Biomedical subjects

Giuseppe Di Lauro

Publications and source records attributed to Giuseppe Di Lauro.

3 recordsLinked to original sources

PubMedDate not supplied

Difficult cholecystectomies: validity of the laparoscopic approach.

OBJECTIVES: The aim of this work was to determine the outcome of "difficult cholecystectomy" caused by acute cholecystitis or cirrhosis, in relation to the number of conversions, principal biliary duct injuries, the length of the operation, and of postoperative hospitalization. METHODS: From 1998 through 2000, 51 patients, 38 females and 13 males, underwent cholecystectomy for acute cholecystitis and cholecystitis associated with liver cirrhosis; the average age was 58.8 years (range, 24 to 86 years). No preoperative selection was made for video laparoscopic treatment. An open laparoscopy was performed in all cases. RESULTS: All interventions were completed by video laparoscopy. No injury of the major bile ducts occurred in the 51 cases. The average time of operation was 110 minutes. The average length of hospitalization was 3 days. CONCLUSION: This study demonstrates that the results after "difficult laparoscopic cholecystectomy" are comparable to those after "open cholecystectomy." Difficult cholecystectomy executed with video laparoscopic methodology is safe and effective if performed with appropriate equipment and by experienced surgeons.

Adult↗

PubMedDate not supplied

Indications for the laparoscopic treatment of gastroesophageal reflux disease.

BACKGROUND: The aim of the study was to evaluate the indications and surgical techniques for the treatment of gastroesophageal reflux disease. METHODS: From 1998 through 2000, we performed gastroesophageal reflux surgery on 12 patients. Preoperative studies revealed third-degree esophagitis in most patients with no functional alterations of the esophagus itself. The patients underwent a laparoscopic Nissen-Rossetti fundoplication. No conversions to open laparotomy were necessary. The mean operative time was 180 minutes. RESULTS: No intraoperative or immediate postoperative complications occurred. The mean postoperative stay was 6.2 days. Transitory postoperative dysphagia was noted in 8 patients. In 5 patients, it was mild and regressed after 2 weeks; in 3 cases, it was severe and regressed over 2 months. CONCLUSION: A laparoscopic surgical approach is a satisfactory method for correcting gastroesophageal reflux disease. The efficacy of medical therapy has been well established. However, in the young person who may be required to take medication for many years or in those persons who are intolerant of standard medical therapy for gastroesophageal reflux disease, a surgical intervention is a satisfactory option. The success of medical therapy can be used as a predictive criterion of the success of laparoscopic Nissen-Rosetti fundoplication when normal motility of the esophageal corpus is present.

Aged↗

PubMedDate not supplied

Elective laparoscopic-assisted colectomy for sigmoid diverticulitis.

OBJECTIVES: The aim of this study was to evaluate the safety and effectiveness of laparoscopic-assisted sigmoid colectomy for diverticulitis and to assess its postoperative advantages. METHODS: From 1999 to 2001, 5 patients were selectively operated on with a laparoscopic-assisted procedure for uncomplicated sigmoid diverticulitis. In the preceding period (September 1997 through December 1998), 4 patients underwent open procedures for the same pathology. The surgical indication with the same criteria was restrictive: at least 2 acute episodes had occurred that were treated with hospital admission and that were separated by an adequate period (2 months) of medical therapy. RESULTS: No conversions of laparoscopy to an open procedure were necessary. Age, sex, weight, morbidity, and mortality were similar between the 2 groups. Operative time was 180 minutes for laparoscopy and 120 minutes for laparotomy. Postoperative resumption of peristalsis was 24 hours versus 4 days, resumption of alimentation was on the second postoperative day versus the fifth postoperative day, and hospital stay was 7 days versus 12 days for laparoscopy and laparotomy, respectively. CONCLUSION: This study shows the feasibility and the advantages of elective laparoscopic-assisted colonic resection for uncomplicated sigmoid diverticulitis. The advantages of the laparoscopic approach are the lower need for analgesics and the more precocious ambulation, canalization, resumption of alimentation, and the shorter hospital stay.

Adult↗