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Biomedical subjects

E Cavina

Publications and source records attributed to E Cavina.

At least 55 records · Page 3Linked to original sources
PubMed1993

Outcome of surgical treatment for extrapancreatic gastrinomas.

Since the availability of the H2-receptor antagonists (1978), seven patients admitted to the Department of Emergency Surgery, University of Pisa, with Zollinger-Ellison syndrome (ZES) sustained by extrapancreatic gastrinomas underwent elective surgical treatment. There were four women and three men, with a mean age of 37.3 years (16 to 67 years of age). Preoperative localization studies included endoscopy of the upper part of the gastrointestinal tract, computed axial tomography, ultrasound, selective angiography and transhepatic portal vein sampling for gastrin and were effective in four patients. In the other three patients, the localization of the gastrinoma was made at laparotomy. Four patients had gastrinomas of the duodenal and jejunal wall. Three underwent excisional operations, whereas the remnant was treated with pancreatoduodenectomy. In three of the patients, the location of the gastrinoma was extrapancreatic and extraintestinal, and surgical treatment consisted of nodal excision (two patients) and hepatectomy. None of the patients had undergone a gastric operation in addition to tumorectomy procedures. Soon after excisional operation, ZES recurred in one patient and a second laparotomy with nodal excision resulted in a cure. On long term follow-up evaluation, ranging from 15 to 136 months (mean of 85.1 divided by 37.3 months), no patients showed a recurrence of ZES. The possibility of extrapancreatic gastrinoma should be suspected in patients with sporadic ZES. The need for emergency surgical treatment in these patients is minimized by the medical control of the gastric secretion that consents diagnostic studies for the preoperative localization of the gastrinoma. Even if only suspected, the site of the extrapancreatic gastrinoma has an increased chance to be identified at operation. This consents to remove gastrinomas mostly by a minimal excisional procedure resulting in the normalization of gastric secretion and the prevention of malignant evolution of these tumors.

Adolescent↗
PubMed1992

Resection of liver gastrinoma leading to persistent eugastrinemia. Case report.

In a 30-year-old man with Zollinger-Ellison syndrome, the only detectable gastrinoma was in the right liver lobe. Removal of the lobe, without additional gastric surgery, was followed by normalization of the gastrin level. Long-term follow-up confirmed the good result. The usefulness of quick intraoperative gastrin assay is stressed.

Adult↗
PubMed1992

[The prevention of postoperative deep venous thrombosis with heparan sulfate per os. A controlled clinical study vs. heparin calcium].

The paper reports the results of a randomised study carried out on a pool of 100 patients undergoing surgery in order to assess the efficacy and tolerability of orally administered heparan sulfate versus heparin calcium in the prevention of postoperative deep-vein thrombosis. Despite the limits of oral administration, heparan sulfate is indicated in the pharmacological prevention of postoperative deep-vein thrombosis.

Administration, Oral↗
PubMed1990

Perineal colostomy and electrostimulated gracilis "neosphincter" after abdomino-perineal resection of the colon and anorectum: a surgical experience and follow-up study in 47 cases.

A series of 47 patients undergoing abdomino-perineal resection of the distal colon and anorectum and construction of a continent perineal colostomy using electrostimulated gracilis muscle is described. External and implanted pulse generators have both been used. An analysis of complications and oncological data are reported. There was no operative mortality. The incidence of complications, divided into three classes, mild (62%), moderate (27%) and severe (11%), has not significantly altered the functional results, with the exception of early ischaemia of the colonic stump in two cases. During the first 22 cases, no preoperative oncological staging was performed. In the last 23 patients endorectal ultrasonography and CT scanning were carried out. Functional results were evaluated by electromanometry, electromyostimulation and dynamic defaecography. Clinical data assessed postoperatively showed good function in 65% of cases, fair in 22.5% and poor in 12.5%. The quality of life in 15 patients with a perineal colostomy and electrostimulated gracilis was significantly better than in 15 patients having an abdomino-perineal resection without gracilis plastic reconstruction.

Adult↗
PubMed1989

[Hepatic metastases of colorectal carcinoma. Case reports].

