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Biomedical subjects

A L Gaspari

Publications and source records attributed to A L Gaspari.

At least 19 recordsLinked to original sources
PubMed1998

[Hürthle cell neoplasms of the thyroid gland].

From 1986 to 1996 the Authors have surgically treated 34 patients affected with Hürthle cell neoplasm of the thyroid (23 benign and 11 malignant). Preoperative diagnosis was obtained mainly by fine needle aspiration biopsy. In thyroid surgery we routinely prepare laryngeal nerve and take great care to avoid devascularization fo the parathyroid glands. Operative procedures performed were hemithyroidectomy plus isthmectomy (18), subtotal thyroidectomy (2) and total thyroidectomy (14). No cervical lymph node dissection was requested, neither we observed post-operative morbidity. Mean follow-up was 116 months. During observation period we documented. No hematogenous metastasis was observed. All patients are now well and alive free of disease. This series stresses the favourable behavior of Hürthle cell neoplasm of the thyroid--even through a prolonged follow-up. A thorough review of the Literature on the topic is conducted. The Authors are in favour of total thyroidectomy as first choice procedure for lesions larger than 40 mm in order to reduce the need of completion thyroidectomy and the potential morbidity.

Adenocarcinoma↗
PubMed1996

Laparoscopic resection of gastric leiomyoblastoma.

Smooth muscle gastric tumors represent 2% of resected neoplasms of the stomach. Clinically, they are often silent and incidentally found at endoscopy or radiologic examination. These tumors can be histologically classified as benign (leiomyoma) or malignant (leiomyoblastoma), but clinical behavior is not strictly related to this classification. When symptomatic, they are present with anemia in 50% of cases due to mucosal ulceration. Surgical removal of the tumor is the accepted therapy, leaving a margin of surrounding free tissue: this treatment can be performed by laparoscopy, usefully associated with gastroscopy. We present one case of a patient with severe anemia due to bleeding from an ulcerated leiomyoblastoma 5 cm in diameter that we resected with combined gastroscopic-laparoscopic technique. We isolated the portion of gastric wall where the mass was located and resected the specimen under gastroscopic control. The postoperative period was uneventful, and the patient recovered promptly with minimal pain and discomfort.

Aged↗
PubMed1996

[Leiomyosarcoma of the mesentery. A case report and clinico-diagnostic considerations].

Leiomyosarcoma of the mesentery is a rare neoplasm. The clinical manifestation is non-specific and preoperative diagnosis is often late. Mitotic activity shows no significant correlation with the biological behavior of neoplasm. The surgical excision is the therapy of choice but local recurrence is high. The authors report a case of leiomyosarcoma which was treated by surgical removal and underline the diagnostic difficulties.

Aged↗
PubMed1996

[The role of Enterobius vermicularis in etiopathogenesis of appendicitis].

The authors present 14 cases of enterobiasis of appendix observed between 1991-94, on a total of 1093 appendectomies. The presence of the parasite was associated, in the majority of cases, to a chronic appendicitis. The symptomatology imitates an attack of acute appendicitis, but the true nature of the disease is diagnosed only through a histological examination. There is probably an etiopathogenic relationship between. E. vermicularis and chronic appendicitis, whereas the relationship between the parasite and acute appendicitis is rare and very disputed.

Adolescent↗
PubMed1995

[Laparoscopic treatment of hepatic cysts].

Laparoscopic treatment of simple hepatic cysts is reported. Recent indications to conservative surgical treatment for this benign disease are considered and different therapeutic options are analyzed. Surgical technique adopted in two cases observed is illustrated. In conclusion, the Authors consider laparoscopic treatment as an effective method for a mini-invasive surgical approach.

Aged↗
PubMed1995

[Colon volvulus].

The authors report a clinical case and review the international literature. After an analysis of the incidence and the predisposing factors causing this disorder, they focus attention on the question of therapy. In forms with vital loop non-surgical derotation must be attempted. In the event of the failure of non-invasive treatment and to prevent recidivation these forms are treated surgically, also using videolaparoscopy. In forms with non-vital loop, surgery consists of the section of the necrotic segment and preparation of anastomosis which may be immediate or deferred depending on general and local conditions.

