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Biomedical subjects

M Bartolotta

Publications and source records attributed to M Bartolotta.

At least 19 recordsLinked to original sources
PubMed2006

Palliative antecolic isoperistaltic gastrojejunostomy: a randomized controlled trial comparing open and laparoscopic approaches.

Gastric outlet obstruction is a common, often preterminal, event for patients with inoperable neoplasms of the distal stomach, duodenum, and biliopancreatic area. It can be surgically managed by open or laparoscopic gastrojejunostomy. This study aimed to compare the results of open and laparoscopic palliative gastrojejunostomy for patients with gastric outlet obstruction resulting from inoperable neoplasms. A total of 24 patients were randomized prospectively to undergo laparoscopic (12 patients) or open (12 patients) palliative laterolateral antecolic isoperistaltic gastrojejunostomy. All the procedures were completed as planned. The mean duration of surgery was not significantly different between the two groups (p = 0.75). The mean intraoperative blood loss was significantly less after laparoscopic gastrojejunostomy (LGJ) (p = 0.0001). Time to oral solid food intake was longer after open gastrojejunostomy (OGJ) (p = 0.04). Two patients in the OGJ group experienced postoperative delayed gastric empting, whereas no patients in the LGJ group experienced such a complication (p = 0.04). The mean postoperative stay was shorter in the LGJ group, but the difference did not reach statistical significance (p = 0.65). No readmissions were registered after a minimum follow-up period of 2 months. The findings show that LGJ is a safe, feasible, and effective alternative to OGJ. However, because the current data involved only a small number of patients, large studies still are required for further evaluation of the this operation's effectiveness.

Aged↗
PubMed2000

Simple versus double jejunal pouch for reconstruction after total gastrectomy.

BACKGROUND: Even though many types of reconstruction after total gastrectomy have been proposed to reduce postgastrectomy syndromes, choosing a method that would further improve the quality of life and nutrition of the gastrectomized patient is controversial. Hunt-Lawrence single pouch reconstruction seems to obtain better results compared with the more common Roux-en-Y technique, but both of these reconstructive approaches are associated with some reduction in food intake and some problems in achievement of ideal body weight. METHODS: In this prospective, randomized trial, after total gastrectomy 18 patients had reconstruction according to the Hunt-Lawrence or single pouch technique (SP group), whereas for 23 patients, the technique was modified with construction of a second pouch in the distal portion of the jejunal loop (DP group). Patients in the two groups were compared at 12 months after surgery for problems in gastrointestinal function, quality of life, improvement in body weight and nutritional parameters, serum albumin, hemoglobin level, and serum protein. RESULTS: The DP group demonstrated fewer symptom problems, better weight maintenance, and better laboratory values when compared with patients undergoing standard single jejunal pouch reconstruction. CONCLUSIONS: Reconstruction with use of a double pouch as a gastric substitute leads to better outcome assessments than with a single pouch reconstruction. Our double pouch technique has demonstrated significant improvement in quality of life and nutritional recovery in terms of functional results as well as patient satisfaction.

Aged↗
PubMed1989

[Current facts on ulcer disease].

In the second half of this century, some important changes characterized the peptic ulcer history. The overall incidence of ulcer disease markedly decreased, with some differences in the various geographic areas and according to socioeconomic development of population. Peptic ulcer seems now more frequent in women and in the elderly patients, in comparison with the past. The appearance of H2-Receptor Antagonists determined a decline of ulcer surgery, because the ulcer is become a medical disease. Pyloric stenosis also, after ten years of H2-Receptor Antagonists treatment, markedly decreased. Indeed, the problem of acute complications is still actual. The detailed analysis of patients hospitalized, shows significative decrease of acute complications in patients with chronic ulcer and a marked anamnestics. The efficacy of medical treatment in the control of acute ulcer complications, seems to be balanced with new etiopathogenetic factors, which are able to start the appearance of acute complications of the disease (increased assumption of ulcerogenic drugs; smoke and alcohol abuse; increased socio-politic engagement of women and improved resuscitations technics).

Histamine H2 Antagonists↗
PubMed1987

[Development of suture materials: from the beginning to our day].

The history of suture materials from the beginnings to the II World War is reported. In this period, catgut and silk were the most employed sutures. The appearance and successive development of synthetic materials revolutionized the field of surgical sutures. This evolution is still active, to the search of ideal suture line.

History, 17th Century↗
PubMed1987

[Treatment of acute cholecystitis, yesterday and today: the role of diagnostic research].

