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Biomedical subjects

P Chiotasso

Publications and source records attributed to P Chiotasso.

29 records · Page 2Linked to original sources
PubMed1986

Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum.

Rectal resection with colo-anal anastomosis was performed in 65 patients with carcinoma of the lower rectum. In 20 a pelvic colonic reservoir was constructed while in 45 a direct anastomosis was carried out. There were no postoperative deaths and morbidity was comparable in the two groups. Functional results were determined by clinical examination and manometry. The frequency of bowel movements was inversely related to the maximum tolerated volume (P less than 0.001). During the first year 60 per cent of the patients with a reservoir and 33 per cent of the patients without had one or two stools per day (P less than 0.05). After one year, 86 per cent of the patients with a reservoir and 33 per cent of the patients without had one or two bowel movements per day (P less than 0.01). The maximum tolerated volume was increased by the reservoir (P less than 0.05). The loss of reservoir capacity of the rectum increases frequency of bowel movements in colo-anal anastomosis. The creation of a colonic reservoir improves function by increasing the maximum tolerated volume without any increase in mortality or morbidity.

Adult↗
PubMed1986

Synchronous abdominotrans-sphincteric resection of low rectal cancer: new technique for direct colo-anal anastomosis.

Sixty-five patients with low rectal cancer 4-9 cm from the anal margin were treated by rectal resection and direct colo-anal anastomosis. The procedure simultaneously combined abdominal dissection with the patient in the lateral position with a trans-sphincteric approach. In 57 cases a temporary defunctioning colostomy was performed. There were no postoperative deaths. Six patients (9 per cent) developed pelvic sepsis or anastomotic leakage. Faecal continence was normal in 46 of 51 patients (91 per cent) who were operated on at least 1 year previously. The remaining 5 complained of occasional minor soiling. No patients require a permanent colostomy for incontinence. Of 29 patients treated for potential cure greater than 3 years previously, 24 (82 per cent) were alive without recurrence. Local recurrence occurred in four patients (6 per cent). Direct colo-anal anastomosis using a combined abdominotrans-sphincteric approach has produced good functional results without impairing the patient's life expectancy.

Adult↗
PubMed1981

[Revascularization using the greater omentum. Results of an experimental study in dogs. Clinical perspectives (author's transl)].

An experimental study was conducted in dogs to study the increase an vascular supply to an ischemic zone after transplantation of the greater omentum. The study design, applied in eleven dogs, is described, and the various technical details emphasized : staged vascular ligature of one paw, preparation of the omentum, and transplantation using microsurgical procedures. The circulatory deficiency, evaluated by comparison with the healthy or similarly ligatured opposite paw, is well-compensated by the omental transplant, and a new circulation is established. This is apparent on pathological examinations and arteriography. Isotopic angiography, by means of labelled erythrocytes, supplies proof that a vascular pool is effectively derived from the transplanted organ and that it reaches the distal region of the ischemic limb. The increase in blood supply obtained suggests the possibility of new clinical indications. Apart from omentoplasty, already widely used in plastic surgery, the omentum could perhaps also be effective in certain areas of cardiovascular surgery, especially in some cases of arteritis where the distal vascular bed is greatly reduced. Further experimental studies, such as these described, are necessary before using this technique in humans.

Animals↗
PubMedDate not supplied

Pre-operative radiotherapy as adjuvant treatment in rectal cancer.

From January, 1975 to December, 1987, 241 patients with rectal cancer underwent pre-operative irradiation and surgical resection. The radiation was delivered with 25 MeV photons, 5 days per week by 2.4 grays fractions up to a total dose of 36 grays. Surgery was curative in 195 patients; 57% had abdomino-perineal resection. Irradiation had to be discontinued in 3 patients and 4 patients subsequently developed severe acute ileitis. Postoperative mortality rate was 2.9%. The most frequent postoperative complications were delayed healing of abdominal wounds (18%) and perineal wounds (14%). Severe late complications occurred in 27 (13%) patients. The incidence of intestinal obstruction was 5%. Follow-up survivors ranged from 18 months to 13 years. Local failure occurred in 24 (12%) of the 195 patients. Local failure rates were 10% for Dukes' A tumors, 11.6% for Dukes' B, and 22.7% for Dukes' C tumors. Five and 10 year actuarial survival rates after curative surgery were 70% and 52%. The Dukes' classification was the only factor that influenced survival.

Adenocarcinoma↗
PubMedDate not supplied

[Inguinal hernia. The Shouldice parietal repair].

Parietal repair according to the Shouldice technique consists of a double line of sutures on each of three musculo-aponeurotic layers of the groin, i.e. successively: plicature of the transverse muscle and attachments; aponeuroplasty by back-to-back suture of the internal and external oblique muscles, and plicature of the aponeurosis of the external oblique muscle. Parietal repair of this kind is only possible after wide dissection of the inguinal region. It can be performed under local anaesthesia during a short hospitalization period. Normal activity is rapidly resumed, and in the experience of those who favour this technique, the recurrence rate is a mere 1%.

Abdominal Muscles↗
PubMedDate not supplied

[Evaluation of systemic antibiotic preventive treatment in colorectal surgery].

A comparison was made of two methods of prophylactic antibiotic therapy against the septic complications of colonic and rectal surgery: --preoperative oral antibiotics associated with peroperative systemic antibiotics; --peroperative systemic antibiotics only, continued for 24 hours after surgery. Both types of antibiotic therapy were of short duration and were designed to cover aerobic and anaerobic organisms. Two groups of 30 patients were selected at random. They were homogeneous. The septic complication rate was 10% in the oral plus systemic and 24% in the systemic group. It is felt that the combination of oral and systemic antibiotics remains preferable, in particular bearing in mind the efficacy of oral metronidazole.

Anti-Bacterial Agents↗