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R Arca

Publications and source records attributed to R Arca.

4 recordsLinked to original sources

[Gallstone ileus].

Gallstone ileus is a rare condition whose diagnosis may be difficult. From January 1976 to December 1991 4 cases of gallstone ileus were treated in our hospital, representing 1% of all patients admitted with mechanical bowel obstruction during that period. Three patients were treated by enterolithotomy alone to remove the impacted stone. In one patient intestinal resection of the bowel tract was associated followed by end to end anastomosis. One patient died (33%) seven days after surgery for cardiopulmonary failure. In one patient the obstruction resolved with the passage of a stone per rectum. The Authors conclude that enterolithotomy alone should be the standard procedure for gallstone ileus. The repair of cholecyst-enteric fistula should be done later only if there are continuing or recurrent symptoms.

Aged↗

[Adenocarcinoma of the cardia: results of resection with nic interposition].

The incidence of cancer of the cardia is increasing. Surgical treatment, in a small percentage of patients in early stage, consists in esophagectomy and total gastrectomy, followed by colon interposition. The operation can be performed through the thorax or by an abdominal and cervical approach. From 1982 to 1989 twenty-five patients were operated on. Between 1980 and 1982 the cancer was resected opening the thorax in 9 patients (group A), while from 1983 to 1989 the esophagus was removed through diaphragmatic hiatus in 16 patients (group B). All cases were analyzed as for histology, staging and resection margin. Average clinical follow-up was 22 +/- 32.7 months (range 1-102). Morbidity was 77.7% in group A and 68% in group B. Mortality dropped to 14% in the last 7 patients. Mean survival time was 23 +/- 34 months in group A and 11.2 +/- 13.7 months in group B (p = N.S.). Follow-up controls showed that all patients, in whom the esophagus was replaced with colon, were able to feed adequately.

Adenocarcinoma↗