Authors report their clinical experience concerning liver metastases from colorectal cancer. 21 (26%) out of 87 patients observed between 1977 and 1988, underwent hepatic resection. In this group the recorded operative mortality was 4.7% and the postoperative follow-up showed a survival rate of 27% five years after hepatic surgery. Hepatic resection should be considered as the most effective treatment for liver metastases from large bowel cancer. Unfortunately only few patients are suitable for surgery. Alternative treatments for unresectable hepatic recurrences of colorectal cancer still remain a most major problem.

Aged↗
PubMed1989

[Arterio-venous popliteal fistula: a rare late complication of a civilian trauma. A clinical case and review of the literature].

In spite of the relatively high frequency of popliteal injuries following war and civilian traumas, a late development of an arteriovenous fistula can be considered an uncommon complication. We report a case of a chronic arterio-venous popliteal fistula in a young boy, caused five years previously by a blunt trauma, while playing. The tardive onset of symptomatology and the conspicuous enlargement of the vein underline the unusuality of the case. A review of the literature and the technique for fistula repair, using adsorbable suture, are examined.

Adolescent↗
PubMed1989

[Use of defibrotide in the treatment of acute superficial thrombophlebitis of the legs].

The efficacy of defibrotide in the treatment of acute thrombophlebitis of the legs has been investigated in 140 patients, randomized into two groups. All patients received defibrotide either alone or as an addition to conventional therapies. Two different schemes of administration were selected and carried out in each group, according to the time of onset of thrombophlebitis. Defibrotide demonstrated a good clinical efficacy in both groups, with a highly significant reduction in those patients receiving defibrotide and conventional therapies. The clinical result were outstanding in two subgroups: extensive thrombophlebitis and brachioaxillary phlebitis.

Acute Disease↗
PubMed1989

[Risk factors and etiopathogenesis of cancer of the gallbladder].

Primary cancer of the gallbladder is uncommon but not rare, being in Italy the fourth cause of death for gastrointestinal cancer in females over 65 years old. Two centuries after the first description, this tumor remains characterized by an unfavorable prognosis due to the silent progression of the clinical course and the frequent unresectability at the time of surgery. Early diagnosis, aggressive surgical approach and chemotherapy are the basis for longer post-operative survival rates; in fact, despite the advances in ultrasonography and computer-assisted imaging devices, the prevention of gallbladder cancer remains a problem. In the statistical terms, the risks of an indiscriminate surgical prophylaxis would outweigh the advantages of cancer prevention; in this optic, a recognition of the patients "at major risk" appears to be essential. With this aim we have undertaken a review of current knowledge of the "risk factors" involved in the epidemiology and etiology of gallbladder cancer, deduced from Literature and our surgical experience. It is reasonable to assume that the etiology of this cancer is based on the correlationship between factors with a wide and different penetration in racial-ethnic areas: genetic, systemic and local risk-factors. A genetic influence can be highly suspected in the familiar cases, in the non-carcinoma tumors and in the geographic predominance of the tumor. None of the systemic factors suggested as risk factors (age, sex, obesity, occupational and chemical carcinogens, drugs, etc.) appear to be directly involved; moreover, the main factors, such as female sex and age, are probably mediated through cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholecystitis↗
PubMed1987

Construction of a continent perineal colostomy by using electrostimulated gracilis muscles after abdominoperineal resection: personal technique and experience with 32 cases.

A series of 32 patients operated on for rectal carcinoma is reported. A new technique by using the gracilis muscles to reconstruct a functional anal sphincter after abdominoperineal resection was performed. No operative mortality was recorded. Functionality of the new sphincter was guaranteed by electromyostimulation. Electrostimulation has been useful in both increasing the muscular trophic level and in improving the postoperative bio-feedback. Perineal infection was recorded in 9 patients being the most common complication although it did not compromise the functionality of the new sphincter. In one case acute colonic ischaemia was treated by resection and definitive left colostomy. 17 out of the 27 patients in which a functional follow-up was obtained, scored a "very good" continence to stool and flatus while in 6 patients occasional episodes of incontinence to liquid stool are referred. Local or distant metastases presented in 6 patients. The obtained results encourage in continuing the research with this technique in the attempt to reduce the number of patients that must pay the high price of a definitive abdominal colostomy for cure.

