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M Perrotti

Publications and source records attributed to M Perrotti.

23 records · Page 2Linked to original sources

Mini-laparotomy pelvic lymph node dissection minimizes morbidity, hospitalization and cost of pelvic lymph node dissection.

PURPOSE: We compared efficacy, morbidity and cost of mini-laparotomy pelvic lymph node dissection and laparoscopic pelvic lymph node dissection. MATERIALS AND METHODS: A total of 40 patients underwent mini-laparatomy, laparoscopic or standard pelvic lymph node dissection during a 24-month period. Nodal yield, complications, hospitalization and postoperative analgesic requirements were retrospectively evaluated. Operative expenses and the cost of postoperative hospitalization were standardized to a base cost for comparison. RESULTS: Mini-laparotomy pelvic lymph node dissection has an operative time (90 minutes) and nodal yield (9) similar to those of standard pelvic lymph node dissection, and morbidity and postoperative hospitalization (1.3 days) are comparable to those of laparoscopic pelvic lymph node dissection. The expense of the mini-laparotomy procedure is approximately 50% that of the laparoscopic procedure due primarily to the prolonged operative time (190 minutes) and disposable instrument costs ($665) of laparoscopic pelvic lymph node dissection. CONCLUSIONS: Mini-laparotomy pelvic lymph node dissection competes successfully with laparoscopic pelvic lymph node dissection in terms of efficacy and morbidity at significant cost savings.

Aged↗

Endo-rectal coil magnetic resonance imaging in clinically localized prostate cancer: is it accurate?

PURPOSE: We assessed the staging accuracy of endo-rectal coil magnetic resonance imaging (MRI) in patients with clinically localized prostate cancer. MATERIALS AND METHODS: In a prospective study 56 consecutive patients underwent endo-rectal coil MRI before scheduled surgery. The ability of MRI to identify tumor involvement of the periprostatic soft tissue, seminal vesicles and pelvic lymph nodes was assessed by comparison with final pathological stage. RESULTS: Specificity of MRI was relatively high (84% for periprostatic soft tissue, 93% for seminal vesicles and 91% for pelvic lymph nodes) and sensitivity was low (22, 23 and 0%, respectively). Accuracy was 64% for identification of periprostatic soft tissue invasion, 77% for seminal vesicle invasion and 86% for pelvic lymph node metastases. Had we excluded from surgery patients with MRI evidence of extraprostatic disease our organ confined disease rate would have improved by 16.6%. However, this improvement would have been obtained at the expense of incorrectly excluding from surgery 21% of our patients with pathologically organ confined disease because of false-positive MRI predictions. CONCLUSIONS: Endo-rectal coil MRI is not sufficiently accurate to influence the treatment of patients with clinically localized prostate cancer. Therefore, we advise against routine use of this imaging modality in staging such cases.

Adult↗

The influence of human chorionic gonadotrophin administration upon the next ovarian cycle.

We examined the influence of human chorionic gonadotrophin (HCG), used as an ovulation inducer and/or for supporting the luteal phase, on the next ovarian cycle. Four women received 10,000 IU of HCG at mid-cycle and another four received the same dose plus 1500 IU on the 17th, 19th and 21st days of the cycle. In the menstrual cycle prior to our experiments, venous blood samples were collected and vaginal ultrasound of the ovaries was performed every other day from day 21-28; the same data were also collected on days 1-10 of the experiment cycle. In such a way, control values were obtained. After the administration of HCG, venous blood samples were collected and ultrasound was performed in the same way and on the same days as in the controls. Follicle stimulating hormone (FSH) and luteinizing hormone were determined by radioimmunoassay in all blood samples, and HCG only in samples collected after the experiment. The results showed that only FSH was lower in the late luteal phase after the administration of 10,000 IU of HCG. Follicular diameters were higher during the follicular phase than during the previous cycle only in women who received the low dose of HCG. In addition, one woman presented with detectable HCG in the following ovarian cycle. The use of HCG in the preceding cycle may reduce FSH and develop persistent follicles in the subsequent cycle. We suggest that an ultrasound of the ovaries should be performed before starting a new ovulation induction cycle in a woman who has received HCG in the previous cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Clomiphene↗

Adenocarcinoma of the stomach: a multivariate analysis of clinical, pathologic and treatment factors.

We performed a retrospective prognostic study of 246 patients treated for adenocarcinoma of the stomach with curative intent over the period 1960-1984. Lesions of the cardia and gastro-esophageal junction were excluded. The study examined the prognostic influence of nine clinicopathologic and six treatment variables by univariate and multivariate analysis. Five-year survival rates (Kaplan-Meier) for TNM stages, IA, IB, II, IIIA, and IIIB were 88%, 80%, 55%, 30% and 9%, respectively. The Cox models of proportional hazards identified five independent variables predictive of death from gastric cancer: high TNM stage, metastatic involvement of four or more regional lymph nodes, poor differentiation of tumor, splenectomy and insufficient scope of regional lymph-adenectomy relative to the nodal stage (R minus N less than 1.5).

Adenocarcinoma↗