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N Bassi

Publications and source records attributed to N Bassi.

At least 19 recordsLinked to original sources
PubMed2003

Supra infection of amoebic liver abscess consequent to acute appendicitis. Clinical case.

Amoebic liver abscess is the most common extra-intestinal manifestation of amebiasis with approximately 10% of the world's population infected by this parasite. Actually, incidence of this infection is also increasing in industrialized countries, as a consequence of the more frequent immigration or travelling. Only 3-10% of patients with intestinal amebiasis develop liver abscess. A clinical case of suprainfection of amoebic liver abscess consequent on acute appendicitis is presented.

Acute Disease↗
PubMed2002

Management of spontaneous bleeding due to hepatocellular carcinoma.

BACKGROUND: Spontaneous rupture is a life-threatening complication of HCC, occurring in 4.8-26% of cases. Liver failure is the main cause of death. Debates still remain on the most appropriate treatment in such patients because of the high operative mortality of emergency surgery and the high risk of rebleeding and less satisfying mid- and long-term results of nonoperative procedures like angiographic embolization. Early and long-term results of a surgically oriented treatment, based on prompt evaluation of the functional liver reserve and tumor resectability was retrospectively review-ed. METHODS: From January 1994 to December 2000, 11 patients (7 males and 4 female, mean age 66.2 (11.86 years) were treated for ruptured HCC, in 10 cases involving a cirrhotic liver. Seven patients underwent emergency surgery and 4 patients transcutaneous arterial embolization (TAE). Liver resection was performed in patients with preserved liver function, after ultrasonography and/or CT scan demonstrated hemoperitoneum and a single resectable liver tumour (5 cases). In one patient with cirrhosis, ultrasonography showed only hemoperitoneum. A bleeding nodule was discovered intraoperatively and resected in a liver with a multinodular HCC. Another patient under-went emergency resection after referral at our Unit with a surgical packing. In 4 cases with poor liver function and/or unresectable tumour TAE of the neoplasm was performed, in one case after surgical packing. Mortality, morbidity and patients survival after treatment were analyzed. All patients had at least 1 year follow-up. RESULTS: All patients underwent minor resection; 2 left lobectomies, 1 segmentectomy (VII), 1 bisegmentectomy (VII-VIII), and 3 wedge resections. Postoperative course was complicated by ascites in 5 cases and subphrenic abscess in one case. Four patients died 3, 4, 6 and 62 months after surgery; 3 patients are actually alive 22, 25, and 89 months after surgery. Four patients were submitted to TAE: all patients died within 6 months. CONCLUSIONS: When ruptured HCC is suspected, preserved liver function (Child A-B7) and a resectable hepatic tumour are considered clear indications to surgery. Emergency liver resection achieved good early and long-term results. In cases of advanced liver disease or multinodular HCC a non-operative approach, like TAE, must be attempted. Surgical direct hemostasis or hepatic artery ligation must be reserved for patients with uncontrollable o recurrent bleeding after TAE.

Aged↗
PubMed2001

Combined endoscopic and laparoscopic removal of ingested large foreign bodies. Case report and decisional algorithm.

Foreign body ingestion is a rare occurrence, but quite more frequent in children; adults with mental disorders, bulimia, and dentition alterations; and prison inmates. Most foreign bodies pass spontaneously through the first digestive tract and can move along the entire alimentary canal without giving rise to any major damage. On the contrary, when foreign bodies, because of their shape, size or potential for danger, must be removed, endoscopy is the method of choice. In a small percentage of cases, however, it may be necessary to remove the foreign body surgically. In such cases, the laparoscopic technique certainly can prove to be a most valuable tool, and can be recommended as a first approach. We describe a case in which a large foreign body was accidentally ingested. After a brief analysis of the data in the literature, we propose the decision-making algorithm that we follow.

Adult↗
PubMed2001

Squamous cell liver cancer arising from an epidermoid cyst.

Squamous cell liver cancer (SCLC) arising from an epidermoid intestinal cyst is rare. Only 65 cases of this cyst have been reported since 1850, with 2 reported cases of squamous cell cancer. We describe here the case of a 21-year-old man who complained of mild pain, a feeling of fullness in the right upper quadrant of the abdomen, and fever and weight loss, who developed SCLC arising from an epidermoid intestinal cyst. The clinical presentation, management, and pathological findings are discussed.

