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Biomedical subjects

P Boccasanta

Publications and source records attributed to P Boccasanta.

30 records · Page 2Linked to original sources

[Minor anal pathology. Suggestions for ambulatory and hospital treatment].

A series of cases of anorectal pathology treated at the out-patient level or after hospitalisation in the course of the last five years is reviewed. Deference is made to subjects with haemorrhoids operated according to Milligan-Morgan or Parks in accordance with varying indications, or treated cryosurgically as out-patients, patients with upper or lower transsphincteric perianal fistula treated by means of the lay-open technique or elastic tourniquet under general or local anaesthesia, patients with acute anal fissures treated by means of internal lateral sphincterotomy under local anaesthesia, and those with inveterate forms subjected to Arnous posterior leiomyotomy. From a critical assessment of the hospital and out-patient activities carried out suggestions and indications are drawn with regard to cases that must be treated in hospital and those for which outpatient management is correct.

Ambulatory Care↗

[Cryogenic treatment of rectal tumors].

10 patients with anal or rectal cancers were given liquid nitrogen cryogenic treatment. In 5 cases the treatment was given prior to abdominoperineal amputation of the rectum. The remaining 5 inoperable cases were given the cryogenic treatment alone, followed, in 3 cases by derivative colostomy. Histological reports on the removed tissues, carried out at different times after the cryogenic treatment, showed the effects of the treatment on the neoplasias and the surrounding tissues and showed the histological equivalent of possible local immunological processes. The thrombosis in the surrounding blood vessels appears to indicate the efficacity of cryogenic therapy in preventing the metastasis of neoplastic cells.

Adenocarcinoma↗

[Doppler ultrasonic method of blood velocity measurement in Raynaud's phenomenon].

Ten patients, 3 males and 7 females, aging less then 50 years (M: 37), suffering from at least one year for a Raynaud's phenomenon surely not due to a costo-clavicular syndrome, were studied. A Doppler ultrasound evaluation was first done recording the pressure and the speed at the omeral, radial, ulnar, and digital arteries. The patients were then submitted to an angiography in general anaesthesia through puncture of the omeral artery and to screening tests to detect possible associated immunopathological diseases. In the patients affected by Raynaud's phenomenon the vascular lesions are generally distal to the omeral artery; the only surgical indication is a thoracic gangliectomy. Our experience shows that the Doppler velocimetry gives all the data necessary to check the efficacy of a pharmacological treatment and to state a correct surgical indication.

Adult↗

[Combined therapy of colonic and rectal neoplasms in an advanced phase].

The results obtained in a series of 75 patients suffering from advanced cancer of the colon-rectum are examined. Survival of these patients is looked at as a function of the extent of surgical demolition, and as a function of postoperative chemotherapy. Demolition interventions were followed by much higher survival than was observed following palliative operations. At the same time, survival was higher in patients who underwent post-operative chemotherapy. The results therefore justify a more aggressive approach in advanced cancer of the colon-rectum.

Adult↗

[Usefulness of the Doppler velocimetry in patients undergoing direct arterial surgery].

Two patients with an atypical and particularly troubled history, due to numerous direct and indirect interventions of vascular surgery, have been monitored in haemodynamic investigation using only Doppler velocimetry. The use of angiography would have necessitated other general anaesthesiae which would have further compromised the already critical conditions of the patients. Doppler velocimetry proved suitable for surgical indication in emergency situations. The value of an arteriograph under general anaesthesia is, however, unquestionable in cases of choice surgery.

Aorta, Abdominal↗

Endoscopic ultrasonography in the evaluation of leiomyoma and extramucosal cysts of the esophagus.

BACKGROUND/AIMS: Leiomyoma is the most common type of benign esophageal tumor, whereas extramucosal cysts of the esophagus are congenital anomalies frequently asymptomatic in the adult and in most cases detected incidentally on chest x-ray. It is worthwhile considering these conditions together, because they present similar diagnostic and surgical problems. Conventional imaging tests do not lead to a precise diagnosis. The purpose of this study was to evaluate the use of endoscopic ultrasonography in the diagnosis of, and planning of treatment modalities for, these conditions. METHODOLOGY: Fifteen patients with esophageal leiomyoma and seven patients with extramucosal esophageal cysts were studied with endoscopic ultrasonography using an Olympus GF- EU-M3 instrument with a 7.5-12 MHz echoprobe. In all patients, the results of endoscopic ultrasonography were compared with the histology of the resected specimens. RESULTS: The histology of the resected specimens confirmed the endosonographic diagnosis in all patients. No malignancy was found in any specimen. CONCLUSIONS: Endoscopic ultrasonography is very accurate in visualizing these lesions and differentiating cystic from solid submucosal esophageal masses; in addition, the test can establish the exact location of the mass in relation to the esophageal wall and mediastinum. Therefore, endoscopic ultrasonography has a great impact in confirming the diagnosis of leiomyoma and extramucosal cysts of the esophagus and facilitates therapeutic decision-making because of its capacity to clearly define the size, layer of the origin, and pattern of the mass.

Adult↗

Circular hemorrhoidectomy in advanced hemorrhoidal disease.

BACKGROUND/AIMS: Milligan-Morgan's hemorrhoidectomy has a high recurrence rate (> 10%) in patients with circular IV grade hemorrhoids. In such cases a circular hemorrhoidectomy with complete elimination of residual piles, and anoplasty might be more successful. The aim of this retrospective study was to compare the results of circular hemorrhoidectomy using the Hopital Leopold Bellan (HLB) technique (Paris) with the reported results of other techniques in patients with advanced hemorrhoidal disease. METHODOLOGY: From January 87 to December 96, 100 consecutive patients with circular IV grade hemorrhoids underwent radical hemorrhoidectomy. Mean hospital stay was 4 days (range 3-7). Patients were strictly controlled in the postoperative period and in cases of early fibrosis anal dilators were used. RESULTS: Eighty one percent of patients had a complete recovery. The recurrence rate was 4%. The cumulative rate of early and late complications was 34%. Early and late hemorrhages were more frequent than in traditional hemorrhoidectomy, while the incidence of anal stenosis was the same. CONCLUSIONS: The HLB operation is the best choice for patients with advanced circular hemorrhoids because of its radicality and good results. The postoperative morbidity of HLB hemorrhoidectomy is higher than traditional hemorrhoidectomy; nevertheless, all complications are tractable without extension of hospital stay.

Adult↗

Retroperitoneal fibrosis: unusual localization.

Six cases of retroperitoneal fibrosis, each with a different pathogenesis and unusual localization were observed from 1980 to 1996. Four patients had had previous surgery for a neoplasm, one patient had idiopathic retroperitoneal fibrosis, and the last patient was hardly classifiable due to the complexity of the clinical pattern. The mean survival in 3 patients with malignant retroperitoneal fibrosis was 7 months. Two patients treated with medical therapy are still alive and in good clinical condition. The aspecificity of the symptoms makes early diagnosis difficult. CT and NMR are essential procedures for differential diagnosis of abdominal masses. Histology differentiates benign from malignant retroperitoneal fibrosis. The choice between medical or surgical therapy depends on the general condition of each patient.

Barium Sulfate↗