Adenocarcinoma↗
PubMed1986

Pylorus preserving pancreatoduodenectomy for gastrinoma. A case report.

A case of a young female patient affected by Zollinger-Ellison syndrome with occult gastrinoma during exploratory laparotomy, is reported. On the basis of transhepatic portal catheterization the patient underwent pylorus preserving pancreatoduodenectomy according to Longmire-Traverso. A malignant gastrinoma of the duodenal wall, 2 mm in diameter, was observed on the operative specimen in the suspected gastrinogenic area. The procedure led to complete clinical recovery of the patient who did not respond to the medical treatment of the ulcer. The prognosis was good with oncologic radicality of surgery confirmed at follow-up and excellent digestive function.

Adult↗
PubMed1984

Anti-ulcer drugs and hypergastrinism: utilization in surgery.

The peptic ulcer disease associated with hypergastrinemia is very often a challenging problem of diagnosis and therapy. In absolute surgical emergency (haemorrhagic and perforative complications), the utilization of the most recently discovered anti-ulcer drugs appears to be extremely helpful; the prevention of incumbent complications can be accomplished, in fact, during the post-operative treatment and the "free time" so obtained can be used for an adequate differential diagnosis (gastrinoma-induced Zollinger-Ellison syndrome: antrum retained, G cells of the antrum hyperplastic, apud-tumours with hypersecretion). The "anti-H2 and anti-muscarinic" drugs (often in association) give the surgeon the possibility of an accurate diagnosis and the choice of the best surgical procedure (tumorectomy, DCP, gastrectomy). Even in elective surgery the prevention with anti-H2 drugs permits greater "safety margins" and an optimal follow-up study. The results of the surgical experience in the General Surgical Clinic of Pisa (18 cases of Z.E.'s) confirm the validity of the associated anti-ulcer therapy.

Cimetidine↗
PubMed1983

[Hemorrhoids; a new method of symptomatic treatment. Sedative cryotherapy using the Criosuppost self-applicator].

Clinical experiments have been carried out on a special new perfrigerant probe giving about 10 degrees C tissue hypothermia of the anal canal. In addition to the hypothermic effect, the probe also permits simultaneous topical pharmacological therapy (ointment, irrigations). The association of sedative cryotherapy with topical symptomatic therapy gives good results. Indications are analysed in connection with the main causes of haemorrhoidal pathology.

Cryosurgery↗
PubMed1982

[Current therapeutic problems in the Zollinger-Ellison syndrome. Personal cases].

The topical nature of the treatment of Zollinger-Ellison syndrome arises from the alternatives to total gastrectomy, namely medical management with cimetidine, and tumorectomy. The various stages in the history of the syndrome are described with reference to a personal series of 16 cases, and various observations are made with regard to the clinical aspects of its diagnosis, treatment, and emergency surgical management. A detailed account is given of several illustrative cases. Detailed assessment of the various factors on which the current indications for surgery are based suggests that a certain degree of eclecticism should be adopted, though the results offered by total gastrectomy must be regarded as sound in the long term.

Adult↗
PubMed1980

[A 1st experience with radical surgery of cancer of the rectum. Critical analysis of the literature and case reports, with special reference to methods "of security" and to technical guidelines for reducing complications and mortality].

An analysis of the most recent approaches to oncological surgery of the rectum, with particular reference to methods combining the greatest radicality with the lowest incidence of early and late complications, is followed by the presentation of work carried out over a period of four years at a subsidiary university department. A series of 77 radical operations (50 anterior and 27 abdominoperineal resections) is examined in function of the pre-, intra-, and postoperative measures making up the treatment protocol. The results are in line with the currently growing preference for anterior resection, and underscore the effectiveness of excluding right colostomy as a protective measure in low colorectal anastomosis. An absence of p.o. mortality a low incidence of complications significant with regard to short and long survival, and the data obtained from a short follow-up show that the methods are sound and in line with the more extensive university series, as well as the data in the literature

Aged↗