Adult↗
PubMed1993

[The effects of protein-energy deficiency in candidates for gastric resection].

The nutritional status of patients subjects to surgical operations represent an important element in determining the incidence of morbidity and mortality. We have examined 19 patients suffering both from benign and from malignant pathology subjected to a gastric resection and treated in the preoperative period for 7-8 days and in the postoperative period for 8-10 days with parenteral nutrition. Nutritional valuation was carried on at the time of admission, in the postoperative period and in proximity to discharge; an accurate observation of possible associated was also carried on. The comparison with the not treated with a nutritional support has shown a smaller incidence in complications of a general character and also in those connected with the operation and a reduction in the postoperative stay in hospital.

Aged↗
PubMed1993

[Partial resection of the spleen for echinococcus cysts with ultrasonic surgical aspirator].

The superior extremity of the spleen was resected in a 52-year-old male patient due to a calcified echinococcus cyst, using an ultrasonic surgical aspirator (Cavitron). Blood loss was limited and no postoperative morbidity was reported. This method appears to be useful in all cases in which it is possible to avoid splenectomy in order to reduce the risk of uncontrolled postoperative infections.

Echinococcosis↗
PubMed1992

[Totally implantable systems for long-term chemotherapeutic treatment].

The authors report their own experience with completely implantable systems for the long-term chemotherapeutic treatment, compared with a review of modern literature. The experience even if low demonstrates a good methodology in reducing the number of complications associated with the use of percutaneous catheters.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Venous grafts in reimplantation of the thumb].

The Authors analyze their experience of 25 thumb reimplantations and revascularizations within 5 years. The importance of the first finger in the functional hand economy as well as the ratio between reimplantation take rate and degree of functional recovery with regard to the type of trauma, technique used, and possible and incidental complications are underlined. The venous autologous grafts are of great importance in this microsurgical area and they are more and more applied. In most cases, indeed, intimal lesions are more extended than their macroscopic appearance and the tract of damaged vessels is always wider than assessed. The graft interposition solves the problem with the further advantage to preserve the maximal bone length and to avoid especially contaminated areas. The results achieved confirm these statements and the Authors conclude for the absolute need of venous grafts in thumb reimplantations, especially after amputation from avulsion or crush traumas, even though a greater skill is necessary in using this technique.

Adolescent↗
PubMed1990

[Latissimus dorsi flap in reconstructive surgery of the lower limbs].

The free latissimus dorsi flap has been used to repair 10 complex losses of substance of the lower extremity. The results have shown the great reconstructive potentialities of the microvascular transfer of this muscle, considered by the authors the most versatile of the myocutaneous flaps. Among the advantages there are the extended surface, its thickness, its pedicle with adequate length and diameter as well as the absence of functional involvement, especially by preserving the upper branch of the thoracodorsal nerve. The indications, however, are limited due to a significant rate of complications which prevent its extended use.

Adolescent↗
PubMed1989

[Microsurgery in gynecology. 8 years' clinical activity].

A series of 110 patients given surgical treatment for "mechanical infertility of varying origin in 1980-88 is examined". The classification system proposed for the microsurgical procedures available is based both on personal experience and on the classification of the causes of mechanical infertility in women according to aetiopathogenesis. Clinical results are judged in terms of pregnancies achieved and suggest that while adhesiotomy, salpyngostomy, t-t tubal anastomosis and cornual reimplantation are all useful, fimbrioplasty is less likely to give good results, particularly in the long term. Finally the links between gynaecological microsurgery and F.I.V.E.T. and G.I.F.T. are analysed.

Female↗
PubMed1988

Reversal of sterilization by microsurgical technique.

Tubal sterilization techniques that spare the fimbriae and cause the least amount of tubal destruction offer the best chance for reversal of sterilization. Patients seeking reversal of sterilization should be carefully selected. Surgical technique and equipment are important factors in reversal procedures; microsurgical techniques are shown to be more effective than macroscopic techniques.

Anastomosis, Surgical↗