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Biomedical subjects

A Consoli

Publications and source records attributed to A Consoli.

103 records · Page 6Linked to original sources
PubMedDate not supplied

[Current trends in the surgical treatment of lesions caused by caustic ingestion].

During a twenty-six year period from 1973 to 1999 a total of 78 patients with severe esophago-gastric lesions after caustic ingestion were referred to and managed at our unit. Hydrochloric acid was the most frequently involved caustic agent and the lesions were located in the esophagus (52.6%), in the stomach (19.2%) and in both the esophagus and stomach (28.2%). Thirty-seven patients were managed by endoscopic dilation of esophageal stricture that gave permanent relief of dysphagia in 13 cases only. Twelve patients are still managed with endoscopic dilation and in another 12 we performed bypass surgery. Two perforations developed and spontaneously sealed after T.P.N. for 6-8 weeks. No death occurred. Fifty-three patients were operated on in emergency or during survey period or for stenotic lesions. Surgical procedures were: in esophageal strictures a substernal esophago or pharyngocologastroplasty without esophagectomy; in esophago-gastric strictures, after an esophago-gastrectomy, an esophago or pharyngocolojejunoplasty in one or two steps; in total gastric stenosis without esophageal involvement a total gastrectomy followed by a Roux-en-Y esophago-jejunal anastomosis and in antropyloric strictures a Billroth I or II partial gastrectomy. The morbidity rate was 32% with a 5.6% mortality rate.

Adolescent↗
PubMedDate not supplied

[Ileal invaginations caused by Peutz-Jeghers polyposis].

The Peutz-Jeghers syndrome is considered a familial polyposis syndrome. The polyps are of hamartomatous type. The symptomatology is due to the more voluminous polyps which can necrotize, ulcerate, bleed and cause intussusception and intestinal obstruction. A case of ileum-ileal intussusception due to Peutz-Jeghers syndrome is reported. The utility of a genealogic research is underlined and the recent results of the genetic research are evaluated. The surgical therapy of Peutz-Jeghers syndrome can have many aims: 1) to remove all big polyps, 2) to avoid the danger of canceration, 3) to prevent the hemorrhagic or occlusive risks and complications.

Adult↗
PubMedDate not supplied

[Surgical treatment of redundant colon after retrosternal esophagocolonoplasty for caustic esophageal stenosis].

The Authors report two cases of transposed colon redundancy occurring after surgical treatment in 37 patients with caustic oesophageal strictures by retrosternal oesophagoplasty. Surgical management was required because of persistent dysphagia and weight loss in both patients. The technique performed was a resection of the redundant loop with a termino-terminal colo-colonic anastomosis via a right thoracic approach.

Adult↗
PubMedDate not supplied

[Emergency treatment of caustic lesions of the upper digestive tract].

The role of an early multidisciplinary approach to the management of upper digestive tract caustic lesions in the acute phase is stressed. The accurate evaluation of the lesions through early endoscopy, performed within 24-48 hours of ingestion, is the best means of assessing the degree of injury after caustic ingestion. Massive gastric and/or oesophageal necrosis, tracheoesophageal fistula, massive gastric haemorrhage, gastric and/or duodenal perforation are indications for emergency surgery. Management techniques of acute lesions are controversial because results of the different surgical procedures proposed are not satisfactory. Surgery of complications is mandatory, but up to date morbidity and mortality rates are still high.

Adult↗
PubMedDate not supplied

[Milligam-Morgan hemorrhoidectomy and stapled mucoprolapsectomy. Clinical comparison of the results].

The aim of this retrospective study was to assess the results of treatment for hemorrhoids by Milligan-Morgan hemorrhoidectomy and by stapled mucoprolapsectomy in terms of operative time, postoperative pain, lenght of hospital stay, incidence of early and late complications, time to return to work and to normal social activities and patient satisfaction. Between January 2002 and December 2003, a total of 65 patients with hemorrhoids (35 men and 30 women with a mean age of 46.9 years) underwent surgical treatment: 41 patients underwent conventional hemorrhoidectomy and 24 patients stapled mucoprolapsectomy. All patients were contacted by phone or were reviewed in the outpatient clinic with a mean follow-up of 2 months (range 8-31). The Authors emphasize that it is difficult to make an objective comparison between hemorrhoidectomy and stapled mucoprolapsectomy because the two procedures are completely different in terms of rationale and technique; however, stapled circumferential mucosectomy in their experience causes less postoperative pain and bleeding and can be considered a valid therapeutic option for third- and fourth-degree disease.

Adolescent↗
PubMedDate not supplied

[Correlation between positive lymph nodes and metastasis of colorectal cancer. Personal experience].

The authors, in a group of 190 patients treated with curative surgery for colorectal cancer, have studied the correlation between lymph nodes positive of primary tumor and rising of liver metastases. Even if the B2 stage nodes were negative, liver metastases were found in 6.25% of the patients probably due to an understaging; in C1 + C2 stage the rate of liver metastases was 28.1%, however in this group has not been demonstrated a statistical correlation with the number of positive nodes as a predictive negative prognostic factor.

Adult↗
PubMedDate not supplied

[A rare association: antral neurinoma with gastric volvulus].

The paper describes a very rare case of obstructing antral neurinoma with associated gastric volvulus. Pathogenetic mechanism of this association, which has never been reported in the literature, is discussed. The authors also focus their attention on the diagnostic difficulties and the choice of therapy. A hiatoplasty and a Billroth II gastrectomy were performed in the described case.

Aged↗
PubMedDate not supplied

[Synchronous primary carcinoma of the colon. Diagnostic and therapeutic problems].

Seven hundred and twenty-three patients with colorectal carcinoma were treated consecutively from November 1973 to April 1997. Seven patients (0.96%) were found to have two colorectal carcinomas (synchronous carcinoma), located in separated colonic areas. Clinical histories were analyzed with reference to sex, age, symptoms, physical findings, disease localization, pathologic classification, and survival data. Preoperative diagnosis of synchronous lesions is difficult, being achieved in only 2 cases, but it is important for the proper treatment of patients. It is concluded that full examination of the colon in all patients presenting with primary colorectal cancer is mandatory and that colonoscopy should be used to effectively screen patients for synchronous cancers.

Adult↗
PubMedDate not supplied

[Self-expanding stents for the palliation of esophageal and gastric cardia cancer].

Twenty-one endoscopic tube implantations were carried out in 24 patients with malignant stenosis of esophagus and gastric cardia using self-expanding metallic stents. The indications to endoscopic intubation were advanced stage of the tumor in 17 cases and risk factors which made resection inadvisable in 7 cases. In 3 patients it proved impossible to implant a stent endoscopically because the Authors were not able to pass the guide wire through the stenosis, while correct stent placement was achieved in 21 patients. Functional results were good in 18 patients, while 3 patients did not have any improvement of symptoms. Complications occurred in 9 patients (42.85%): 2 bleedings, 3 neoplastic obstructions, 1 food obstruction and 3 distal dislodgements of the prostheses were observed, but could readily be corrected. No death occurred. The median survival time was 151 days (range 25-545). This study suggests that endoscopic placement of metallic self-expanding stents is safe and has to be preferred to plastic stents for easier implantation and lower morbidity.

Aged↗