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R Biasiato

Publications and source records attributed to R Biasiato.

At least 19 recordsLinked to original sources
PubMed2004

[Two cases of small bowel ischemia due to unusual cause].

The authors report 2 cases of small bowel ischemia due to unusual cause. In both cases, vasculopathy was the cause of ischemia, but with a different etiology. In the first case, a mesenteric inflammatory veno-occlusive disease, with striking features of extensive phlebitis and venulitis affecting the veins of the small intestine and mesentery, without arterial involvement of this district was observed and histological examination showed inflammatory lymphocytic infiltrates and myointimal hyperplasia of the veins. The second case affected by intestinal ischemia from secondary and multiple cholesterol embolism, the histological examination showed inflammatory infiltrates with (lymphocytes and granulocytes) in the vessels of submucosal mesenteric area, by loose intimal fibrosis incorporating cholesterol clefts. Both patients required surgical exploration with resection of ischemic bowel. In the second case laparoscopy was the initial approach which allowed to identify the extension of ischemia with special regard to the perforation. The ultimate diagnosis is possible only with histological examination. Clinically, patients show the general signs of intestinal ischemia with pain, vomiting and bloody diarrhea. Prognosis depends on the extension of the lesions and the early surgical treatment.

Aged↗
PubMed2001

[Sigmoid occlusion due to endometriosis. A case report].

The Authors report a case of sigmoid obstruction due to endometriosis and review the literature about. Unusual localisation and difficult preoperative differential diagnosis with IBD and bowel carcinoma are stressed. A 45-years old woman with previous history of oophorectomy was admitted at the hospital with symptomatic bowel obstruction. A barium enema showed a sigmoid stenosis thought to a carcinoma of bowel. A laparoscopic approach confirmed the diagnosis and a laparotomy was performed with a subsequent anterior resection (end-to-end anastomosis with stapler) plus myomectomy. The Authors do believed, during surgery, to be treating a carcinoma which disappeared with opening the specimen. The mucosa were intact and muscular layers so think to form a strong ring to be able to invaginate the upper colon for 3-4 cm. A stromal tumor was supposed and the definite diagnosis of endometriosis was very surprisingly. Intestinal resection to be necessary, with associated salpingo-oophorectomy and hysterectomy in older patients and treatment with oral contraceptive in younger female. Laparoscopy may be helpful in the diagnosis showing pelvic endometriosis with bowel wall involvement. Laparoscopic treatment in our opinion must be confirmed to particular situation and to well experience of surgeons.

Colon, Sigmoid↗
PubMed1998

[Gastric pull-up in pharyngo-esophageal reconstruction: a personal experience].

During the five-year period from 1992 to 1997 a total of 62 patients with advanced hypopharyngeal carcinoma extended to the cervical esophagus came to our attention. Of these 42 (67.7%) were deemed operable and of these 31 (23 males, 8 females; age range 48 to 74 years; mean age 58.5 years) underwent total pharyngolaryngoesophagectomy and gastric pull-up reconstruction. Post-operative mortality was seen in 3 cases (9.7%). In addition, the following complications were encountered: dehiscence of the anastomosis (3 cases), neck hemorrhage (2 cases), pyloric stenosis (1 case). Two patients required intraoperative splenectomy to stop the hemorrhage caused by gastric mobilization and one required thoracic drainage, again because of hemorrhage. The average period of hospitalization was 36 days (range: 20 to 63 days). Per os feeding was restored from 20 to 63 days after surgery (average 20 days). Three patients (9.6%) showed functional failure--that is the inability to feed without the nasogastric probe. To date 10 patients (32.2%) are alive and disease free at an average 18.8 months after surgery (min. 1 month, max. 66 months); 7 patients (22.5%) are alive but not disease free; 11 (35.5%) passed away (in addition to the 3 post-operative cases) and 10 (32.2%) of these deaths were due to recurrence while 1 patient was still disease free at the time of autopsy. In conclusion the authors feel that total pharyngolaryngoesophagectomy with gastric pull-up is a safe treatment; i.e. with an acceptable mortality rate. Post-operative morbidity is high but the final functional outcome is good and, in most cases, can certainly improve the quality of the patients' remaining life. Even though prognosis is quite severe, with average survival of around one year, some of our patients are still alive and disease free 4-5 years after treatment.

Aged↗
PubMed1990

The use of somatostatin in acute pancreatitis--results of a multicenter trial.

This study involves a multicenter trial aimed at evaluating the comparative beneficial therapy of somatostatin and traditional symptomatic therapy in the management of acute pancreatitis. According to our final data somatostatin has not proved to be any better than traditional medical treatment. Nevertheless, in our opinion, the advantage of a single and expeditious therapy makes somatostatin administration preferable to the combined employment of several therapeutic measures usually applied in these circumstances.

Acute Disease↗
PubMed1988

[Angiographic and clinical evaluation of the topical administration of nitrate derivatives in distal obstructive arteriopathies of the legs. Initial experiences].

The vasodilator effect obtained by the topic use of a nitroglycerin compound (TNG) has been angiographically tested on 11 patients affected by distal arteriopathy of the legs. All patients presented arteriosclerotic vascular lesions; two of them also suffered from diabetic angiopathy. Arteriography of the legs has proved to be a very important tool in the evaluation of the patients' response to the administration of the drug. An hour after 80 mg of TNG had been applied to the skin of the examined leg, arteriography showed a marked dilation, especially of the muscular arteries and the undamaged tracts of the arteries of the legs. Angiographic evaluation of the functional blood supply thus obtained provides prognostic information and helps in the choice of the subsequent therapy. Furthermore, the clinical efficacy of prolonged treatment with this drug has been tested in 10 out of the 11 patients. They all responded with an immediate and persistent hemodynamic improvement, evaluated according to Fontaine's classification.

