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Biomedical subjects

R Paolucci

Publications and source records attributed to R Paolucci.

At least 19 recordsLinked to original sources
PubMed2005

Avoiding axillary dissection in breast cancer surgery: a randomized trial to assess the role of axillary radiotherapy.

BACKGROUND: The need to dissect axillary nodes in patients with early breast cancer and clinically negative axilla remains controversial. The aim of the study was to assess the role of axillary radiotherapy (RT) in reducing axillary metastases in patients with early breast cancer who did not receive axillary dissection. PATIENTS AND METHODS: From 1995 to 1998, 435 patients over 45 years old with breast cancer up to 1.2 cm and no palpable axillary nodes were randomized 214 to breast conservation without axillary treatment and 221 to breast conservation plus axillary RT. RESULTS: After a median follow-up of 63 months, overt axillary metastases were fewer than expected: three cases in the no axillary treatment group (1.5%) and one in the RT group (0.5%). Expected cases were 43 in the no axillary treatment group and 10 in the RT group. Rates of distant metastases and local failures were low, and 5-year disease free survival was 96.0% (95% confidence interval, 94.1%-97.9%) without significant differences between the two arms. CONCLUSIONS: This study suggests that occult axillary metastases might never become clinically overt and axillary dissection might be avoided in patients with small carcinomas and a clinically negative axilla. Axillary RT seems to protect the patients from axillary recurrence almost completely.

Aged↗
PubMed2003

Management of true splenic artery aneurysms. Two case reports and review of the literature.

Few series of splenic artery aneurysms (SAA) have been reported, but today asymptomatic SAA are detected with increasing frequency. Their importance lies from their potentially fatal consequences as life-threatening hemorrhage. SAA management still remains controversial as reported in this review. Our 2 patients treated with resection of the aneurysms, both located in the middle third of the splenic artery. Some authors demonstrated that when splenic artery has been ligated (or embolized) and the patients remain anatomically splenic, they may not retain any splenic function. Laparoscopic SAA ligation repair appears to be optimal and useful for aneurysms protruding from the pancreas and it is gaining interest because clinical recovery is rapid with a poor morbidity and economic and cosmetic advantages. Transcatheter embolization too offers a temporary control in urgency to stop hemorrhage and go back at later date to make much better elective operation. Endovascular interventions as percutaneous embolization has recently gained popularity: it offers a safe alternative or adjunctive therapy to traditional surgery. We hope in the future instrumentation will likely improve so that this procedure can be done percutaneously by development of prosthetic devices in the 21th century.

Adult↗
PubMed1994

[Stereotactic fine-needle aspiration biopsy (FNAB) of nonpalpable breast lesions: cyto-histological correlations].

There are not complete consensus if mammographically guided FNABs of nonpalpable breast lesions can replace open biopsy. To elucidate this problem, we have reviewed the efficacy of stereotactic FNAB in a series of 502 cases of nonpalpable lesions observed in a period from 1990 to 1994, with a immediate cytologic control of adequacy of material. In 144 patients of the lesion is achieved with 4% sterile coal localisation and an open biopsy of the area performed. In each case cytologic findings, with a brief description of probable histotype of the lesion, are correlate with surgical pathologic diagnosis, with a comparison between two time period (1990-92; 1993-94). In our study particularly ductal and lobular hyperplasia (with or without atypia) restrict the efficiency of the FNAB. In fact the specificity varies from 83.3% to 90.3%, the sensitivity from 78.7% to 77.8%, positive predictive value from 86.0% to 90.3%, negative predictive value from 75.6% to 70% and diagnostic accuracy from 80.0 to 82.4%, considering ductal and lobular hyperplasias as true negatives or true suspects. Cytologically we have 2 false positive in the first period of time, 3 false suspects in the second period of time and 7 false negatives. However benign/malign biopsy ratio is well (0.97). Moreover histopathologic informations of cytological diagnosis is variable according the histotype of the lesion. In conclusion our study confirm that FNAB is an reliable method that avoid unnecessary biopsy but is insufficiently sensitive to replace open biopsy of nonpalpable breast lesions, also with an immediate cytological control of adequacy of aspirate.

