluating surgery-related complications and determining the causes of erectile dysfunction and other unsatisfactory long-term results. Moreover, color Doppler US of the penile vessels and vascular anastomoses following revascularization allows direct evaluation of flow characteristics, shunt patency, and venous engorgement. Color Doppler US is the imaging modality of choice in evaluating patients who have undergone penile surgery.
Adult↗
Use of the sonographic contrast medium in the study of pelvic masses: preliminary remarks.
PURPOSE: To evaluate the role of intravenously injected sonographic contrast medium (CM) in characterising space-occupying pelvic lesions. MATERIALS AND METHODS: Forty-seven women with palpable pelvic mass underwent color Doppler US before and after the intravenous injection of an ultrasound CM. The examination results were divided into three categories: Class I = no additional diagnostic information supplied by the contrast-enhanced examination; Class II = the use of CM facilitated the identification of vascular structures but did not significantly affect the diagnosis or the patient's subsequent diagnostic/therapeutic procedures; Class III = the information obtained significantly affected treatment decisions regarding the single patients. RESULTS: After the CM injection, 9/47 (19.1%) cases were assigned to Class I, 25/47 (53.2%) to Class II, and 13/47 (27.7%) to Class III. At baseline, all 13 lesions later assigned to Class III had shown an avascular appearance or only peripheral vascularisation. This type of vascular distribution was confirmed by the contrast-enhanced study, which helped determine the haemorrhagic nature (with solid appearance) of some lesions, or support the hypothesis put forward during the baseline study, that the lesion was a poorly vascularised benign mass. This lent further support to our choice to undertake a laparoscopic surgical approach in 2 lesions, it altered our decision as to the type of surgery to be performed (laparoscopy vs. laparotomy) in 5 patients, and confirmed our intention to undertake only the follow-up in the 6 remaining cases. CONCLUSIONS: The use of the sonographic CM proved clinically useful in 13/47 patients with space-occupying pelvic lesions. The most important result of this examination was its ability to confirm the nonvascular or poorly vascular component of a lesion, and therefore to suggest its benign nature.
Adult↗