Adult↗
PubMed1997

A simple solution to a technical complication in "piggyback" liver transplantation.

"Piggyback" orthotopic liver transplantation is a technical modification of the standard technique that has found favor with a number of surgeons. One possible complication is that of venous outflow obstruction, which presents as an acute Budd-Chiari syndrome. If not rapidly corrected, it is almost inevitable that the newly implanted graft will fail. Additionally, severe portal hypertension and general infradiaphragmatic venous stasis may compound the damage. We find that anastomosing the donor infrahepatic vena cava to the recipient suprarenal vena cava in an end-to-side fashion is an excellent way to correct the problem.

Budd-Chiari Syndrome↗
PubMed1997

[Acute hyperparathyroidism associated with follicular carcinoma in the thyroid: possible role of juvenile cervical irradiation. Description of a case].

Acute onset of primary hyperparathyroidism is uncommon; neuropsychiatric signs are prominent clinical features in acute hypercalcemia and they can subside after normalization of serum calcium. Radiation therapy is a well-known risk factor for non medullary thyroid cancer, but it induces also parathyroid tumors. Data from the literature show that patients previously treated with neck radiation have an increased risk of primary hyperparathyroidism. Furthermore concomitant thyroid cancer is more frequent in radiation-induced hyperparathyroidism than in sporadic primary hyperparathyroidism. The case of a 63-year-old female patient who at the age of 14 had been irradiated to the neck for goiter and at the age of 50 had been repeatedly hospitalized for psychosis is presented. She was admitted to the hospital for suspected recurrence of psychosis, but clinical findings and urgent biochemical data showed on the contrary that she had a severe hypercalcemic crisis. Serum parathormone concentrations, neck echography and 99mTc-Sestamibi scintigraphy suggested hyperfunction of the right lower parathyroid gland; therefore the patient was operated on. Pathological examination disclosed a parathyroid adenoma but also two foci of follicular cancer in the right thyroid lobe with a metastasis to a lymph node were observed. Neuropsychiatric signs disappeared after normalization of calcemia and 6 months after operation the patient is free from psychiatric symptoms, despite she had stopped neurolectic drugs. It is underlined that patients who had received neck irradiation must be carefully observed because they are at increased risk of primary hyperparathyroidism and concurrent thyroid cancer.

Acute Disease↗
PubMed1994

Aprotinin efficacy on intraoperative bleeding and transfusion requirements in orthotopic liver transplantation.

BACKGROUND: Bleeding complications frequently occur during orthotopic liver transplantation (OLT), particularly in patients with liver cirrhosis. Enhanced fibrinolytic activity in plasma was seen to play a key role in the development of the hemostatic disorder and of hemorrhages. Aprotinin, a serine protease inhibitor, has been used in the prevention and/or treatment of hyperfibrinolytic states. STUDY DESIGN AND METHODS: In the present study, the effect of aprotinin on bleeding complications and transfusion requirements was investigated in OLT patients with liver cirrhosis. Seven consecutive cirrhotic patients undergoing OLT were infused with aprotinin following an original protocol (1,000,000-KIU intravenous loading dose plus 500,000 kallikrein-inhibitory units per hour until skin closure). Seven previous cirrhotic OLT patients not receiving aprotinin were used as controls. RESULTS: In the treated group, a significant decrease in the number of transfused units of packed red cells (48.7%, p < 0.01), fresh-frozen plasma (24.4%, p < 0.05), platelets (35.9%, p < 0.01), and autologous blood (55.2%, p < 0.01) was observed as compared with the control group. Moreover, the mean length of operation was significantly shorter in the aprotinin-infused patients than in untreated patients (8.3 +/- 1.2 vs. 10.1 +/- 1.8 hours, respectively; p < 0.01)). In the aprotinin-treated group, the antifibrinolytic efficacy was confirmed by the lack of increase in D-dimer levels and decrease of fibrinogen in plasma; on the contrary, these changes were always seen in the group not receiving aprotinin. CONCLUSION: Infusion of aprotinin during OLT in cirrhotic patients can be recommended for the prevention of hyperfibrinolysis-triggered bleeding, thus reducing transfusion requirements. A possible protective effect on the primary nonfunction of the grafted liver is suggested.

