Biomedical subjects
Publications and source records attributed to A Cunsolo.
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In many cases, surgery is not considered for anaplastic small cell carcinoma even in localized lesions. A review of the literature and the results obtained in our series of 30 patients prompt us to recommend surgery in stage I disease.
The immediate, or staged reconstruction of the digestive tract after total abdominal colectomy for benign bowel disease with an ileorectal anastomosis (I.R.A.) finds adamant supporters and opposers, thus confirming the controversial aspects of this procedure. The follow-up of 27 cases operated upon between 1973 and 1985, is discussed on the basis of clinical, radiological, endoscopic, histological and functional assessments.
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The clinical, laboratory and radiological data of 17 cases of toxic megacolon (TM) complicating either ulcerative colitis (UC) or Crohn's disease (CD), referred to the Department of Clinica Chirurgica II of the University of Bologna in a twenty year-period, are reviewed. The surgical strategies and results are compared and discussed, and the mortality and morbidity considered along with the important advances in resuscitative medicine and the employment of total parenteral nutrition (TPN).
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The authors analyze their experience in the management of 64 cases of Crohn's disease, located in the colon in 47 cases. The clinical and therapeutical aspects are discussed with particular attention to the surgical problems for which even today there is no general consensus of opinion especially when the colon is involved.
Ten case of arterio-enteric fistula are presented, 3 spontaneous and 7 following surgery on the aorta. In the majority of cases "herald bleeding" allows enough time to study the patient. Spontaneous fistulae are very rare and their diagnosis can be very difficult if the aneurysm is not palpable. In any case of gastrointestinal haemorrhage in a patient who has undergone an aortic operation an A-E fistula will be suspect. The only useful diagnostic procedure is gastroduodenoscopy which usually does not show any organic cause for the bleeding. Arteriography seems only a dangerous waste of time: emergency explorative laparotomy, if a fistula is suspected, is surely harmless and preferable. The only sure surgical technique consists in removal of the prosthesis followed by an extra-anatomic by-pass.
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Gastric lymphomas are still diseases for which no clear picture is available, owing to their anatomical, pathological, clinical, radiological, and endoscopic polymorphism. Reference is made to 28 cases observed over about 20 years in a discussion of the clinical diagnosis and treatment of these neoplasias. The results are compared with those obtained in cases of gastric carcinoma, which has a markedly poorer prognosis.
An assessment is made of the development of surgical techniques and results obtained throughout a series of 1748 cases of colon and rectum cancer observed over a period of 40 years. Attempts to improve survival have included an extension of lymph duct resection. This approach has proved successful, though a longer period of study is still needed. Lastly, rectal cancer is examined in terms of survival in function of various biological factors associated with the neoplasia.