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Biomedical subjects

R De Angelis

Publications and source records attributed to R De Angelis.

At least 55 records · Page 3Linked to original sources
PubMed1990

Effect of preoperative colonoscopy on the incidence of synchronous and metachronous neoplasms.

Colonoscopy and air-contrast barium enema performed preoperatively in 389 patients with colorectal cancer revealed synchronous cancer in 4% and polyp in 14%. Nine of the 16 synchronous cancers were located in other surgical segments than the index cancer, and six of the nine were in stage A or B1. Of the 54 synchronous polyps, 28 were located in such other segments. Half of the synchronous cancers and almost half of the synchronous polyps were missed at double-contrast barium enema. All synchronous cancers and three-fourths of the synchronous polyps were detected at colonoscopy. No patient with preoperative colonoscopy presented with metachronous cancer within 3 years from surgery, and only two were subsequently found to have adenocarcinoma arising from an adenomatous polyp. Endoscopic polypectomy was performed in 21 cases during follow-up. Extensive use of preoperative colonoscopy is recommended in the evaluation of colorectal cancer, in order to promote detection of synchronous tumors, reduce the incidence of 'early metachronous' cancer and avoid malignant degeneration of adenomatous polyp.

Adult↗
PubMed1989

Right colon cancer: long-term results after curative surgery and prognostic significance of duration of symptoms.

Between 1976 and 1986, a consecutive series of 195 patients with right colon cancer were admitted at the First Department of Surgery of the University of Rome. Patients were divided into five groups according to the absence of intestinal symptoms (group 1) and the duration of the symptomatic phase (groups 2-5). Analysis of the preoperative investigation showed that colonoscopy was able to identify 33 (26.2%) of tumors misdiagnosed by double contrast X-ray barium enema. We did not notice any correlation among symptom duration and tumor stage, tumor differentiation, operability rate, and survival. Patients admitted in the asymptomatic phase presented tumors of less advanced stage and, thus, had the best survival rate (71.4%). In this group, patients promptly treated had a better survival rate (87.5%) than those treated after 2 months (50%). Our study suggests that only neoplasms diagnosed in asymptomatic patients and treated promptly are related to a good survival rate. We, therefore, emphasize the importance of education of patients and family physicians about right colon cancer and the necessity to investigate all patients with a suspected right colon cancer by means of colonoscopy.

Colonic Neoplasms↗
PubMed1989

Synchronous large bowel cancer: a series of 47 cases.

The incidence of synchronous cancer has been reported to be 1.5% to 7.6%. A retrospective review of all colorectal cancer patients was conducted to determine the incidence of synchronous cancers. 47 synchronous cancers were identified in an operative series of 2586 patients with an incidence of 1.8%. The patients were divided into two groups based on preoperative diagnostic examinations. The first group included 1608 patients examined by double contrast x-ray barium enema (1141) and/or single contrast barium enema (381) and/or rigid sigmoidoscopy (112). The second group included 978 patients examined by double contrast barium enema (459) and/or flexible sigmoidoscopy (631) and/or colonoscopy (389). The incidence of synchronous tumors was 1.6% for patients evaluated only with double contrast roentgenographic study and 4.1% for patients who underwent preoperative colonoscopy. Fifty percent of synchronous cancers detected by colonoscopy were missed at double contrast x-ray barium enema. While twenty two percent of synchronous tumors detected by barium enema were located in different surgical segments and were all "advanced" tumors, when preoperative colonoscopy was performed, 56.2% of synchronous tumors were not located in the same surgical segment, and 66.7% of these were "early" cancers. None of the patients who underwent preoperatively colonoscopy developed a metachronous tumor within 3 years. One percent of patients undergoing flexible sigmoidoscopy or double contrast barium enema developed a second tumor 3 years after surgery. An extended use of preoperative colonoscopy in the diagnosis of colorectal cancers, to increase the detection od synchronous tumors and to decrease the incidence of the so-called "early" metachronous cancers, is stressed.

Adult↗
PubMed1988

Tolerance of the oral clonidine test in 75 pediatric patients.

We evaluated the tolerance and effectiveness of the oral clonidine test for GH in 75 children, 84% with hyposomia and 16% with other diseases. The test was well tolerated, since 97% of the examined children had no side effects with the exception of occasional drowsiness, pallor and myosis of short duration. Two of the children at the end of the test, had more severe symptoms 30 min after (deep asthenia, pallor and a further small blood pressure drop) which however, resolved after 4-6 h. No correlation was observed between the clinical picture and the drops in blood pressure and/or plasma cortisol in the children examined. We confirm the effectiveness of the clonidine test in the release of GH since in our study we observed no negative false subnormal responses.