To evaluate the influence of both ultrasonography and cholescintiscan on the choice of the treatment and prognosis of acute cholecystitis, the authors reviewed their series of 187 patients observed between 1974 and 1985. On the basis of diagnostic investigations employed, two distinct periods are considered, 1974-79 and 1980-85. In the I period, the exact diagnosis of the disease was obtained in 31 patients (26.3 percent) and the treatment was conservative in 81.3 percent of cases and surgical in 18.7 percent. In the II period, the disease was exactly diagnosed in 95.6 percent and all patients underwent surgery. The overall mortality and complication rate was respectively 5.1 percent and 11.8 percent in the I period and 1.1 percent and 5.8 percent in the II period. Authors conclude that ultrasonography and cholescintiscan, arising rapidly to the exact diagnosis of disease, influenced markedly the choice of surgical treatment, improving the prognosis of these patients.

Acute Disease↗
PubMed1986

[Changes in the levels of reverse triiodothyronine (rT3) during and after surgery of the thyroid gland].

The thyroid activity of twenty euthyroid patients, with single or multiple "cold" nodules was investigated, with determination of seric T3, T4, reverse-T3 (rT3) and TSH. The blood-drags were performed respectively, during (with seric samples from the inferior thyroid vein ipsilateral to the affected lobe) and after (1, 3 and 7 days) surgery. The results of this study--and particularly the significative decrease of T3 and the rapid rT3 increase, either during or after operation - suggests a condition similar to the described "Low T3 syndrome", as expression of both the stress determined by surgery and the correlated thyroid metabolic "adaptation". The clinical and biochemical euthyroidism, expressed by normal levels of TSH in all the samples, confirm the persistence of normal feed-back mechanism by the diencephalon-hypophysis-thyroid axis, even in stress conditions.

Adaptation, Physiological↗
PubMed1986

[Cytologic aspiration biopsy in the diagnosis and therapy of solitary cystic nodular thyropathies].

Between January and December 1983, 36 patients with single and benign cystic thyroid nodules underwent fine needle aspiration. They received, after fine needle aspiration, medical treatment (antiinflammatory drugs and L-T4). Clinical and ultrasonographic follow-up was performed either 6 and 18 months after FNA, to evaluate the lesion evolution. The six-month follow-up demonstrated no ultrasonographic signs of cystic lesion in 11 cases (30.6%); a decreased volume in 21 (58.3%) and four recurrences (11.1%), which underwent surgical treatment (lobectomy). In 21 patients with persistent lesions at 18 month follow-up, a cystic reduction in a 79.9% rate was documented. These data suggests the diagnostic importance of FNA and the safety of this method not only to surgical selection of patients, but also to the treatment of benign thyroid cysts.

Adolescent↗
PubMed1985

[Current orientation in the surgical treatment of cancer of the thyroid].

The authors reviewed their series of thyroid cancers and analyzed possible factors of the low incidence of these neoplasms in their experience. They outline the importance of total thyroidectomy which must be performed as soon as possible. Cervical lymphadenectomy must be reserved only to papillary cancers in which intraoperative histologic examination give the evidence of multiple metastasis of cervical nodes.

Adult↗
PubMed1985

[Acute appendicitis: clinico-diagnostic and therapeutic considerations].

Since january 1970-december 1982, 58 patients underwent emergently appendectomy for acute appendicitis. 31 (53,4 percent) where males; the average age was 21 +/- 2,3 years (M +/- SEM). The duration of symptoms ranged from 1-6 hours (10,3 percent of cases) to over 48 hours, before the hospital admission (15,4 percent of cases). 27 patients (46,5 percent) had a clinical examination at home by a physician. 21 patients (36,4 percent) came to hospital emergency unit without previous physical examination; 10 (17,2 percent) were transferred from other departments. In 6,9 percent of cases was present a perforated appendicitis with peritonitis. During operation, in 50 percent of patients was performed a therapeutic peritoneal lavage. In 63,7 percent of cases multiple drains were placed in peritoneal cavity. In all patients was effected postoperative antibiotic profilaxis. The mortality rate was 3,4 percent. General complications were observed more in patients with perforated appendicitis. This review suggests the following remarcable data: morbidity of this disease is still high; the physical examination is more important than laboratory work (especially in the elderly patients, which are often immunodepressed and in children, with leucocitosis-lack at hospital admission); early surgery is the most important factor to the improvement of prognosis in these cases and the results of surgical treatment are improved by large vertical incisions, peritoneal lavage and application of multiple intracavitary drains.

Acute Disease↗
PubMed1984

[Liver injuries. Clinico-diagnostic and therapeutic problems].

Out of 116 cases of abdominal trauma observed, 6 (23%) consisted of hepatic lesions. In 2 cases (33.3%) the hepatic lesion was isolated. In the other cases, it was associated with lesions to the diaphragm, duodenum, pancreas or thorax. After emphasis on the gravity of such lesions and the high mortality rate (33.3% in the cases observed) the factors contributing to the extremely gloomy prognosis are discussed and the basic therapeutic approach to injuries of varying gravity is outlined.

Adolescent↗