Administration, Topical↗
PubMed1984

Peristomal hernia following end-colostomy: a conservative approach.

Available data from follow-up of 183 patients who survived abdominoperineal excision for cancer of the rectum are reviewed. Sixteen patients developed a peristomal hernia, but none required surgical correction for over 20 years of observation. An additional group of 50 long-survivors has been recently examined to verify whether our restrictive surgical indications are adequate. Seven of these patients presented with a hernia, but none suffered obstructive symptoms and surgery was judged unnecessary in every case. Thereby, in our view, the benign evolution of peristomal hernias support a conservative approach based on a confident observation, control of the diseases which increase the abdominal pressure, and hernia compression by a colostomy belt.

Colostomy↗
PubMed1976

[Notes on the embryology and anatomy of the diaphragm].

The main steps in the embryogenesis of the diaphragm are summarised, with particular reference to details of major importance in the formation of congenital hernias. Morphogenetic abnormalities of the diaphragm are described. Malformations occurring during the different stages of embryonal development (agenesia, total or partial aplasia or eventratio, restructuring defects) and their incidence are also illustrated. A personal view concerning the topography of congenital hernias of the diaphragm is expressed, with particular reference to those proceeding through incostant foramina.

Diaphragm↗
PubMed1976

[Acute complications of hernias caused by congenital defects of the diaphragm].

Following a classification of the various types of congenital hernia of the diaphragm, the acute complications that may be caused by such defects of diaphragmatic morphogenesis are reviewed. Relative physiopathology is considered, particularly as regards the thoracic dimension of large hernias of the cupola. As regards visceral hernia, the most typical pictures of the two commonest complications, volvulus and strangulation, are described among other aspects. The clinical situation is outlined bearing in mind the diversity of anatomoclinical pictures in relation to the age of the patient, the type of hernia involved, and the period in which the observation was made. The surgical problems involved in acute complications concern the approach--although agreement is almost unanimous depending on the type of hernia--viscous reduction modalities and the type of plastic surgery which is required on each occasion. Postoperative complications and the prognosis for these hernias are reviewed briefly.

Diaphragm↗
PubMed1975

Postoperative chylothorax. Six cases in 2,500 operations, with a survey of the world literature.

We have systematically reviewed the literature concerning iatrogenic chylothorax and shall report our personal observations on the subject. Despite an increasing number of thoracic operations, injuries to the thoracic duct are infrequent. Cardiovascular and esophageal procedures are the most frequent causes of chylothorax. Malformations of the thoracic duct and other organs of the mediastinum have often been involved in lymphatic injury. Consequently, we believe that a complicating chylothorax may result from varied causes rather than solely from a surgical error.

Adolescent↗
PubMedDate not supplied

[Surgical treatment in acute cholecystitis emergencies].

The aim of the study was to demonstrate the importance of early laparoscopic cholecystectomy for acute cholecystitis, without "conservative" treatment (intravenous fluids and antibiotics for 48-72 hours) to reduce inflammation. Early laparoscopic cholecystectomy reduces bile duct injury and the percentage of conversion to open cholecystectomy. Thirty-five patients with acute cholecystitis were submitted to early laparoscopic cholecystectomy, equally divided according to sex. All patients were submitted to US scans preoperatively and operated on by surgeons skilled in emergency laparoscopic operative techniques. Laparoscopic cholecystectomy was always performed with 4 trochars and the use of a 30 degrees laparoscope. Technical modifications during early laparoscopic cholecystectomy were drainage and decompression with subsequent de-tension and distention of the gallbladder. These manoeuvres entailed the use of Babcock, Endopatch (Ethicon) atraumatic forceps. In the presence of acute gallbladder inflammation we dissect the gall-blader well with a suction-irrigation tube. In patients suspected of having common bile duct stones, biliary duct injuries and/or anatomical changes due to inflammation, we perform intraoperative cholangiography. Five patients had conversion to open cholecystectomy (14.2%), in two cases (5.7%) for concomitant choledochal stones, in two cases (5.7%) for biliary peritonitis and in the fifth case (2.8%) for severe empyema of the gallbladder. Laparoscopic cholecystectomy was performed in 20 patients for acute cholecystitis (57.1%), in 9 patients for empyema (25.7%) and in 6 patients for gangrenous cholecystitis. Four cases presented postoperative complications owing to bile leakage from the liver bed, treated with antibiotic therapy. One patient presented jaundice on day 30 after laparoscopy owing to inadequate positioning of the clips on the cystic duct, near the common bile duct; ERCP was performed with application of a prosthesis, which was removed after two months. Our experience and results support the validity of early laparoscopic cholecystectomy in the treatment of acute cholecystitis, because it reduces the postoperative length of hospital stay and hospital costs. Early treatment is always helpful for inflamed and oedematous tissue which favours dissection, while dense, fibrotic adhesions hinder regular dissection with a greater risk of injury to the biliary duct and and a higher conversion rate to open cholecystectomy.

Acute Disease↗
PubMedDate not supplied

[Ketoprofen in the prevention of postoperative pain in abdominal surgery. A multicenter study].

Two-hundred-forty-eight patients undergoing abdominal surgery were admitted to a multicentric clinical trial. The patients were randomly assigned to a single i.v. dose of ketoprofen or acetylsalicylic acid, 15 minutes after the end of operation. Ketoprofen showed a better analgesic activity with a statistically significant difference at 2 and 4 hours after administration. Two patients treated with ketoprofen reported vomiting and skin rash respectively. The results of this study confirm the efficacy of ketoprofen for the prophylaxis of postoperative pain in abdominal surgery.

Abdomen↗