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Biomedical subjects

A Peracchia

Publications and source records attributed to A Peracchia.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Anatomo-surgical notes on mesenterico-caval anastomosis with interposition of a prosthesis].

On the base of 17 interposition meso-caval shunts and of 24 cadaver dissections, the Authors discuss some technical details concerning this method of portal decompression. The segment of the superior mesenteric vein more suitable has his superior limit at the mid-point of the third duodenal portion, where his diameter is already as at the converging point with the splenic vein. The length of this segment nevertheless is conditioned by the different anatomical rapports with the third duodenal portion. The insertion of the graft can be obtained either dissecting through the mesenteric root, either after mobilization of the right colon. With the last procedure resulted easir the inferior vena cava dissection, while no technical differences where encountered during the procedures with the superior mesenteric vein isolation.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Esophagogastric anastomotic leakage.

Anastomotic leakage of esophagogastric anastomoses can be prevented by administering adequate preoperative nutritional support and by employing mechanical circular staplers. In a series of 299 intrathoracic anastomoses, 35 leakages were observed, 11 of which gave asymptomatic radiological findings. In a series of 46 cervical anastomoses, nine leakages were observed. In the majority of cases conservative treatment was adopted. This is based upon external drainage of septic collections, gastric emptying, antibiotics and intensive nutritional care. The mortality rate in cases of anastomotic fistulas was 1.74% (6 patients) in the patients with esophagogastric anastomoses.

Cardia↗
PubMedDate not supplied

A new technique for the treatment of esophageal bleeding in portal hypertension.

A new method to operate on patients with bleeding due to portal hypertension is presented. It consists of splenectomy, devascularization of the gastric corpus, fundus and distal esophagus, resection-anastomosis of the lower esophagus, selective vagotomy with pyloromyotomy, and antireflux cardioplasty. All these procedures are carried out through a laparotomy; the esophageal resection-anastomosis is performed using the American circular EEA mechanical stapler. The method was used on 15 patients; there was one postoperative death. As regards the varices, early results were optimal. No encephalopathy was observed. Endoscopic dilatation of the anastomosis was required in four cases. No recurrence of hemorrhage has yet been observed.

Esophageal and Gastric Varices↗
PubMedDate not supplied

The surgical treatment of cancer of the cervical esophagus: complications and preliminary results.

Out of 129 cancers of the cervical esophagus, 74 (57%) were resected. After laryngopharyngectomy and segmentary esophagectomy, the reconstruction was performed by substernal coloplasty in 18 cases and by free bowel autotransplantation in 18. When total esophagectomy was performed, pharyngogastroplasty was performed in 32 cases and pharyngocoloplasty in seven. The total postoperative death rate was 18.9%. In cases of segmentary resection the three-year survival rate was 14.34% and 15.87% in cases of total esophagectomy.

Colon↗
PubMedDate not supplied

Fibergastroscopic study of early and advanced gastric cancer in a series of 8,000 consecutive patients.

Eight cases of early gastric cancer (EGC) (histological diagnosis on the resected specimens) were detected Type III (excavated; seven out of eight cases). In three endoscopies. They constituted 3.3% of the gastric cancers observed (239 cases). The most frequent type of EGC was Type III (excavated: seven out of eight cases). In three patients the diagnosis was made only at a second examination, since the first had been negative for malignancy; at the follow-up examination in these cases, the lesion seemed to have healed. The operation was therefore carried out only on the basis of the histological interpretation of endoscopic biopsies.

Adenocarcinoma↗
PubMedDate not supplied

[Surgery of loco-regional recurrences in colorectal cancer].

By the term of local recurrence (LR), after apparently curative resection of a colorectal cancer, we mean the recurrence of the disease at the site of the original tumor, in correspondence to the regional lymph nodes or to intestinal anastomosis. The frequency of LR, which differs widely from one case to another because of the unhomogenity of the samples under examination, is on average around 16%, although this figure is to be considered an underestimation since it is not supported by routine autopsies. The authors analyse, together with the data in the literature, the results of their personal experience relating to 1164 patients undergoing surgery for colorectal cancer in the space of 18 years, in order to evaluate the true effectiveness of surgery on patients affected by LR. Surgery on the original tumor had a curative aim in 791 (68%) of these cases, 33 patients died during the postoperative period and 37 were lost to follow-up. Among the remaining 721 patients, recurrence was observed in 218 cases (30.2%): in 81 of these was confirmed a LR, with simultaneous distant metastasis in 45. During the same time span, 15 patients were admitted who were affected by LR from colorectal cancers treated surgically in other hospitals. Of these, only 2 had concomitant distant metastasis. 58 of these 96 patients (60.4%) underwent surgery, which had a curative aim in 22 cases (37.9%)/ Up to present, 12 patients undergoing curative surgery are still alive, 4 (33.3%) being affected by further relapse. The data reported demonstrate that in patients with proven LR surgical intervention is widely indicated, being the only therapeutic approach able to provide tangible results. However, the choice of exeresis must be carefully weighed: surgery of LR can be said to be truly curative in few cases, and thus the operative risks may not be acceptable in situations where limited results, in terms of duration and quality, are foreseen.

Adult↗