Biomedical subjects

V Casaburi

Publications and source records attributed to V Casaburi.

3 recordsLinked to original sources

PubMed2006

[Nearly total thyroidectomy: versus total thyroidectomy: our experience].

AIM: Generally, the classification of thyroidectomy as benign pathology is: multinodular toxic goitre, simple goitre, toxic adenoma, Base-dow disease, Hashimoto's tyroiditis Subtotal thyroidectomy provides for the removal of the gland except for a bilateral residue of about 6-10 g, near total thyroidectomy provides for the near total removal of the gland except for a residue inferior to 5 grams. Near total thyroidectomy has taken the place of the subtotal thyroidectomy. METHODS: In two years, in our institute, there have been exeuted: 96 near total thyrodectomies, 96 total thyroidetomies, 8 lobectomies ad two revues for recurrencies. RESULTS: In 2 cases there have been haemorrhagies after nearly total thyroidetomy. Only in 1 case we practiced tracheotomy for follicular carcinoma infiltering thiroidic cartilage. In 2 cases treated with nearly total thyroidetomy and in 4 cases treated with total thyroidetomy, there has been temporary hypoparathyroidism. In no case treared wih nearly total thyroidetomy and in 2 cases treated with total thyroidetomy, there has been permanent hypo-parathyroidism. In 5 cases treated with total thyroidetomy and in no case treated with nearly total thyroidetomy, there has been, monolateral, temporary paralysis of the inferior laryngeal nerve that solved in 6 months for 3 patients and in 2 months for 2 patients. CONCLUSIONS: There has not been permanent paralysis of the mono or bilateral inferior laryngeal nerve. Even if the surgical approach to the benign disease is now orientated to the total thyroidectomy, a more conservative surgery is, in our opinion, justified when a malignant pathology is excluded and considering also the low effect of recurrencies and hypothyroidism.

Adolescent↗

PubMed2002

[Parietal metastasis in laparoscopic surgery of colorectal carcinoma].

The role of videosurgery in the treatment of gastrointestinal cancers is still controversial. However port-site metastases, reported with high rate (0.6-21%) have reduced the enthusiasm and still represent object of research. Port-site metastases pathophysiology is not yet clear. However in the last years the incidence is decreased at a percentage less than 2% and similar to that reported after traditional surgery (0.6-5.3%) due to a patient selection and a better videosurgical technique. Implant for direct contact, pneumoperitoneum, gas utilized, trocar positioning and relative tessutal trauma, visceral manipulation, frequent instrumental reintroduction represent the main pathophysiologic factors involved. Pneumoperitoneum produces an increase of the abdominal pressure with turbulent flows and the CO2 (stimulating of neoplastic cells growth?) transports neoplastic cells at the port site. However metastases occurs only when an elevate cellular concentration is present "gas less" videosurgery is not free from this complication but with a lower incidence. "Chimney effect", due to the leakage of gas or fluid containing aerosol neoplastic cells at port site, represents another important factor. In accord with such studies employing alternative gas (Helium) reduces the implant of neoplastic cells. Port site parietal trauma produces fibrin deposites that represents a substratum for cellular implant, growth and protection against immunitary host defense. Wound ischemia induces a macrophagic activity decrease. In view of these concepts the surgeon must respect some mandatory principles in the videosurgical approach to neoplastic diseases. Safety parietal trocar fixation avoiding gas or fluid port site leakage such as abdominal desuffling only through trocars in site are mandatory. Instrumental cleaning with cytoxic solution (Betadine)--neoplastic cells are isolated from instrumental lavage liquid--such as as irrigation and sterilization (5 FU) of porte site are very important rules. Wound incision--never too small--must be accurately sutured. During operation cutting through or handling tumor are contraindicated, especially when the neoplasm involves serosa. Surgical specimens must be extracted in bags absolutely through parietal protection system. High vascular ligature represents another technical rule to respect in every case like in traditional surgery.

Clinical Trials as Topic↗

PubMedDate not supplied

[Complete rectal prolapse in a patient with Hirschsprung disease: a clinical case].

The disease of Mya-Hirschsprung (HD) it's rare and congenital, usually diagnosed in child age, but that it can also remain unknown until the adult age. It's associated to genetic mutations and it can involve other pathologies and malformations. The variability of the anatomopathological and clinical phenomena is correlated to the length of the aganglionic segment. The Authors describe the clinical case of one young female patient, who presented chronic constipation (less than 3 evacuations to week), tenesm, meteorism, abdominal pain. To the inspection of the anal region after the evacuation the presence of complete rectal prolapse (3) cylinders of the length of 30 cm was appraised, with presence of ulcerations of the mucosa. The patient came subordinate to diagnostic study that they demonstrated the presence of HD. The Authors operated the patient with the technique of Frykman and Goldberg. In the follow-up the patient had the complete remission of the symptomatology and resumption of the rectoanal inhibitory reflex, remarkable diminished in the preoperative manometric examination. The pathogenesis of the association of HD and rectal prolapse goes searched in the presence of ultrashort HD (aganglionic defect of a limited segment of rectum), pathological variety somewhat rare that can determine subocclusive phenomena and that it favors the prolapse of the rectum for the continuous evacuating strains.

Adolescent↗