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Biomedical subjects

L Cangiotti

Publications and source records attributed to L Cangiotti.

15 recordsLinked to original sources
PubMed1999

A mini-invasive technique for axillary lymphadenectomy in early breast cancer: a study of 15 patients.

Axillary lymphadenectomy is the major cause of morbidity reported in breast surgery, but remains the gold standard in breast cancer staging procedures. The aim of this study was to evaluate if endoscopic lymphadenectomy, preceded by fat suction, could reduce morbidity and hospitalization, giving better aesthetic results, while conserving the same oncologic radicality as the traditional open technique. We studied 15 cases of breast cancer with tumour diameter < or = 25 mm, N0. The subjects underwent endoscopic lymphadenectomy. We removed an average of 15.5 node/patient, the volume of lymphorrea was 580 ml, the drainage was kept up for 5 days, the mean length of hospitalization was 6 days. One seroma (4.6%) was found. No shoulder restriction has been reported and aesthetic results were excellent. The follow-up will demonstrate if this technique can reduce the incidence of lymphoedema.

Adult↗
PubMed1996

Temporary axillo-femoral bypass graft for renal transplant protection during aortic aneurysm repair.

Aortic surgery in renal transplant recipients requires a method of maintaining intraoperative graft perfusion. Here we present a case in which temporary axillo-femoral bypass was used to perfuse a renal transplant during the aortic aneurysm repair; the rationale of inserting the temporary axillo-femoral bypass on transverse arteriotomies is pointed out. Other methods of renal graft perfusion are discussed.

Aortic Aneurysm, Abdominal↗
PubMed1995

Surgery for obstructive lesions of the main trunk of the renal artery. A review of the literature and personal experience of 41 operated patients.

Today, surgical revascularization of the renal artery seems to maintain interest in the therapy of renovascular hypertension and chronic ischemic nephropathy because both medical therapy and angioplasty show limits and inconveniences. The authors present here their experience of 45 revascularized renal arteries in 41 patients and they discuss early and late morphological and functional results related to isolated arterial renal pathology (Group 1 of 23 patients) and associated to aorto-iliac pathology (Group 2 of 18 patients). Mortality related to arterial renal reconstruction was nil. There were 3/45 arteries (6.6%) with early thromboses and 4/32 (9.3%) with late thromboses. Early functional results, with respect to renovascular hypertension and/or chronic ischaemic renal insufficiency, showed 16/41 (39%) healed patients, 16/41 (39%) improved patients and 9/41 (22%) unvariated patients. Late results among 28 observed patients (average follow up at 49 months, range from 18 to 144 months) showed 14/28 (50%) healed patients, 11/28 (39%) improved patients and 3/28 (11%) unvariated patients. Results of the Group I were significantly better than results of Group 2 with regards to healed patients (p < 0.01) but not summarizing healed and improved cases. These data have been discussed in comparison with the Literature review of 46 references.

Adult↗
PubMed1994

Unusual localizations of hydatid disease: a 18 year experience.

The Authors report their experience with rare localizations of hydatid cysts during a period of 18 years. In 8 patients (14%) other organs than liver or lungs were involved: in particular one case of hydatid cyst of the spleen, one of the pancreatic area and one of the soft tissue of the back presented as primary locations. In 5 patients the disease of the liver was associated to hydatid cysts in other sites: 3 multiple peritoneal localizations, one in the abdominal rectus muscle and one of the gallbladder. Four cases (10% of the patients with liver disease) of cyst ruptures in the biliary tree were reported. In all cases differential diagnosis was more challenging than usual, but imaging devices combined with immunobiological tests could solve the diagnostic problem. Surgical treatment was as radical as possible considering the benign character of the disease. Postoperative results were satisfying: no recurrence but one was found at follow up.

Adolescent↗
PubMed1994

Superior mesenteric artery emboli during renal PTA: successful surgical treatment after fibrinolysis failure.

The paper presents a rare case of iatrogenic embolization of the superior mesenteric artery which required an emergency operation after an unsuccessful fibrinolytic treatment. An old woman, who had undergone renal percutaneous angioplasty (r-PTA), presented sudden but transient abdominal pain. Angiographic control of the angioplasty showed the goal of r-PTA but also an embolic occlusion of the main trunk of the superior mesenteric artery that did not respond to a selective fibrinolytic treatment. Within a few hours, the abdominal pain appeared again and induced an exploratory laparotomy which showed an extensive ischaemia of the whole jejunum. A successful embolectomy was performed associated with the resection of about 20 cm of necrotic jejunum. The postoperative period was uncomplicated. The case underlines several topics: close collaboration is necessary between interventional radiologists and surgeons in order to get a surgical "stand-by" during PTA procedures; the embolic occlusion of the superior mesenteric artery can produce irreversible, even if segmentary intestinal damage, also within a very short time after onset and, therefore, it seems to be at high risk for a fibrinolytic approach.

Aged↗
PubMed1991

Hydatid disease of the liver: long term results of surgical treatment.

