Hemorrhoids and hemorrhoidectomies.
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Digestive System Surgical Procedures↗
Biomedical subjects
Ignazio Massimo Civello
Publications and source records attributed to Ignazio Massimo Civello.
Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study.
OBJECTIVES: To evaluate the therapeutic role of botulinum toxin injection in men with benign prostatic hyperplasia. METHODS: Men with benign prostatic hyperplasia were enrolled in a randomized, placebo-controlled study. After a baseline evaluation, each participant received 4 mL of solution injected into the prostate gland. Patients in the control group received saline solution and patients in the treated group received 200 U of botulinum toxin A. The outcome of each group was evaluated by comparing the symptom scores, serum prostate-specific antigen concentration, prostate volume, postvoid residual urine volume, and peak urinary flow rates. RESULTS: Thirty consecutive patients were enrolled. No local complications or systemic side effects were observed in any patient. After 2 months, 13 patients in the treated group and 3 in the control group had subjective symptomatic relief (P = 0.0007). In patients who received botulinum toxin, the symptom score was reduced by 65% compared with baseline values and the serum prostate-specific antigen concentration by 51% from baseline. In patients who received saline, the symptom score and serum prostate-specific antigen concentration were not significantly changed compared with the baseline values and 1-month values. Follow-up averaged 19.6 +/- 3.8 months. CONCLUSIONS: Botulinum toxin injected into the prostate seems to be a promising approach for the treatment of benign prostatic hyperplasia. It is safe, effective, and well-tolerated. Furthermore, it is not related to the patient's willingness to complete treatment.
Aged↗
Safety of botulinum neurotoxin treatment in patients with chronic anal fissure.
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Adult↗
Tension-free inguinal hernia repair in "one-day surgery". Experience of 1091 cases.
BACKGROUND/AIMS: In recent years new techniques to repair inguinal hernia have evolved in order to reduce recurrence rate and the overall costs of treatment of this pathology. This paper analyses our experience in verifying the theoretical advantages of the "tension-free" technique, after six years of this surgical practice. METHODOLOGY: We describe the experience of 1091 "tension-free" hernia repairs with open placement of a mesh in 1034 patients, under local anesthesia with a "one-day surgery" regimen; these patients were observed during the period 1994 to 1999 at the Surgical Unit of Catholic University of Rome. The patients were between American Society of Anesthesia Status I to IV. Eight hundred patients underwent a mean follow-up of 29.7 months (range: 4-72) to evaluate the occurrence of late complications and recurrences. RESULTS: No mortality or major intraoperative complications was observed. The only minor intraoperative or postoperative complications encountered were easily managed. Early pain disappearance, fast convalescence and rapid resumption of working activity were observed. Six recurrences occurred in the patients undergoing follow-up (0.75% recurrence rate). CONCLUSIONS: Our data confirm the safety, rapidity, and reproducibility of the "tension-free" technique under local anesthesia performed with a "one-day surgery" regimen for inguinal hernia repair. These characteristics explain the diffusion of this surgical procedure with reduction of social costs.
Adolescent↗
[Treatment of pancreatic necrosis and secondary pancreatic infections].
Acute pancreatitis is a disease capable of the widest clinical expression, ranging from mild discomfort to multiorgan failure and death. Moreover, the process may remain localized in the pancreas, or spread to regional tissues, or even involve remote organs. Despite several efforts, the pathophysiology of acute pancreatitis and its complications remains obscure. In the absence of an understanding of the pathogenesis and the reasons for the variations in severity, the study and management of acute pancreatitis has necessarily been empirical. There is little doubt that the development of pancreatic necrosis in patients with acute pancreatitis results in an increase in clinical severity and an escalation of the mortality risk when compared to interstitial pancreatitis. Furthermore, the mortality risk of patients with sterile pancreatic necrosis is markedly different from that of patients developing secondary infections in pre-existing pancreatic necrosis. Infected pancreatic necrosis is uniformly fatal, if untreated. While most authorities agree that surgical debridement is required for survival in patients with secondary pancreatic infections, the precise form of the subsequent drainage has become a matter of some controversy. In this paper we discuss the most recent insights relating to the nosographical classification of pancreatic necrosis and secondary pancreatic infections, along with an analysis of the findings in the literature regarding the surgical treatment of these conditions.
Abscess↗
Laparoscopic fenestration of symptomatic non-parasitic cysts of the liver.
BACKGROUND/AIMS: The use of laparoscopic technique for management of symptomatic liver cysts is documented to be a feasible and safe procedure with proved symptomatic relief. In the present study, we reviewed the results of this approach in the management of symptomatic liver cysts. METHODOLOGY: Retrospective review of all patients with symptomatic liver cysts that were treated by laparoscopic fenestration in our department over a 3-year period from 1999 to 2001. RESULTS: Ten patients were treated using a laparoscopic approach. All patients achieved short-term alleviation of symptoms and an uneventful postoperative course. The mean hospital stay was 3 days. Long-term follow-up (24 months) was available for all the patients. In all the patients, there was no clinical and radiographical recurrence. CONCLUSIONS: The present study confirms that relief of symptoms can be achieved with the laparoscopic approach for non-parasitic liver cysts. Omental packing is not necessary to prevent recurrence of simple hepatic cysts.
Aged↗