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M Trignano

Publications and source records attributed to M Trignano.

30 records · Page 2Linked to original sources
PubMed1981

[Raynaud's phenomenon: diagnostic and therapeutic aspects].

The Authors report their experience concerning 120 patients with Raynaud's Disease (50 pats.) or Syndrome (70 pats.). All patients were studied before and after treatment, by clinical, thermometric, oscillographic and photoplethysmographic observation and by the Doppler examination, in order to evaluate the functional and organic component of the disease. Surgical treatment was reserved to 45 patients with secondary or primitive Raynaud's phenomenon refractory to medical therapy. The treatment of choice was thoracic sympathectomy. The result was excellent in 64% of cases, fair in 26%, and nil in 8%. 75 patients were treated with various drugs for a period of 6 months or 1 year. In 54% of cases the result was excellent, fair in 29%, and nil in 16%. The Authors conclude that diagnosis of Raynaud's Syndrome is above all clinical, that a leading part is played by photoplethysmography and the Doppler examination, and that medical therapy is indicated in the first instance, since it is capable of preventing the rise of those distal trophic disorders that constitute one of the main indications of surgical treatment.

1-Propanol↗
PubMed1980

[The role of the Billroth I operation peptic ulcer surgery].

The conviction is expressed that none of the operations today available for treatment of peptic ulcer is always effective for all types of patient; the surgeon must in fact be able to select and perform the operation most suitable for each case. In this connection the advantages and disadvantages of gastric resection according to Billroth's first method are considered. The fundamental stages of this operation are described in detail, with a critical analysis of the various pathological conditions in which its performance is indicated or, on the contrary, there is a precise contraindication. On the basis of the main parameters of judgment (follow-up, operating mortality, relapse rate, dumping syndromes and Visick's scale) obtained from personal experience and wide research on literature, a comparative evaluation is then made between Billroth I and other operations commonly used in treatment of gastroduodenal ulcer. In conclusion it is asserted that Billroth I is a technically good, physiological operation capable of ensuring immediate and long-term results not inferior to those of Billroth II and other operations; it therefore deserves to be considered among the methods of choice and more widely used.

Gastrectomy↗
PubMed1979

[Agenesis of the gallbladder and cystic duct (author's transl)].

The authors describe a case of agenesis of the gallbladder and cystic duct diagnosed at operative cholangiography; they discuss the embryological, etiopathogenetic and clinical aspects of this abnormality, and pertinent treatment policies. They stress the need for operative teleradiocholangiomanometry for the correct diagnosis and treatment of the disorder.

Adult↗
PubMed1979

[Intraoperative evaluation of the high pressure zone in anti-reflux plastic operations].

It has been done a manometric intraoperating study on 18 patients (7 acalasical megaoesophagi, 6 herniae of hiatus, 5 duodenal ulcers) who had undergone an operation of modified Dor's anti-reflux plastics. After Haller H.P.Z. pressure has gone down of 13 mmHg, and has gone up again of 5,5 mmHg after modified Dor; after plastics H.P.Z. average intraoperating pressure has been of 18 mmHg. The posterior plastics of hiatus and the reconstruction of His' angle for hernia of hiatus modify scarcely H.P.Z. pressure. During a superselective vagotomy we have recorded a modest reduction of H.P.Z. pressure, of which average intraoperating values after vagotomy and anti-reflux plastics have been of 16,5 mmHg. At a distance of 30 months from the operation it has been done a follow up on 70% of patients that had undergone an operation of anti-reflux plastics and also 18 patients that had had en intraoperating inspection. However it has been, a degradation of manometric values, the results have been satisfactory over 90% of cases. The authors insist on the utility of intraoperating manometry for a valuation of the completenes and the efficacy of the operation.

Adolescent↗
PubMed1978

[Current criteria of treatment of angiomas].

The authors set out their therapeutic trend in the treatment of angioma and the criteria governing the use of the various therapies according to the type of dysplasia and its clinical course; they then report on the results obtained in a series of 400 cases. Only 22 cases with unfavourable trend (evolution of lesion) were observed, whereas the others exhibited spontaneous regression (85 cases), arrest of evolution (50 cases) or regression or cure (243 cases).

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Video-thoracoscopic sympathectomy in the treatment of Raynaud's disease and palmar hyperhidrosis].

