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Biomedical subjects

E Forni

Publications and source records attributed to E Forni.

At least 55 records · Page 3Linked to original sources
PubMed1980

[A rare case of esophageal pathology: leiomyosarcoma (author's transl)].

The AA. report a clinical case of rare oesophageal pathology: the leioomyosarcoma sole case on 200 oesophageal neoplasms that they have observed. The clinical likeness with oesophageal carcinoma and the complete superimposition of reports that have been obtained in this case with instrumental examinations respect to the oesophageal carcinoma, didn't permit to do the diagnosis of histotype, while this diagnosis could be done only after the preparation of an histopathologic preparation. The patient who was operated on for superior polar esophago-gastrectomy, after 18 months is in good general conditions. THe AA. draw their conclusions after a short discussion. We must show in these paragraphs the particular macroscopic form of neoplasm that they have observed and the great difficulty of a diagnosis of leimyosarcoma without an histopathologic preparation. Agreeing with the most part of other Authors, they point out that the best therapy for these forms is surgical therapy.

Aged↗
PubMed1979

[Surgical treatment of hiatal hernia in adults. Indications, technical and tactical considerations on 310 operated cases].

On the basis of 310 cases of hiatal hernia surgically treated, the anatomical, pathophysiological and clinical aspects are reviewed together with their surgical consequences. In rolling type hernia, gastroesophageal reflux and its sequelae do not occur: the treatment is based only on reduction and suture of the fundus to the undersurface of the diaphragm with repair of right crus. In sliding hiatal hernia the purpose of operation is functional one, that is satisfactory and lasting control of gastro-esophageal reflux. With one exception, the fundamental step of all successful procedures of repair is the creation of restoration of an infradiaphragmatic segment of esophagus: it puts the lower esophageal sphincter into the abdominal cavity with restoration of gastroesophageal competence.

Adult↗
PubMed1979

[Association of idiopathic megaesophagus and carcinoma].

In the light of three cases of esophageal carcinoma developing on a pre-existing idiopathic megaesophagus the authors examine etiopatological, clinical and terapeutic problems related to this association. They believe that carcinoma of the esophagus tends to be a complication of cardiospasm in patients inadequately treated for the primary condition. Early diagnosis and an adequate Heller operation for cardiospasm will lessen the chance of cancer developing in megaesophagus with stasis. When finally diagnosed, this variety of esophageal carcinoma has an extremely poor prognosis. An even more important claim upon the clinician is to be alert to the hazards of continued stasis in megaesophagus and to devise earlier techniques of recognition, including more frequent recourse to biopsy during esophagoscopy.

Aged↗
PubMed1979

[Traumatic hernias of the right hemidiaphragm].

Four cases of right traumatic diaphragmatic hernia are reported. The original aspect of this type of lesion is that herniation of abdominal viscera into the chest is usually delayed due to the liver temporary plugging of the diaphragmatic defect. Diagnostic importance of diaphragm elevation combined with mediastinal push-back is stressed, as well as the value of x-ray examination following pneumoperitoneum. Reduction of the hernia and repair of the diaphragmatic defect can easily be accomplished by abdominal route alone, instead by a transthoracic approach usually preferred by surgeons in delayed presentation, particularly in those patients with marked limitation of pulmonary reserve.

Adult↗
PubMed1979

[Internal biliary drainage in benign diseases of the extrahepatic bile ducts].

Through analysis of a fairly large series of cases treated by internal biliary drainage for non-neoplastic disorders of the terminal choledochus and papilla (72 cases of choledochal anastomosis, mostly to the duodenum; 238 cases of surgery of the Oddi sphincter), the authors present a remarkable accurate picture of the indications for this kind of surgery and of the immediate and long-term results obtained with it. Their collected observations also provide an opportunity for comparison with published reports from other quarters; in particular, the authors offer a detailed discussion of the relative advantages and limitations of the two main procedures in this category, namely papillosphincterotomy and choledocoduodenal derivation. From their own experience and in good agreement with current dominant opinion, they conclude by recommending the last-named procedure as the most rewarding, provided that the indications be correct and the operation be done with the necessary technical accuracy.

Ampulla of Vater↗
PubMedDate not supplied

[Neoplastic obstruction of the vena cava inferior in general surgery].

