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Biomedical subjects

L Ferri

Publications and source records attributed to L Ferri.

44 records · Page 3Linked to original sources
PubMedDate not supplied

[Acidosis, hypoxia and hypotension in abdominal chemotherapy with blockade of arterial and venous circulation (stop flow)].

BACKGROUND AND AIM: A study was performed of the perioperative systemic effects of a recent zoned chemotherapy technique administered in conditions of extreme acidosis, hypoxia and modern hypotension. METHODS EXPERIMENTAL DESIGN: a prospective analysis of the changes compared to basal values using Student's t test for paired data. SETTING: Operating theatres and Recovery room. PATIENTS OR PARTICIPANTS: A population of 16 consenting patients suffering from abdominal or pelvic neoplasms, ASA 1-3, recruited according to the parameters suggested by the international literature. SURGERY: central venous catheter, radial arterial catheter, open catheter of the e.v. femoral artery, general anesthesia using isoflurane. Tests performed: Blood gas analysis of systemic arteries, abdominal veins and the superior vena cava at times preceding clamping (T0) and 7 and 14 mins after the start, at declamping, on reawakening from anesthesia and 30 and 60 mins afterwards (T1, T2, T3, T4, T5, T6). Serial evaluation of activated coagulation time. RESULTS: Mean 25% reduction of neoplastic mass, systemic arterial and venous pH diminished at T1 and T2, but more marked and transient at T3; district venous pH significantly diminished during entire Stop-Flow. Systemic PaO2 increased throughout method (SaO2 > 98%). PaO2 in the superior vena cava recorded significantly higher intraoperative values compared to basal and postoperative levels, no major differences found at time T3. SaO2 showed statistically significant differences between the superior vena cava and the abdominal distrist at both T 1 (p 0.0002) and T2 (p 0.004). No toxic effects due to NPS were observed. CONCLUSIONS: This is a safe technique but not without risks, which requires considerable anesthesiological commitment.

Abdominal Neoplasms↗
PubMedDate not supplied

Bilateral concurrent massive hemoptysis successfully controlled with double endobronchial tamponade. A case report.

Massive hemoptysis is a potentially lethal situation for which emergency diagnosis and treatment are necessary. Endobronchial tamponade is widely used as a method for conservative management of massive hemoptysis by occluding the bleeding bronchus with a balloon catheter. Some balloon catheters can be introduced through the inner channel of a flexible bronchoscope. The main challenge in performing this procedure is how to remove the bronchoscope without displacing the catheter. Another technique is to place a catheter next to the fiberoptic bronchoscope and then advance the catheter to the hemorrhaging bronchial division. An advantage of this ''parallel technique'' is that the working channel is available for suction, lavage and for a biopsy forceps, that can be used to facilitate the positioning of the catheter. We used this technique to perform bilateral endobronchial tamponade with two 5 Fr Swan-Ganz catheters. This case shows that bilateral concurrent massive hemoptysis can be successfully controlled with the placement of more than one balloon catheter. This is a rare event and in the literature we found only one reference. The procedure was relatively easy to perform and well tolerated by the patient. In our opinion, this technique should be considered as a viable option in the treatment of massive hemoptysis especially in hospitals or patients where other treatments are impossible or contraindicated.

Balloon Occlusion↗
PubMedDate not supplied

Ten years experience in the treatment of pseudomyxoma peritonei by cytoreduction, peritonectomy and semi-closed hyperthermic antiblastic peritoneal perfusion.

BACKGROUND: In the literature good results have been reported for the treatment of Pseudomyxoma peritonei (PMP) by cytoreduction, peritonectomy and hyperthermic antiblastic peritoneal perfusion (H.A.P.P.). Forty-eight patients affected by PMP have been treated with this technique over the past ten years. PATIENTS AND METHODS: Peritoneal perfusion has been performed with the original semiclosed tecnique after complete surgical cytoreduction in 188 patients affected by peritoneal carcinomatosis. In 48 of the cases the patients were affected from PMP. Aggressive surgical cytoreduction was performed with multiple visceral resections and peritonectomies. RESULTS: Seventeen patients (38%) presented major perioperative complications, and in five cases the reoperation of the patient was required. In spite of this high complication rate, there was no perioperative mortality. The results of the Kaplan-Meier 5- and 10-year survival analysis, were 94% and 82%, respectively, with a disease-free survival of 80% at 5 years and 70% at 10 years. Thirty-nine patients (81.2%) had no evidence of disease at follow-up (range 1-120 months). DISCUSSION: Up to date, the most effective treatment for PMP has been aggressive cytoreduction plus H.A.P.P.

Adult↗