[The operative risk in the surgical treatment of bile duct stones].
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Bile Ducts↗
Biomedical subjects
M Turrisi
Publications and source records attributed to M Turrisi.
[Trans-anal resection of low rectal neoplasms].
BACKGROUND: The rising incidence of colorectal neoplasms, and in particular those localised in the lower rectum is stressed and the therapeutic opportunities offered by the trans-anal resection technique are underlined. METHODS: The indispensable conditions for adopting a surgical approach are pointed out. These are identified as the size of the neoplasm, which should not exceed 4 cm, the fixity, site, the polypoid and non-ulcerated nature of the lesion, and the involvement of not more than 1/4 of the circumference of the bowel. Using these inclusion criteria, the authors operated on five patients in the 4th Division of General Surgery at G. Martino Polyclinic in Messina, using trans-anal resection of low rectal neoplasm. RESULTS: No hemorrhagic complications or lesions in the visceral wall occurred. All patients underwent a follow-up of up to 36 months and to date no patient has presented long-term metastasis; local recidivation was observed in one patient after 14 months and this was treated using the trans-anal method. CONCLUSIONS: The authors affirm that trans-anal resection may be regarded as the elective treatment of patients with neoplasms confined to the visceral wall and without dissemination; it is palliative in cases where the tumour is larger than 4 cm, with lymph node involvement. But even in this case, and in more advanced situations, this method allows mortality due to occlusive complications to be reduced and ensures a better quality of residual life.
Adenocarcinoma↗
[Use of monofilament prosthesis in inguinal hernia treatment: cost-benefit ratio].
BACKGROUND: The authors aimed to demonstrate the real advantages in terms of cost and patient comfort of inguinal hernia surgery using monofilament prostheses. METHODS: A retrospective survey was carried out on two groups of patients: the first group, consisting of 1032 patients who underwent inguinal hernia surgery under general anesthetic between 1985 and 1995 at the Institute of General Surgery at the University Polyclinic of Messina, included cases of both emergency and elective surgery that did not use monofilament prosthesis. The second group, consisting of 348 patients operated under local anesthesia between 1996 and 1999 at the IV Division of General Surgery at the University Polyclinic of Messina, included cases of both emergency and elective surgery using tension-free techniques and polypropylene mesh. The numbers of recidivations and complications were compared, together with the relative costs of the methods used in both groups. CONCLUSIONS: In the light of these experimental results, it is clear that the use of biocompatible alloplastic materials in monofilament considerably reduces the risks of recidivation, without no significant increase in the number of dehiscences, infections or postoperative complications. Moreover, there was a striking reduction in costs linked not only to the shorter hospitalisation of patients and the reduced use of painkillers, but also a fall in the number of future hospital admissions owing to recidivation.
Cost-Benefit Analysis↗
[Anal carcinoma].
The authors, want to demonstrate the operation of abdominal perianal rectum amputation, and it is considered absolute, even 80 years, in the treatment of the anal neoplasia, it is superseded by alternative methods represented by protocols radio-chemo-therapeutic associated or less to the surgery treatment. They make then a retrospective valuation since 1963 till our days on 54 patients. In the 6 patients (stadium I-II) treated after 1982 with protocols of freemall, it is was obtained disappearance of the neoplasia about 50% the cases. On overcoming of the results there was in a second group of 8 patients (1987) treated always with protocol of Greenall, in 5 of these (62.5%) could observe absence of remaining of disease. In the third group (1993) on 8 patients treated with therapy fixed radio-chemo, it was registered the absence of the residual of illness in 6 patients(75.5%). Finally, from the analysis of patients observed in the last seven years, 5 of which suffered by Ca squamous in different evolutive stadium (one I stadium, three II stadium and one stadium III-B), the stadium I and II were treated with the protocol radio-chemotherapeutic obtaining total remission of the disease in the 100% of the cases. In the follow-up of 45 patients, 12 of whose were treated with the therapy combined radio-chemo and of these 10 were valuable for survival to 5 years which was about 70% superior to patients treated with only surgery therapy.
Anus Neoplasms↗
[Carcinoma of the gastric stump].
After having emphasized that carcinoma of the gastric stump represents a "major" risk in patients undergoing gastric resection, the authors describe the physiopathology of the new anatomical and functional status of the gastroenteric apparatus and underline the probable etiopathogenetic stages attributable to carcinogenesis. They then describe the treatment of this neoplasia with a marked aggressive character and conclude with the affirmation that the surgeon's efforts must be focused on the correct execution of gastroresection and the follow-up of gastro-resected patients in order to allow the early identification of precancerous conditions and therefore the commencement rational oncological prophylaxis.
Adult↗