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Biomedical subjects

D Mascagni

Publications and source records attributed to D Mascagni.

At least 37 records · Page 2Linked to original sources
PubMed1989

Endoluminal ultrasound for early detection of local recurrence of rectal cancer.

The diagnostic potential of endoluminal (endorectal and endovaginal) ultrasound to detect asymptomatic resectable local recurrence after rectal cancer surgery has been assessed in 120 patients: 17 recurrences (14 per cent) were detected. The method showed 97 per cent accuracy, 94 per cent sensitivity and 98 per cent specificity; the positive predictive value was 85 per cent and the negative predictive value was 99 per cent. A longer follow-up is, however, necessary to confirm these results. Of the 17 patients with local recurrence, six were asymptomatic and underwent reoperative surgery. Of the other 11 patients with symptomatic recurrence, only two underwent reoperative surgery.

Adenocarcinoma↗
PubMed1988

[Somatostatinoma].

Explore the source record for details and available documents.

Duodenal Neoplasms↗
PubMedDate not supplied

[Traditional cholecystectomy in a patient with situs viscerum inversus partialis].

The authors discuss the etiology of situs viscerum inversus partialis (SVIP), the associated anomalies and the malformations and the relative clinical problems, reviewing the international literature. The present a case of a 51 years old female with a diagnosis of umbilical hernia and cystocele. During hospitalization the patient complained a typical acute cholecystitis pain. The patient underwent ultrasonography, CT scan, and MNR that allowed us to diagnosis a calculous cholecystitis with SVIP and was elected for an open cholecystectomy. The Authors describe the surgical technique in relation to the anatomic anomalies, in particular vascular ones, that were discovered with the imaging studies and confirmed at laparotomy.

Cholecystectomy↗
PubMedDate not supplied

[Synchronous and metachronous colorectal cancers: a case series contribution].

The Authors, on the basis of their experience with neoplastic colorectal pathology and after a review of the Literature, report a reappraisal of the problems related to colorectal multiple carcinomas. They emphasize the importance of routine preoperative pancolonoscopy for the identification of possible synchronous tumors (both benign and malignant) and periodic endoscopic follow-up (ideally a life-long one) for the detection and removal of all adenomatous polyps as well as early stage metachronous carcinomas, especially for patients with HNPCC. Besides, they stress the importance of sensibilization of the population about the heritability of colorectal carcinomas.

Adenocarcinoma↗
PubMedDate not supplied

[Compatibility, indications, and limits of nerve sparing technique in lateral pelvic lymphadenectomy for advanced rectal carcinoma].

The aim of radical surgical treatment of rectal cancer is to control the spread and prevent recurrence of the disease. In an attempt to improve the results of treatment of locally advanced rectal cancer, we advocate an extended surgical approach consisting of total mesorectal excision, lateral pelvic lymphadenectomy and the nerve sparing technique with resection of autonomic nerves whenever these fibers are affected by locally advanced tumor. Nine cases (9.2%) in a personal series of 98 patients with rectal carcinoma, operated on over the period from January 1992 to December 1997, underwent total mesorectal excision, lateral pelvic lymphadenectomy and the nerve sparing technique procedures for locally advanced extraperitoneal disease. In 7 patients with stage II or III disease, the 5-year survival rate was 80% and the 5-year disease-free survival rate 66.7% after a mean follow-up of 55 months. None of them experienced local recurrence, but one patient died of diffuse metastatic disease 50 months after surgery. One patient with stage IV rectal cancer died of disease 13 months postoperatively, while another patient with the same stage of disease is still alive with disease 26 months after surgery. One patient underwent liver resection for a solitary metastasis 25 months after the primary operation. Two patients suffered postoperatively from urinary retention with mild irregular flow at urodynamic testing, but no long-term urinary disturbances persisted. Retrograde ejaculation occurred postoperatively in one of the two patients who experienced urinary disorders, and another patient had erection disturbances. These sexual dysfunctions did not improve during long-term follow-up. Total mesorectal excision, lateral pelvic lymphadenectomy, and the nerve sparing technique, with resection of the autonomic nerves whenever these fibers are involved, allow satisfactory results to be achieved in terms of survival and functional outcome in patients with locally advanced rectal cancer. In western subjects, however, this procedure is safe only after careful patient selection.

Adult↗
PubMedDate not supplied

[The megacolon in myotonic dystrophy: case report and review of the literature].

Myotonic dystrophy (MD) is an autosomal dominant inherit disease, slowly progressive, involving multiple organ systems. Disorders at any level of the gastrointestinal tract are relatively common and manifest as disturbances in motility, such as impaired esophageal transport, delayed gastric emptying, and megacolon. A 51 years-old man was admitted to our surgical department with obstructive symptoms. Diagnostic evaluation showed megacolon and the typical clinical features of the MD, such as weakness, myotonia, frontal baldness and testicular atrophy. Risk of perforation and dehydration led to emergency total colectomy with ileorectal stapled anastomosis. The patient didn't suffer for compliance related to surgical treatment but, after 1 month in intensive care, died of pneumonia and myocardial infarct. The overall frequency of perioperative complications in patients with MD ranges from 8.2 to 42.9%. The risk of perioperative pulmonary complications is particularly high. Thus, we believe that the conservative treatment of motility disorders of the bowel in patients with MD is to be justified and that surgical treatment should be reserved, as last resort, performing a early diagnosis and careful monitoring during perioperative period.

Fatal Outcome↗
PubMedDate not supplied

[The preoperative staging of rectal cancer with endorectal echography].

The authors stress the value of the routine use of endorectal US for the preoperative staging of rectal cancer. This method accurately demonstrates the exact level of the lesion, the degree of circumferential invasion, the depth of local involvement and the extent of eventual spread beyond the rectal wall, the invasion of the surrounding structures and the presence of enlarged perirectal lymph nodes. A hundred and forty-one patients with rectal carcinoma located 3-16 cm from the ano-cutaneous line were examined with endorectal US preoperatively; a comparison was made between US findings and pathological data, so that a correlation could be made between US (uT) and histologic (pT) findings. A radial probe and a 7-MHz transducer were employed. Our results show US accuracy to be 93.6% with only 4 cases of understaging and 5 of overstaging. A hundred and twenty-nine patients who had undergone major surgery were also studied to evaluate US accuracy in lymph node detection: in 110 cases the actual lymph node status was correctly demonstrated; US diagnostic accuracy was 85.3% with 16 false positives and 3 false negatives. The correct evaluation of the actual local tumor spread, as demonstrated by endoluminal US, allows the choice of the correct treatment, together with a personalized therapeutic schedule, to reduce the incidence of local recurrences and to save, whenever possible, sphincter functionality.

Adult↗
PubMedDate not supplied

Peritoneal mesothelioma in a case of inguinal hernia. A review of the literature.

The peritoneal mesothelioma (PM) is a rare, benign or malignant, primary tumour, arising from the peritoneal membrane. The most frequent histological form is the malignant one with an incidence of 2-2.6 new cases per million per year. The symptomatology is insidious and poses difficult problems in the diagnosis and the treatment. Instrumental diagnostic investigations are useful only in the diagnostic orientation. Only the pathologic examination allows to distinguish a peritoneal carcinomatosis from PM. The prognosis of MPM is pour. An intense multimodal therapy, combining surgery with CT and RT, increases the survival rates in the patients with MPM. It has been proposed that hernia of abdominal wall play a role in the pathogenesis of this tumor. We believe that hypothesis seems unlikely considering the enormous discrepancy between the incidence of hernial pathology and PM.

Antibiotics, Antineoplastic↗