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Biomedical subjects

M Fenoglio

Publications and source records attributed to M Fenoglio.

6 recordsLinked to original sources
PubMed2001

Laparoscopic management of a gastric diverticulum.

Gastric diverticuli are rare entities that may present with a variety of vague abdominal symptoms. Diagnosis requires endoscopic and radiologic evaluation preceded by clinical suspicion. This is the first report describing the laparascopic excision of a gastric diverticulum. A description of this procedure and suggestions for the workup of gastric diverticuli are presented.

Diverticulum, Stomach↗
PubMed1999

Recurrent common bile duct stones containing metallic clips following laparoscopic common bile duct exploration.

A case of recurrent common bile duct stones 2 years following laparoscopic cholecystectomy and laparoscopic common bile duct exploration in a 52-year-old man is reported. Surgical material as a nidus for recurrent stone formation has been reported and occurred in the present case. Factors influencing metallic clip migration after biliary surgery are discussed, with recommendations for decreasing recurrent stones caused by foreign material.

Cholangiography↗
PubMed1997

Use of fine needle aspiration for solid breast lesions is accurate and cost-effective.

BACKGROUND: Palpable breast tumors have traditionally been diagnosed with open biopsy or core biopsy. We propose fine needle aspiration biopsy (FNA) as a reliable, cost-saving initial procedure in these patients. METHODS: Eighty-five palpable solid breast masses of the breast in 85 patients were classified by a combination of physical examination, mammography, and/or ultrasound as probably benign, indeterminate, or highly suspicious for cancer. All tumors had FNA biopsies. All patients had either a confirmatory open biopsy (55) or close clinical follow-up (30) with a mean follow-up of 29 months (range 6 to 36). RESULTS: Thirty-four patients classified as clinically benign had a benign FNA biopsy. No cancers were detected in this group by either open surgical biopsy or clinical follow-up. Twenty patients were classified clinically as indeterminate. All had FNA biopsies, and 6 were either positive for cancer or suspicious for cancer. Fourteen patients had negative FNA biopsies. Five of the 6 abnormal biopsies had cancer on open biopsies. The 1 false-positive result occurred in a lactating patient. Thirty-one patients were classified clinically as highly suspicious for cancer. Twenty-three were confirmed as cancer with FNA biopsy. Eight needed open surgical biopsy to confirm cancer. All 31 patients clinically suspicious for cancer had cancer. In patients classified clinically as highly suspicious or probably benign, FNA was a reliable first diagnostic step (100% positive predictive value, 100% specificity, 87% sensitivity, and 89% negative predictive value). CONCLUSIONS: Fine needle aspiration biopsy of solid palpable breast lesions should be the diagnostic procedure of choice for those patients classified clinically as probably benign or clinically as highly suspicious for cancer. Cost analysis revealed elimination of an open biopsy in such cases would save $1,100 per patient. For highly suspicious cases, a negative fine needle aspiration should not deter an open surgical biopsy. For patients classified as indeterminate, fine needle aspiration biopsy results are not reliable enough to determine treatment.

Biopsy, Needle↗
PubMedDate not supplied

Laparoscopic paraesophageal hernia repair.

BACKGROUND AND OBJECTIVE: Paraesophageal hernias are uncommon yet potentially lethal conditions. Their repair has now been facilitated by laparoscopic technology. We present a series of 20 patients with paraesophageal hernias repaired laparoscopically. METHODS: Twenty patients with paraesophageal hernias had laparoscopic repairs. Eighteen patients had primary repair of their hiatal defect. Two required mesh reinforcement. Fifteen patients had a fundoplication procedure performed concomitantly. RESULTS: Long-term follow-up is available on 17 patients. There was no in-hospital morbidity or mortality. Average length of stay was 2.3 days. One patient recurred in the immediate postoperative period. There were no other recurrences. The only death in the series occurred in the oldest patient 18 days postoperatively. He had been discharged from the hospital and died of cardiac failure. No patients have had complications from a paraesophageal hernia postoperatively. CONCLUSION: Laparoscopic repair of paraesophageal hernias is possible. Preoperative work-up should include motility evaluation to assess esophageal peristalsis as the majority of these will need a concomitant anti-reflux procedure. This data helps the surgeon to determine whether or not a complete or partial wrap should be done. Repair of the diaphragmatic defect can be accomplished in the majority of patients without the use of prosthetic material with excellent results.

Adult↗