PubMed Health⌕ Search

Biomedical subjects

M Trignano

Publications and source records attributed to M Trignano.

At least 19 recordsLinked to original sources
PubMed2004

[Indications, techniques, complications and results of sleeve lobectomy].

AIM: The authors analyse their personal series and compare it with reported data in order to assess the functional results sleeve lobectomy offers with respect to traditional techniques. METHODS: Sixty-six sleeve lobectomies were carried out from 1986 to 2000. In 49 cases the operation was carried out on the basis of criteria of choice and in 17 of functional necessity. Three vascular sleeves and 5 tangential vascular plastic operations were associated. The disparity of lumen was corrected with oblique sections on the intermediate bronchus according to Merendino. In the case of reimplantation of the intermediate on the left main bronchus high frequency jet ventilation was necessary. The anatomoses were covered with broad pedunculated pleural strips. In 3 cases extramucosal myectomy of the medio-thoracic esophagus was carried out associated in 1 case with mucous resection and subsequent direct suture. RESULTS: Morbility was 34.5% (21% atrial fibrillation, 7.5% parenchymal complications, 4.5% anastomotic complications and 1.5% mediastinitis). Mortality at 30 days was 6% (massive hemoptysis in 3 cases and respiratory failure in 1 case). The pTNM of the 57 survivors was IB in 35 cases, IIB in 6 and IIIA in 16. Follow-up showed 5-year survival of 62% for stage IB and 24% for stage IIIA. CONCLUSIONS: On the basis of their experience, with a postoperative mortality and a rate of complications comparable to literature data, the authors consider that sleeve lobectomy, although it presents postoperative problems requiring more prolonged clinical control, is preferable to traditional operations because of the functional advantages it offers patients with lung cancer.

Female↗
PubMed2002

Percutaneous vacuum-assisted core breast biopsy with upright stereotactic equipment. Indications, limitations and results.

PURPOSE: To assess the usefulness of stereotactic vacuum-assisted core breast biopsy (VCBB) performed using a stereotactic add-on device and film-screen technology with the patient in an upright seated position. MATERIAL AND METHODS: We reviewed a series of 129 women with non-palpable mammographic abnormalities who required stereotactic VCBB from December 1999 to November 2000. Twenty-seven (20.9%) cases were excluded due to difficulties in keeping the correct position during the procedure, while the other 102 (79.1%) underwent successful VCBB. Patients with lesions consisting of either atypical ductal hyperplasia or lobular carcinoma in situ were considered for excisional biopsy. Patients with either ductal carcinoma in situ or infiltrating breast cancer were referred for definitive surgery. The results of stereotactic VCBB were correlated to the subsequent surgical histology. RESULTS: Stereotactic VCBB was interrupted because of bleeding in 1 case and vasovagal reaction in 5 cases. Two haematomas occurred after the procedure. Overall underestimation rate was 10.5%. No new lesions were discovered after a mean follow-up of 18.7 months. CONCLUSION: Stereotactic VCBB performed using a standard add-on device with the patient in an upright seated position and analog technology is feasible in about 80% of cases, has a low complication rate, is not significantly time-consuming, and can offer the same accuracy as dedicated prone equipment.

Biopsy, Needle↗
PubMed2001

[Pleuro-pneumo-phreno-pericardiectomy with pericardial and diaphragmatic plasty].

Aim of the paper is to evaluate 43 extrapleural pneumonectomy performed from 1988 to May 2000. Criteria for extrapleural pneumonectomy were pleural biopsy by thoracoscopy, potentially completely resectable unilateral disease by computed tomography and predicted postresection forced expiratory volume >1,3 L/sec. The resections regarded 33 pleural mesothelioma, 9 pleural lung-carcinosis and 1 pleural melanoma effusion. The perioperative mortality rate was 2,2% (1 death) and morbidity 21,4%.

Diaphragm↗
PubMed1998

[Videolaparoscopic treatment of biliary lithiasis. Evolution of our experience].