BACKGROUND AND AIM: Raynaud's syndrome is a clinical entity characterised by episodic vascular spasm, digital ischemia in response to cold or emotional stimuli and hyperhidrosis. Many patients suffering from Raynaud's syndrome are successfully treated using medical therapy alone. Those patients who do not respond to medical treatment undergo surgery but the indications continue to be a source of controversy. A modern approach to thoracic sympathectomy requires a video-assisted technique. The aim of this study is to attempt to use mini-invasive type surgery to treat Raynaud's disease and hyperhidrosis in order to evaluate the real efficacy of thoracic sympathectomy in a large number of patients. The results of this method were compared for the two different pathologies in question. METHODS: The methodology used by this study is based on instrumental and clinical tests performed before and after surgery on treated patients using a comparative criterion and with a minimum 5-year follow-up. The pre- and postoperative diagnostic tests were performed by the vascular surgery laboratory and using a C.W. Doppler and a reflected light photoplethysmograph. Capillaroscopy and laboratory evaluations relating to secondary Raynaud's disease were carried out by internist type structures. The patients enrolled in the study responded to the following criteria: primary Raynaud's disease, palmar hyperhidrosis and associated syndromes. The population came from a mixed sociodemographic background, albeit within a strictly regional zone (Sardinia). A total of 42 patients were studied. The surgical technique used consisted of the ablation of thoracic ganglia from the 2nd to the 4th. RESULTS: The results showed a resolution of symptoms in 95% of patients treated for hyperhidrosis, whereas a 50% recidivation rate was observed in patients with Raynaud's disease alone, although symptoms were less intense. The results for Raynaud's disease were more disappointing, but it is important to remember that surgery is the ultimate choice for cases with advanced lesions which do not respond to medical treatment. Under these circumstances, the possibility of halting the evolution of the pathology represents an auspicious achievement. CONCLUSIONS: The authors affirm that mini-invasive surgical treatment of hyperhidrosis was resolutive during a mean follow-up of 3 years. It therefore represents a valid method which causes minimum esthetic damage to the patient and the greatest functional benefit. The postoperative period is short (about 3 days) and free of major complications. There is virtually no post-surgical pain.

Adult↗
PubMedDate not supplied

[Monofilaments in digestive system surgery].

The most important physical and chemical properties of the new synthetic absorbable suture materials are shown. Particularly this paper make a comparison between multifilament and monofilament suture wire from the point of view of tensile strength, "in vivo" tensile strength retention, reabsorbability, foreseeability of the reabsorption time of the capillarity. On these theoretical basis the AA. think that actually the best suture wire for the gastrointestinal surgery must be a synthetic absorbable monofilament suture material. Clinical and experimental experience of the AA. utilizing in the surgery of the gastrointestinal tract a copolymer monofilament of the glycolic acid and of the trimethylene carbonate (polyglyconate-Maxon), resorbable by not-enzymatic hydrolysis in about 180 days are described. The clinical experience was acquired performing 43 manual gastroenteric anastomosis by polyglyconate suture material and making an endoscopic follow-up in 19 cases (12 oesophago-jejunal anastomoses and 7 colo-rectal anastomoses). The experimental study consist of 30 enteric anastomosis performed on rats. The results evaluation was made from three points of views: bacteriological, optical diffuse light microscopy and electronic transmission microscopy. The conclusions of the clinical and experimental studies are favourable for the use the polyglyconate suture wire in digestive surgery, and confirm also "in vivo" its theoretical properties.

Animals↗
PubMedDate not supplied

[Rationale for the use of bile salts after cholecystectomy: results of a controlled clinical study using tauroursodeoxycholic acid (TUDCA)].

Cholecystectomy causes alterations in bile composition. In particular it rises the proportion of highly detergent bile acids with the possible consequence of the manifestation of dyspepsia in a high percentage of patients: this is the well-known post-cholecystectomy syndrome. In this clinical trial we studied the activity and safety of tauroursodeoxycholic acid--TUDCA--(500 mg/die) in the prevention of dyspepsia in cholecystectomized patients, in comparison with no treated group. We enrolled 203 patients (101 TUDCA--group A--and 102 control-group B). The two groups were comparable for age (47.1 years in group A and 50.7 years in group B), sex (m/f: 28/73 and 37/65 in the two groups) and for other characteristics connected to surgical procedures. After operation all patients suffered from dyspepsia symptoms. In patients treated with TUDCA we registered a prompt regression in severity of symptoms when compared with no treated group: in fact we noted a significant difference only at the first control planned after one month from operation. No difference were registered at the other controls (two and three months after operation). Two patients in A and 3 in group B manifested adverse events. In conclusion, the treatment with TUDCA, a new hydrophilic bile acid, seems to contribute to the improvement of clinical course in cholecystectomized patients.

Adult↗
PubMedDate not supplied

[Sutures without sutures in digestive surgery. Experimental study of the rat intestine].

The aim of the experimental study was to evaluate the possibility of performing an end-to-end anastomosis by using fibrin adhesive as the only means of suture. To this end, 24 Wistar rats were used, of which 16 underwent ilear resection and 8 underwent colotomy, and they were divided respectively into two groups. On the rats of the first group the anastomosis was performed by using only fibrin adhesive; on the rats of the second group operated the anastomosis was performed by using fibrin adhesive in association with non adsorbable suture material, while on those operated of colectomy the anastomosis was performed by fibrin adhesive and adsorbable suture material. The anatomo-phatological studies on the anastomosis have shown a similar healing process in the cases treated only with fibrin adhesive and by using absorbable material and has demonstrated the trange material from the suture, which are a possible causes of complication.

Anastomosis, Surgical↗