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Biomedical subjects

L Belli

Publications and source records attributed to L Belli.

118 records · Page 7Linked to original sources
PubMedDate not supplied

Thromboendarterectomy (TEA) in the recipient as a major risk of arterial complication after kidney transplantation.

The authors analyze a series of 383 kidney transplantation pointing out the role of recipient's vessels atherosclerosis in the determination of vascular complication of the kidney graft. Three groups were considered. The first included 55 patients which required TEA for severe atherosclerotic lesion of the anastomosed vessels. The second group included 305 patients who didn't required TEA; the third group was of 20 patients who received a graft with multiple arteries which required more than one anastomosis. A significative higher rate of arterial complications was evident in the first group (p less than 0.001). Within this group the end to end arterial anastomosis was more frequently associated to thrombosis or stenosis than the end to side one (p less than 0.05). Kidney with multiple vessels also presented with an higher rate of complications (p less than 0.05).

Adult↗
PubMedDate not supplied

Associated aneurysms of celiac axis, infrarenal aorta and right common iliac artery. (Report of a successful operated case).

A successful operated case of associated aneurysms of celiac axis, infrarenal aorta and right common iliac artery is reported. The hepatic artery was reanastomosed with the splanchnic artery after aneurysmectomy; the other two aneurysms were treated with resection and aorto-iliac by-pass. The unfrequent association of this type of arterial lesions is stressed. A brief world's literature review is also reported.

Aneurysm↗
PubMedDate not supplied

A critical re-appraisal of lymph-venous shunt in the management of massive ascites.

Lymph-venous shunt is one of most investigated procedures in the management of intractable ascites. However, there is considerable variation in the reported results. Personal experience with twenty-one operated cases reveals a dubious role for this intervention. Frequent anatomical variations and uncertain role and incidence of duct-end stenosis, in our opinion, reduces the efficacy of the procedure.

Adult↗
PubMedDate not supplied

Splenic artery aneurysms in portal hypertension.

In a group of 170 cirrhotic patients with portal hypertension an 8.8% incidence of splenic artery aneurysm was found. These patients have been analysed. Attention was focused on the possible pathogenic mechanisms. On the basis of our experience, ligature and resection is considered the best treatment for large aneurysms. In nine patients a small sized aneurysm was left in situ in order to avoid splenectomy; none of these patients developed aneurysm rupture during a follow-up period from 6 to 48 months.

Adult↗
PubMedDate not supplied

Extrahepatic portal obstruction: Clinical experience and surgical treatment in 105 patients.

While the whole incidence of portal thrombosis is, in our experience, similar to other literature reports, there is evidence, in the last years, of an increase of idiopathic adult onset and post-cirrhotic versus childhood onset extrahepatic portal obstruction. One hundred five patients, or 24.6% of a 426 total series of patients operated upon for portal hypertension, suffered from an extra-hepatic block (52.4% pre-hepatic, and 47.6 mixed post-cirrhotic obstruction). The total series of patients were classified according to portal involvement degree: 47.6% had portal, 46.7% massive porto-radicular and 5.8% radicular obstruction. Physiopathologic differences were found among patients with acute, recanalized, or recurrent thrombosis. The clinical picture in massive or post-cirrhotic block was generally more severe, due to repeated massive and lifethreating digestive hemorrhages. The width of portal tree involvement proportionally affects the possibility of surgical management, with particular regard to shunting procedures, which, in our experience, seem to be much more effective than disconnecting operations, in avoiding bleeding recurrences and warranting a better long term survival.

Adolescent↗
PubMedDate not supplied

Left thoracic approach for cancer of cardia: early and late results.

BACKGROUND: The surgical treatment of cancer of the cardia is controversial and results are often disappointing. Concern exists not only with regards to the surgical approach but also to the extent of the resection. The authors analyze their experience over a 20-year period adopting almost exclusively a "limited" esophagogastrectomy with a wide regional lymphadenectomy through a left thoracotomy. The aim of the study is to determine if this approach actually plays a role in the treatment of this tumor. METHODS: 148 patients were evaluated for cardial cancer. Of these 22 (14.8%) were not resectable and 6 (4%) received other types of resections for technical reasons. 120 patients are the basis of the present analysis. More than 75% of patients were in stage III or IV. Follow-up was completed in 92.5% of cases; all surviving patients had at least 5 years of follow-up. RESULTS: Four (3.3%) patients died in the postoperative period. In 6 cases (5%) an anastomotic leakage occurred and this caused the death of 2 patients. Nine (7.5%) patients had severe pulmonary complications. Dysphagia was relieved in all non complicated patients. 13 (10.8%) patients had anastomotic recurrence. Overall survival rate after 5 years was 25.62 +/- 6.1%. A significant difference in survival was noted in patients at stages II and III after 5 years (61.3% vs 18.6, p < 0.02). CONCLUSIONS: This operation has proved to be a good option providing satisfying long-term results and a lower incidence of complications if compared with more extended procedures. It can be performed in the majority of patients with carcinoma of the cardia with a low mortality and morbidity and with excellent palliation of dysphagia. In our opinion it remains an optimum treatment for cardial cancer.

Adenocarcinoma↗
PubMedDate not supplied

[Magnetic resonance angiography with TOF-TONE tridimensional sequences in the study of steno-occlusive diseases of the renal arteries. Comparison with digital angiography].

The authors examined 32 patients (68 renal arteries in all) with suspected renovascular hypertension with MRA (3D TOF-TONE sequences) and DSA. MRA visualization of the renal vessels was considered good in 96.8%, 91.6%, 76.6% and 16.6% of cases for the ostium, the proximal third, the distal third and the hilum, respectively. MRA correctly assessed the 4 occlusions in our series and 19/20 atherosclerotic stenoses, all in proximal site. In proximal stenosis detection, MRA had 100% sensitivity and 98% specificity in atherosclerotic sclerosis-occlusion grading considering a 50% caliber reduction as the cut-off value. The two techniques were in agreement in 68% of cases; MRA overestimated stenosis grade in 25% of cases. The 3D TOF-TONE sequence is a reliable diagnostic tool in the study of the proximal tract of the renal arteries, but its major limitation remains in distal tract studies. Nevertheless, this technique has elective indications in a selected group of patients, namely the elderly with hypertension and impaired renal function.

Adolescent↗