Patients with primary or secondary tumoral occlusion of the inferior vena cava are difficult to be managed with safety and success. Nevertheless, their survival may be prolonged by an aggressive surgical approach according to the technical advances of liver transplantation. In fact, it is possible to perform a tumoral exeresis including the inferior vena cava by a total vascular exclusion of the liver (HVE) and a pump-driven veno-venous bypass (ECC). The Authors report the management of 8 patients with inferior caval tumoral involvement (8 M, 1 F, mean age 63.7 yrs). Vascular occlusion was caused by caval leiomyosarcoma (n 1), renal cell carcinoma (n 3), hepatocellular carcinoma (n 1), liver metastases (2 colorectal, 1 renal). Five patients (62.5%) underwent surgical treatment (2 laparotomy, 2 wide nephrectomy with partial caval wall resection in HVE, 1 ex vivo liver resection with caval venoplasty in HVE and ECC). Operative mortality was 40%. Three patients underwent medical treatment (radio-chemotherapy, chemoembolization). Total survival rate was 75% at 3 months, 50% at 6 months, and 25% at 24 months. Two patients (25%) are still alive at 3 months from the diagnosis and at 36 months from the operation.

Aged↗
PubMedDate not supplied

[Surgical resection of hepatic hilar tumors].

Hepatic hilar cancer has an extremely poor prognosis and resection for cure is a realistic possibility in only 15-20% of patients. Tumours confined strictly to the biliary confluence can often be excised locally without resorting to hepatic resection (Bismuth's type I, II). Tumours extending beyond the second order bifurcation (Bismuth's type III) require hepatic resection. In the period 1996-1998 ten patients with hilar cancer (adenocarcinoma) underwent curative resection at our Institution. There were 9 men and 1 women with a mean age of 61.7 years (range 49-76 yrs). One neoplastic lesion was Bismuth's type I, five type II, four type III. The mean preoperative bilirubin level was 20 mg% and the mean duration of jaundice was 4 weeks. Four patients had skeletonization resection of the tumour and extrahepatic bile ducts, clearing all lymphocellular and other tissue from the hepatic pedicle and coeliac axis. Bilioenteric continuity was reestablished by a Roux-en-Y jejunal loop with separate biliary duct anastomoses. Six patients required also hepatic resection to adequately remove the tumour (1 right hepatectomy, 2 right lobectomy, 2 left hepatectomy, 1 segmentectomy III). Three patients had liver metastases. One patient had involvement of the left arterial and portal branch. The postoperative staging was 2 stage II, 1 stage III, 7 stage IV. In 5 patients hepatic lymph nodes (N1) were involved. In no patient the tumour was found at the margin of resection. The median estimated blood loss for hepatic resection was 1,000 ml and for skeletonization 500 ml. Intraoperative mortality was 0%. Operative mortality was 20%. Three patients had a complicated postoperative course (1 cerebral TIA, 1 multiorgan failure, 1 ictus cerebri). All patients died. The mean postoperative survival was 7.4 months. Four patients (N1+) died of local tumour recurrence at 8, 11, 6, and 8 months. In our experience resective procedures can achieve a longer survival and a better quality of life. The operative mortality may be kept to a minimum by adequate selection of patients and technical expertise.

Aged↗
PubMedDate not supplied

[Hepatic cystadenoma: a case report].

Hepatic cystadenoma is a rare tumor arising from the biliary system. Although ultrasound and CT scan show peculiar features, diagnosis is not easy preoperatively. Because of the unreliable natural history of cystadenoma, total excision of the neoplasm by hepatic resection seems to be the treatment of choice. A case of benign cystadenoma treated by minor liver resection is reported.

Adult↗
PubMedDate not supplied

Delaying rejection in discordant heart xenografts in the rat: efficacy of cyclosporin, prostaglandin I2 and exchange transfusion.

If effective modes of prevention of hyperacute rejection were available, the problem of the absence of enough suitable donors could be solved by the use of organ xenografts. Organ xenograft rejection is principally mediated by preformed antibodies which are responsible for the hyperacute pattern of rejection. We decided therefore to study various methods of prevention of rejection in the guinea pig to Lewis rat combination (donor-recipient discordant species) in which hyperacute rejection is particularly intense. Three series of experiments were performed. In the first series immunosuppression of the recipient was induced using an oral solution of cyclosporin A. In the second series antiplatelet-aggregation therapy was administered to the recipient, using intravenous prostacyclin (PGI2). In the third series antibody depletion of the recipient was attempted using exchange transfusion with or without prostacyclin perfusion. The most significant (p less than 0.01) prolongation of graft survival time was observed when combining exchange transfusion (8 ml) and PGI2 infusion (620 ng/kg/min). This observation suggests that, if antibody depletion in the recipient is the primary goal, measures aiming at reducing the consequences of the antigen-antibody reaction are also necessary to improve the results of organ xenografting.

Animals↗