Adult↗
PubMed1993

Protein C, factor VII and prothrombin time as early markers of liver function recovery or failure after liver transplantation.

Irreversible initial non-function of the graft liver is a life-threatening early complication of orthotopic liver transplantation (OLT), which needs immediate retransplantation if the patient is to survive. Since protein C (PC) is a vitamin K dependent protein synthesized in the liver and with the same half-life as factor VII (FVII), the behaviour of PC in patients undergoing OLT was studied in comparison with prothrombin time (PT) and FVII. Twelve OLT patients were divided into two groups on the basis of clinical outcome: group A (six cases) in which OLT was successful, and group B (six cases) who developed initial non-function of the graft liver. PT, FVII activity (FVII:act) and antigen (FVII:Ag) and PC activity (PC:act) and antigen (PC:Ag) were carried out on six blood samples collected during the operation. At baseline, coagulation disorders were in agreement with the underlying liver disease, but no differences were seen between the two groups when all tests were considered. Ten minutes, 1, 2 and 3 h after liver reperfusion, mean PT and FVII:act were always significantly increased in good responder patients compared to non-responders. FVII:Ag and PC:Ag were significantly higher in group A than in group B starting 2 h after the liver graft reperfusion; no difference was seen in PC:act levels between the two groups. In addition, PC:Ag mean levels were increased with respect to corresponding PC:act values in non-responder patients, suggesting a qualitative rather than quantitative defect of protein synthesis due to liver damage. In conclusion, PT and FVII:act were more sensitive than PC activity as early prognostic indices of clinical outcome in OLT.

Adult↗
PubMed1993

[Timing in disorders associated to tracheo-pulmonary pathology].

Although a wide variety of extrathoracic pathologies may be associated to tracheo-pulmonary lesions, this paper draws attention to tumour pathologies due to their frequency and the difficulties involved in their treatment in relation to the question of "whether to carry out treatment" as well as the importance of timing. This dual nature is particular true of malignant conditions, since the lung may be the site of primary tumours and metastasis. The most frequent associations reported in the literature are tumours of the upper airways-digestive tract and colon carcinoma. Although tumours of the upper airways-digestive tract and lung cancer are both primary and primary tumour must be given priority treatment and only when oncologically satisfactory results have been obtained and there is no evidence of metastasis in other sites, are lung metastases. As far as concerns tracheal pathologies, this often takes the form of a locoregional extension of tumours from nearby organs such as the thyroid gland. In these cases, it is preferable to carry out total thyroidectomy and tracheal resection using T-T anastomosis.

Follow-Up Studies↗
PubMed1991

[Thymoma: anatomo-clinical and therapeutic aspects. Analysis of our 26 cases].

The paper reports the authors' personal experience with regard to 26 cases of thymoma treated surgically over the past 10 years. 96% of cases were associated with myasthenia gravis. Surgery was performed in all cases and 13 cases (50%) underwent additional RT. 92% of patients were affected by invasive thymoma (11 stage II cases, and 13 stage III). From an histological point of view, 38.5% of cases were epithelial-type thymomas, 38.5% were lymphoepithelial and 23% were lymphocytic. Survival was influenced by the stage of disease and the radicality of surgery. At present, 76% of patients are still alive between 10 months and 10 years of surgery. There was a perioperative mortality of 11.5% (3 cases), whereas 2 patients died some 2 months later due to pulmonary embolism. The paper also includes a critical review of the most recent literature, and the authors compare their experience with that of other centres.

Adult↗
PubMed1991

Current situation in the treatment of gallbladder cancer. Considerations on the utility of an extended resection.