Many surgical techniques have been used in the management of the hydatid disease of the liver. The aim of the treatment should be to minimize the high risks of complication and recurrence. The Authors reviewed the records of 33 consecutive cases of hydatid disease of the liver surgically treated during a 6 year period (1974-1979) to determine complications and long term results (10 years) of the different surgical procedures applied. Partial pericystectomy with tube drainage was the most common treatment (30/49 cysts) followed by total pericystectomy (15/49) and partial liver resection (4 cases). Complication rates were 13.3%, 6.6% and 0% respectively. There was no perioperative mortality. In 1989 all patients were investigated for cystic recurrence: it was possible to study by CT scan or abdominal US 23 patients. Only three of them showed an asymptomatic recurrent disease. They had undergone partial pericystectomy in 1974 (2 cases) and 1977 (1 case) for recurrent hydatid disease of the right hepatic lobe and, in one case, even of the rectus muscle. Complication and recurrence rates seem to be higher with conservative surgical procedures compared to more radical treatment, but indiscriminate application of total pericystectomy or major liver resection may be followed by a higher incidence of major postoperative complications and mortality. Therefore, total pericystectomy or wedge resection were performed only for peripheral cysts since we believe liver resection for hydatid cyst is a very radical approach taking into account the type of disease.

Adolescent↗
PubMed1977

[An unusual case of perforation of Meckel's diverticulum].

An infrequent case of puncture of Meckel's diverticulum whose aetiopathogenesis was attributed to a segmentary intestinal dyskinetic phenomenon is reported. The pneumoperitoneum consequent on the puncture was not associated with peritonitis and histology showed that the diverticulum did not show either inflammatory phenomena or areas of ectopic mucosa, namely none of the causes which are usually at the origin of Meckel's diverticulum puncture.

Child↗
PubMedDate not supplied

Surgical treatment of lesions obstructing the external carotid artery.

Atherosclerotic lesions obstructing the external carotid artery are generally disregarded in the evaluation of patients with symptoms of cerebral ischemia; nevertheless, in the presence of occlusion of the ipsilateral or of both the internal carotid arteries, external carotid artery endarterectomy may be indicated, in order to increase the flow to the brain through collaterals. A lesion of the external carotid artery may be the source of retinal emboli; patients may benefit from surgical treatment of the lesion. The Authors of the present paper operated on 6 such patients, from a total of 230 carotid bifurcation endarterectomies performed in the period between January 1982 and March 1988. Morbidity and mortality were nil and 5 of the 6 patients are free of symptoms after a mean follow-up period of 23 months. One patient died 2 months after surgery due to a myocardial infarction. On the basis of this experience, the Authors discuss indications, surgical techniques and results of the surgical treatment of lesions obstructing the external carotid artery.

Aged↗
PubMedDate not supplied

Factors affecting prognosis in acute intestinal ischemia.

The anamnestic, clinical, laboratory, radiological and intraoperative data on 34 consecutive patients affected by acute intestinal ischemia or infarction, caused by superior mesenteric obstructive and nonocclusive pathology were collected and assessed. The aim of this study is the identification of the factors influencing the prognosis which in this disease is still really displeasing, with a mortality of over 90% in many surveys, and 73.5% in this report. The mean age of the 34 patients was 73. Cardiac ischemic disease and or arrhythmias were present in 83.8% of the patients. The most significant prognostic factors were those related to the evolutive stages of the intestinal ischemia. Among the anamnestic ones, the interval between the onset of the symptoms and diagnosis (mortality of 50% if less than or equal to 24 hrs., 86.4% if greater than 24 hrs.). Among the clinical factors, the presence of peritoneal signs was followed by a mortality of 82.3%, in contrast with the 33.3% when the same signs were absent. Also significant was the presence of shock (100% mortality), in contrast with 50% in patients presenting systemic systolic pressure greater than 100 mmHg. Extensive intestinal infarction caused a 100% mortality rate, while early revascularization allowed the survival of 81.8% of the patients treated in the absence of infarction or when irreversible ischemic damage was limited to less than 1 meter of bowel.

Acute Disease↗
PubMedDate not supplied

[Indications and short and medium time results of crossover bypasses in the treatment of obstructive arteriopathies of the lower limbs].

The authors evaluate the indications, the hemodynamical aspects, the short and medium term results over their track record of 49 crossover bypass (44 dacron and 5 PTFE grafts) performed between 1981 and 1993. Crossover bypass grafts were mainly inserted for unilateral iliac arterial disease in order to avoid aortic manipulation. This procedure was particularly selected when in presence of: young patients (< 60 years old), high surgical risk, poor run-off, high risk of prosthetic infection, thrombosis and/or infection of orthotopic grafts. 3 ilio-iliac, 27 iliofemoral, 18 femorofemoral and 1 femoropopliteal bypass have been performed. The postoperative resting pressure Index increase was highly significant in recipient limbs. There wasn't perioperative mortality; during the follow up (mean 24.4 months) no amputation of recipient limb was observed. 4 patients died of A.M.I. and 1 of neoplastic disease. Late cumulative patency rate was 81% at 2 years and 67.3% at 3 years. These values rise to 97.2% and 86.1% respectively when considering patients with "ideal" indication (excluding 7 patients operated on for complications of previous bypass grafts and 6 with extremely poor run-off). An accurate evaluation of the lesion topography and haemodynamic pattern of donor and recipient iliofemoral districts are stressed as key points for a correct surgical indication.

Adult↗