Administration, Oral↗
PubMed1988

Tissue CEA as prognostic indicator in a series of 31 cases of gastric cancer.

The role of tissue CEA localization as a complementary factor in prognosis of patients affected by gastric cancer is analyzed. In a group of 31 gastric tumors, tissue CEA was always present in the apical portion of the tumor cell cytoplasm and in the glandular lumen, while in 23 cases it was found in the stroma, and in superficial and deep cell cytoplasm in 26 and 20 cases respectively. The serum marker levels were over 3 ng/ml in 19 patients. A relationship between CEA localization and tumor stage was observed. The more the tumors were advanced, the more the marker was found in the stroma and in the cytoplasm of superficial and deep cells. The same was found for CEA localization and serum CEA levels. The opposite trend was evidenced for the degree of tumor differentiation. In well differentiated tumors in a high percentage of cases the marker was present in the stroma and in the cytoplasm of superficial and deep cells as compared with undifferentiated tumors. No relationship between the histologic type and CEA localization was found.

Biomarkers, Tumor↗
PubMed1987

Tissue CEA as prognostic indicator in a series of 44 cases of colorectal cancer.

The role of tissue CEA determination as a complementary test in the staging of colorectal cancer and monitoring of the marker in the follow-up of patients, is stressed. In a group of 44 colorectal cancer patients, tissue CEA was determined by the immunoperoxidase assay in the apical and cytoplasmic portion of tumor cells, stroma, glandular lumen, and cytoplasm of superficial and deep cells. A correlation has been observed between spread and stage of tumor and CEA localization at the level of the stroma and cytoplasm of deep cells. It has been also evidenced that in all cases where CEA was present in the stroma and cytoplasm of deep cells, high serum levels of the marker were detected.

Biomarkers, Tumor↗
PubMed1987

Carcinoma arising in previously partially excised congenital choledochal dilatation. Case report and review of literature.

A 20-year-old man with congenital choledochal dilatation associated with carcinoma was treated. At the age of 10 years he underwent a cholecystectomy and partial resection of the cyst. At admission the patient complained of hypochondriac and back pain combined with bilious vomiting. He underwent a palliative operation. A review of the literature is presented on treatment and prognosis of patients with carcinoma arising in choledochal congenital dilatation previously treated by surgery other than excision. It is emphasized that the cystic dilatation should be removed at the time of the first operation. Furthermore, in patients who underwent surgical treatment without excision of the choledochal dilatation, the dilated biliary tract should be removed even in absence of subjective symptoms.

Adult↗
PubMed1985

Surgical treatment of liver metastases from colorectal cancer.

The experience with 28 patients undergoing hepatic resection for metastases from colorectal cancer is reported. In 15 cases the metastases were synchronous, in 13 metachronous, appearing 12 to 60 months after surgery of primary cancer. Six patients underwent right lobectomy, 2 left lobectomy, 9 left lateral segmentectomy, 6 right wedge resection and 2 bilateral wedge resection. In 20 cases the lesions were solitary, in 8 multiple. Overall operative mortality was 14.2%. Mean survival for synchronous metastases was 16 months with 3 patients living beyond 12 months, and 26 months for metachronous metastases with 4 patients living beyond 12 months. The obtained results are analyzed on the basis of staging of primary cancer, of the metastatic disease and type of resection, examining the morbidity and cause of long term mortality. It is evidenced that, even if correct pre- and intraoperative staging of metastatic disease is impossible, an aggressive surgical approach is the treatment of choice in surgically resectable liver metastases from colorectal cancer.

Actuarial Analysis↗
PubMed1984

Iatrogenic lesions of main bile duct.

Eighty-six patients operated for stenosis caused by previous iatrogenic lesions of main bile duct over a 13-year period are reported. The incidence of operative lesions of main bile duct is 0.2 to 0.7% and a number of them are caused by surgery on the biliary tract (90%-95%), gastric resection or portacaval shunt. Sixty-five cases were treated by hepaticojejunostomy, 3 by hepaticojejunoduodenostomy and the remaining 18 patients underwent choledochoduodenostomy. Postoperative complications and long term results are also examined.

Bile Duct Diseases↗
PubMed1984

Pathophysiological patterns of hepaticojejunostomy. Scintigraphic evaluation.

Results obtained using 99mTc HIDA in the follow-up of 17 patients who underwent hepaticojejunal bypass for different indications are examined. Results are also compared to other commonly used procedures such as echography and cholangiography (I.V. or PTC). Preliminary results appear to confirm that cholescintigraphy is an accurate procedure which allows an anterograde and physiologic visualization of the anastomosis.

Adolescent↗