Biomedical subjects

Carlo Manzoni

Publications and source records attributed to Carlo Manzoni.

4 recordsLinked to original sources

PubMed2002

Sacrococcygeal teratoma. Outcome and management. An analysis of 17 cases.

AIMS: The authors compare their experience of 17 cases of sacrococcygeal teratoma (SCT) with the literature in an attempt to clarify the natural history of this tumor and to identify factors related to its prognosis and management. METHODS: The obstetrical, neonatal and surgical data were analyzed for 17 cases of SCT observed between July 1985 and December 1998. RESULTS: Three fetuses died in utero or shortly after birth. In the remaining 14, the tumors were removed. Twelve of the infants are currently tumor-free, with good sphincter control and lower-limb function. The remaining two died: one had a malignant tumor, and the other had a recurrence of an embryonal carcinoma. Recurrent tumors (mature histotypes) were also removed from two of the 12 patients who survived. CONCLUSIONS: Benign SCTs generally have favorable prognosis. Negative prognostic factors for SCT include solid tumors, those detected early in pregnancy, malignant histotypes, polyhydramnios, placentomegaly, and fetal hydrops.

Birth Weight↗

PubMedDate not supplied

Megaureter.

Obstructive megaureter is shown by ureteral dilatation most frequently due to an obstacle at the level of ureterovesical junction. The obstacle is caused by a stenotic tract and/or the absence of peristalsis. The diagnosis of primary obstructive megaureter is usually prenatal. The pediatric surgeon together with the pediatric radiologist and nephrologist should pose the indication for surgery. The main criteria on which this approach should be indicated are the grade of megaureter and the renal function. Megaureters of low-mid grade should be followed by a "wait and see" approach because they may resolve spontaneously, while megaureters of high grade should undergo operative repair and ureterovesical reimplantation. Results are good with a low rate of complications (recurrence of stenosis or vesicoureteral reflux).

Child↗

PubMedDate not supplied

Ureteral valves.

Ureteral valves together with stenosis and diverticula represent congenital malformations of the ureteral tract between the pyeloureteral junction and the ureterovesical junction. They are rare malformations and even more rarely they cause an obstacle to urine flow. The proximal subjejunal ureteral tract is more frequently involved. The most reliable pathogenetic hypotheses suggest a delay in the canalization of fetal ureter or an ischemic damage. The true ureteral valves should be distinguished from Ostling embryonic folds that can be documented in 5% of newborns and disappear with growth. Treatment, when necessary, consists in the resection of the affected ureteral tract followed by ureteral or pelviureteral end-to-end anastomosis.

Child↗

PubMedDate not supplied

Posterior urethral valves.

Posterior urethral valves represent the most common post-vesical obstructive malformation. They affect the male gender and appear as intraluminal folds located immediately proximal to the verumontanum. One of the most credited pathogenetic theories considers them an anomalous insertion of mesonephric duct into the cloaca or an incomplete involution of plicae colliculi. At present, the diagnosis of posterior urethral valves is prenatal and the pattern is characterized by detrusor hypertrophy and more or less marked hydroureteronephrosis. Urinary tract disorders that accompany posterior urethral valves include moderate hydroureteronephrosis to severe functional impairment of the entire urinary tract with consequent renal failure. Treatment of posterior urethral valves consists in their resection. At present, with miniaturized endoscopes, valve fulguration is feasible also in newborn infants. In low-weight patients or in case of poor general condition, temporary external urinary bypass (e.g. cystostomy) is feasible.

Female↗