Twenty-two of the 25 patients with carcinoma of the gallbladder seen during the last 9 years have been analyzed for survival in relation to treatment and disease stage. All patients were classified according to Nevin's staging scheme, and a correct preoperative diagnosis was made in 31.8% of cases. The median survival of the 8 stage V patients who had no surgery or alternatively underwent only limited excision of the tumor was 16.5 days (for the two patients receiving explorative laparotomy); 2 months for a patient undergoing a debulking operation and 5 months for the 5 patients receiving nonoperative biliary drainage. Survival in patients undergoing cholecystectomy, whether associated with biliary drainage or not has proved to be adversely affected by the stage of the malignancy, the stage I patient being alive and well at 2 years whereas the stage II patient died after 5 and a half months, the stage III patient survived 1 year and the stage IV patient 1 year and 6 months. Stage V patients receiving simple cholecystectomy (1 case) or associated with biliary drainage (5 cases) died 16.5 days and 4.5 months following surgery, respectively. More radical operations have been performed in 4 other stage V patients, who had resection of segments IV and V (2 patients, one of them survived 3 months and the other is still alive and well at 5 months), resection of segment IV (survival was 15 days), and right hepatectomy (survival 7 months). In view of our limited experience no statistically significant conclusions can be drawn.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1990

[X-ray diffraction study of biliary calculi. Morphological and composition correlations of calculi].

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).

Calcium↗
PubMed1989

[Applied effectiveness of human fibrin glue (Tissucol) in tracheal reconstruction. Experimental research with a clinical orientation].

Tracheal surgery is not without complications in the genesis of which a by no means secondary part is played by the suture material use. To obviate these complications a variety of resorbable materials have been studied. In a personal experimental study in the rabbit, the usefulness of a human fibrin glue was assessed in terms of two of its properties: its adhesive capacity and its ability to seal the anastomosis. In the first place, use of the glue made it possible to reduce the number of suture points employed in fashioning the anastomosis. This is an important result considering the role played by the suture material in favouring the appearance of granulations and restenosis. Second, Tissucol has a good sealant effect on the anastomosis and reduces postsurgical complications such as subcutaneous emphysema and perianastomotic abscess. Finally, it should be observed that this material also offers good control of intraoperative haemorrhage.

Animals↗
PubMed1989

Cost-benefit of follow-up after total gastrectomy.

An appraisal in terms of cost/benefit or follow-up gastrectomy for gastric cancer is made. Between 1981 and 1987, 90 patients underwent surgery (resectability 94%); of the radically treated patients, 32 underwent total gastrectomy (55%) and 26 subtotal resection (44%). In the group of 32 patients receiving palliative treatment, 11 underwent total gastrectomy. Two patients (4.6% died postoperatively of pulmonary complications and hyperosmolar coma during TPN. Instrumental, clinical and laboratory follow-up was performed in 82 patients out of 88 (93%), 6 not being available for outpatient follow-up. Our standard follow-up examination in these patients includes the following studies (chest x-ray, EGD, liver ultrasound, upper abdominal CT scan, cholescintigraphy with HIDA and barium examination of the upper G.I., tract when needed) performed every 6 months for the first 2 years and then annually for the next 5 years. Laboratory tests were performed every 3 months for the first 2 years and then every 12 months in order to monitor both evolution of neoplasia and possible metabolic functional problems. In the group of patients who underwent total radical gastrectomy, no side-effects or dysfunctional problems were observed, and the recovery of body weight was never less than 80% of the weight prior to diagnosis of the disease. Until now, 4 deaths due to neoplasia have occurred, 2 of which following recurrences after total gastrectomy for peritoneal carcinosis and multiple liver metastases, with an average survival time of 21 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Surgical management of tracheal stenoses: personal experience with 105 cases.

A 10-year experience with 105 tracheal lesions is reported. Of these, 61 were inflammatory stenoses (27 post-tracheotomy, 26 post-intubation, 6 mixed and 2 post-irradiation), 30 neoplastic stenoses, 12 traumatic lesions and 2 degenerative lesions. The therapeutic approach should consider the type, site, extension and multifocality of the lesion. In inflammatory stenoses resection followed by end-to-end anastomosis was performed: resection with Montgomery T-tube in 16, and laryngeal release in 3 since the resected portion was extensive. In neoplastic forms it is necessary to utilize techniques (Montgomery or laser) which permit the respiratory lumen to remain open since surgery is not always possible. As for traumatic lesions in 4 cases resection followed by end-to-end anastomosis, in 5 a simple suture of a lesion and in 3 intubation, was performed. This experience showed that the treatment of choice for tracheal stenoses is resection with primary anastomosis. The Montgomery T-tube prosthesis and laser therapy were also effective.

Adenoma↗