Videolaparoscopic cholecystectomy is considered the treatment of choice for simple cholelithiasis. Now many surgeons consider the laparscopic procedure usable also in the complicated biliary lithiasis like acute cholecystitis and choledocholithiasis. The authors report their recent experience of the laparoscopic treatment of biliary lithiasis, regarding 221 non-selected patients (69% symptomatic cholelithiasis, 20% chronic cholecystitis, 4.5% acute cholecystitis, 4.5% coledocolithiasis, 2% hydrops). The diagnostic-therapeutic protocol and the results are described and compared with the beginning of their experience, when they treated only symptomatic gallbladder stone disease, and with the reports of the literature. The authors concluded that the laparoscopic procedure is a good chance for the surgeon in the treatment of all cases of benign biliary disease. But, in particular for patients with choledocholithiasis, he has be able to know all the diagnostic and therapeutic possibilities, to choose the best in every single case.

Adult↗
PubMed1997

[Minimally invasive surgery and neoplasms of the inferior third of the rectum: personal technique].

In the last decade minimally invasive surgery has gained an increasing success and was firstly applied to the treatment of benign pathologies, and recently to the malignant ones. The Authors report two cases of inferior rectal neoplasm treated with Miles operation through a video-laparoscopic-perineal approach. The abdominal phase of the operation was performed only through 5 small laparoscopic incisions. The perineal phase and the stoma were performed using traditional technique. The method appears feasible and oncologically correct; however, further trials are needed to evaluate long-term results.

Adenocarcinoma↗
PubMed1996

Preliminary reports on morphological and ultrastructural changes in the corpora cavernosa of the rat after chronic arterial obstruction.

OBJECTIVES: Various authors have investigated the pathological findings of penile tissue after chronic arterial obstruction, but the significance of these changes in the corpora cavernosa remains unclear. In order to evaluate the possible damages in the erectile tissue after chronic arterial obstruction at different levels, we utilized an experimental model in rats to determine the changes in smooth muscle cells and elastic fibers of the erectile tissue by microscopic immunohistochemical and ultrastructural studies. METHODS: Twelve adult male Wistar rats were employed in this study. Ten were used for the experiments and two as control. The rats were anaesthetized with ether and intraperitoneal 10% chloral hydrate. Microsurgical isolation of the involved vessels was performed with the aid of a Zeiss dissecting microscope. Partial stenosis was achieved with 11/0 nylon and amputation of the penis was performed at previously established time periods. The partial stenosis was carried out at the level of the aortic below the renal vessels (Group A), the common iliac artery on both sides (Group B) and the hypogastric artery on the left side (Group C). Arterial obstruction was maintained in each group for 50, 40 and 25 days, respectively. RESULTS/CONCLUSIONS: In comparison with normal controls, the histological findings revealed discrete and diffuse interstitial hyalinosis with reducted elastic fibers, while dilated vascular lacunae were also present on TEM (Transmission Electron Microscope) and SEM (Scanning Electron Microscope) examination. The greatest ultrastructural damages were observed in the group with obstruction of the common iliac artery on both sides. The foregoing confirms that an eventual chronic obstruction of these arteries does not allow the formation of collateral vessels for the corpora cavernosa.

Animals↗
PubMed1993

[Laparoscopic cholecystectomy. Our experience].

This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign proliferative pathology of the cholecystic wall. Calculosis of the main biliary tract was also found in 3 patients and was treated by preoperative endoscopic papillosphincterotomy. In addition to routine tests and ultrasonography, endovenous cholangiography, or retrograde cholangiography (ERCP) in cases of suspected calculosis of the biliary tract, was always performed prior to surgery. Mean operating time was 60 min. Two procedures were converted into laparotomy due to laceration of the cystic artery. In one case laparotomy was performed on day two due to choleperitoneum following a lesion of the cystic duct. Pneumoperitoneum could not be performed in three cases. Mean hospital stay was 48 hours. No other intra- or postoperative complications were reported. These results support the opinion that laparoscopic cholecystectomy is a safe method, with few limitations and represents the treatment of choice in the therapy of symptomatic cholelithiasis.

Adult↗
PubMed1993

[Lipiodol chemoembolization in the treatment of hepatic carcinoma. Our experience].