Adult↗
PubMed1993

[Proposal of a surgical technique to avoid deformities after conservative treatment of T1 tumors of centroinferior quadrants of the breast].

An important aim of breast surgery is to perform a conservative treatment in which both oncological and cosmetic purposes are fulfilled. This is achieved for the T1 tumors of the upper quadrants by means of the elliptical radial quadrantectomy. In the central or inferior quadrants the cosmetic results performing the same technique are poor. We have recently published a new technique called Centroinferior Hemimastectomy for the treatment of T1 breast cancer with which both the aims are respected. We report the data obtained from thirty-three consecutive Centroinferior Hemimastectomies performed from January 1989 until June 1993. The tumors were removed as described and for those centrally located also the nipple areola complex was removed. The reconstruction was carried out by immediate reimplantation of the nipple (10 cases) or later by tattooing (16 cases). For the tumors located in the inferior quadrants, the nipple-areola complex was made to emerge through the circular skin incision and sutured separately (7 cases). The oncological follow-up (range 3-42 months, mean 16 months) did not show local or systemic relapses. The cosmetic evaluation of the patients was subjectively and objectively very good. Thus the technique can be considered a research progress offering a better quality and quantity of life.

Breast Neoplasms↗
PubMed1993

Contralateral spontaneous pneumothorax after single lung transplantation for fibrosis.

The authors report the treatment of a case of contralateral spontaneous pneumothorax during single lung transplantation. This is a unusual complication that must be treated to avoid life-threatening problems. There is no consensus of opinion on therapeutic procedures. This work underline the success obtained with a simple thoracostomic drainage.

Adult↗
PubMed1989

[Use of prostheses made of ePTFE in anastomoses of the rat uterine horn].

ePTFE prostheses were used in the microsurgical anastomosis of the rat uterine horn. Handling characteristics of this synthetic material during the performance of anastomosis were tested. Patency rates, infections and local tissue reaction were evaluated after thirty and sixty days. Connective tissue infiltration and incomplete endothelialization by normal endometrial elements were observed on the luminal surface of the prosthesis.

Anastomosis, Surgical↗
PubMed1981

[Cancer of the kidney. Natural history and therapeutic problems].

Radical nephrectomy with initial ligation of the renal artery and removal en bloc of the perirenal fat and lumboaortic lymphadenectomy was carried out according to the technique of Robson (1969) in 10 cases at the University of Parma 1st Surgical Clinic between 1976 and 1978. The usefulness and superiority of the technique were demonstrated in this albeit small series, which included four stage I, two stage II, one stage III, and four stage IV patients, according to the classification of Flocks et al. Supplementary antiblastic and/or hormonal treatment was given, except in stage I cases. 1.4 mg/m2 Velbe i.v. (1st day) followed by 80 mg/m2 BCNU i.v. (2nd, 3rd, 4th days) was of no avail, whereas progesterone (Depot-provera 200-500 mg/day for 1-3 months) and testosterone propionate (300 mg/week) still seem to be effective. Improvements in this oncological sector, however, are geared to the outcome of radical nephrectomy.

Adenocarcinoma↗
PubMed1978

[The clinical significance of Serratia infections during the post-operative course (author's transl)].

A series of 25 cases of Serratia infections, during the period from november 1977 through aptile 1978, is reported. Serratia isolates were identified with increasing frequency from urine, surgical incisions and blood. All the patients had received antimicrobial therapy prior to the time Serratia was first isolated. These patients (92%) had had indwelling urinary catheters inserted during the post-operative course and Serratia was isolated predominantly from the urinary tract. In 3 patients who died, Serratia played a role in the ultimate demise of the patient. Prophylaxix and antimicrobial therapy are discussed.

Aged↗
PubMed1977

[Surgical treatment of complications in cases with cancer of the colon and rectum].

Personal experience and the literature are referred to in an examination of complications arising in the course of cancer of the large intestine. A personal series assembled in about 20 years is presented. It consists of 135 cases of heteroplasia, including 57 emergency admissions for complications. The surgical technique employed is described. The results show that surgical risk and post-operative mortality are lower in patients subjected to major radical surgery, as opposed to those for whom symptomatic management or simple, derivative operations are prescribed.

Adult↗