Of the alternative methods of treatment to surgery in the treatment of liver cancer, chemoembolization with Lipiodol appears to have obtained encouraging results. After a preoperative study to confirm the diagnosis and staging of the tumour, lipiodolisation is performed: a mix of Adriamycin, Iopamidol and Lipiodol is injected using selective catheterism of the hepatic artery; gelfoam is then added. Lipiodol selectively localises in the hepatocarcinoma and has a distal embolising effect on the vessels of the tumour, thus necrotising it, acting as a carrier for chemotherapy. Since july 1990 a total of 15 hepatocarcinoma have been observed: 6 in healthy livers and 9 in cirrhotic livers; 3 patients recovered after radical surgery, 1 patient underwent associated surgery and chemoembolization, whereas in 11 the only therapy was chemoembolization, at six monthly intervals. Lipiodolisation enabled a better diagnosis to be made and was found to be a valuable therapeutic aid both when used alone in Inoperable patients and in association with non-radical surgery.

Carcinoma, Hepatocellular↗
PubMed1993

[Crossectomy combined with sclerosis in the ambulatory treatment of varicose veins].

This paper focuses on the advantages of an outpatient technique in the treatment of the 1st various syndrome based on crossectomy and complementary sclerotherapy to eliminate the proximal reflux. In addition to the speed, low costs and total absence of discomfort for the patient, this method results in a low percentage of easily correctable failures provided the patients to be treated are carefully chosen. Selection involves a preoperative screening phase based on anamnesis, semeiological tests, Doppler and evaluation of tibial venous pressure, as well as careful topographical mapping of proximal refluxes which allow a correct postoperative follow-up in the event of possible recidivation (14.3% based on the authors' experience). The surgical technique used entails an accurate crossectomy with full exposure of the SF crosse (??) and its affluent branches, and subsequent sclerotherapy with atoxysclerol in a variable quantity and % as required. Of a total of 91 cases treated with a 3-year follow-up, 5 cases of recidivation were observed during the first year and 8 during the third. In both cases postoperative pressure values in the tibial veins were considerably higher than in other patients and recidivation occurred through perforating sclerosed recanalised vessels.

Adult↗
PubMed1986

[Colonic and rectal cancer screening using fecal occult blood analysis (our experience)].

The authors describe their experience with colorectal cancer screening by means of the Hemoccult test for the detection of occult fecal blood according to Gregor's method. In particular, the decentralized aspect of the screening is examined, and the results discussed are in agreement with those observed in larger study populations. The authors go on to stress the effective possibility of conducting this type of screening also on the basis of collaboration with general practitioners.

Aged↗
PubMed1985

[Transluminal esophagoplasty (TE)].

The authors analyze their experience on 9 cases of esophageal stenosis dilated by "Grüntzig" type balloon catheter under fluoroscopic examination (transluminal esophagus plastica: TE). This procedure also allows dilatation of severe narrowing, offering distinct advantages represented by: low risk, easy performance, good tolerance, reduction or disappearance of disphagia. Esophageal perforation is possible, though it never appeared in author's experience.

Barrett Esophagus↗
PubMed1984

[The interposed jejunal loop after resection for gastric ulcer (endoscopic study)].

Authors refer about an endoscopic study concerning twenty patients who have been previously operated for gastric ulcer. In these patients it was performed a reconstruction of the alimentary canal by means of a gastro-duodenal interposition of an isoperistaltic jejunal loop. Authors show that this method has been proved valid to prevent duodeno pancreatic reflux in the residual gastric sac.

Adult↗
PubMed1981

[Proximal selective vagotomy in treatment of duodenal ulcer (author's transl)].

Thirty duodenal ulcer patients were subjected to proximal selective vagotomy (p.s.v.) and modified Dor antireflux plastic surgery. Accurate clinical, radiological, endoscopic, gastrosecretory, radioimmunological and PH-manometric tests were made before and 7 and 30 days after surgery. The results confirm the effectiveness of p.s.v. in treatment of ulcerous disease, and the usefulness of combining modified Dor plastic surgery in order to prevent postoperative feedback.

Adult↗