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Biomedical subjects

E Montresor

Publications and source records attributed to E Montresor.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Spontaneous rupture of the esophagus (presentation of a case)].

The authors describe the case of a 67-year-old patient with spontaneous rupture of the middle third of the oesophagus, occurring apparently without any involvement of intraluminal hypertension. The surgical treatment consisted in the execution of an aspiration drainage of the left pleural cavity, followed by a right thoracotomy with exploration of the mediastinum. A gastrostomy according to Witzel was also performed. Total parenteral nutrition was instituted in the post-operative period. Healing of the oesophageal lesion was confirmed radiologically 2 months after admission to our department.

Aged↗
PubMed1988

Bronchopulmonary carcinoids: report of nine surgically treated cases.

Nine cases of bronchial carcinoids treated by surgery are reported. Six of them were females and three males. Their ages ranged from 37 to 68 years (median 52.8 years). Lobectomy was carried out in four instances (bilobectomy in one) and pneumonectomy in three. Based on preoperative histology two conservative operations were performed: one patient underwent segmental resection of the right upper lobe for a peripheral carcinoid and the other sleeve resection of the bronchus. The operations were complicated only in one case in which a broncho-pleural fistula appeared postoperatively and was successfully treated by thorachoplasty. There was no postoperative death. The only patient with an atypical carcinoid died one year after pneumonectomy. The other eight patients, with typical carcinoids are alive and without recurrent disease at 6 months to 8 years from surgery. Lymph node and parenchymal infiltration, observed in 3 patients, were not fatal. It is concluded that carcinoids should now be considered malignancies; typical carcinoids carry a more favorable prognosis than atypical ones and can be managed by conservative operations without affecting the survival rate. The spreading of the tumor to lymph nodes and surrounding tissues was not associated with an increased mortality in the reported cases.

Adult↗
PubMed1987

[Esophagogastroplasty in the treatment of squamous carcinoma of the esophagus (our experience)].

The authors report on their experience with 42 cases of squamous carcinoma of the oesophagus subjected to oesophagectomy and oesophagogastroplasty. The patients' mean age was 55.2 years (range: 41-70) with a 13:1 male/female ratio. A positive history of cigarette smoking and of alcohol consumption was found in 87% and 80% of patients respectively. The sites of the neoplasms were as follows: 24 in the mid 3rd of the oesophagus, 9 in the lower 3rd, 6 in the upper 3rd of the thoracic oesophagus and 3 in the cervical oesophagus. In 39 patients the operation was performed in two stages according to Lewis and in 2 cases it was performed in 3 stages according to McKeown, while one patient was treated with a pull-through operation according to Akiyima. Six patients died during the first 30 days postoperatively as a result of circulatory complications or ARDS. Fistulization of the anastomosis as observed in 5 cases, though this was clinically manifest only in two. Mean survival was 5.9 months, 18.6 months and 10.5 months according to the period considered.

Adult↗
PubMed1987

[Clinical results after proximal selective vagotomy (considerations on 42 cases)].

The authors report the results of a 6-8 year follow-up of 42 patients treated by selective proximal vagotomy with pyloroplasty for gastric or duodenal ulcer disease. On the basis of Visick's classification, the patients broke down into the following categories: Cat. 1: 66.6%; Cat. 2: 26.1%; Cat. 3: 2.3%; Cat. 4: 4.7%, with 92.7% belonging to the first two categories. These data are in agreement with other data reported in the literature, and show no significant differences as compared to follow-up one year after surgery.

Duodenal Ulcer↗
PubMed1987

[Esophageal localization of granulosa cell tumor (presentation of a clinical case)].

The authors report on a case of granular cell tumour localized in the lower third of the thoracic oesophagus. The patient, a 49-year-old male, suffering from symptoms of dysphagia over the previous few months, was treated surgically by thoracotomy enucleation of the neoplasm. Despite its slow growth, this rare benign neoplasm, which probably originates in Schwann's sheath, is a candidate for endoscopic or surgical resection.

Diagnosis, Differential↗
PubMed1987

[Preoperative evaluation of the patient candidate for surgical intervention on the chest: methods of study and risk factors].

The authors review the main methods designed to evaluate operability and surgical risk in candidates for chest surgery. They also report on their own experience with 135 cases operated on for thoraco-pulmonary diseases requiring surgery; in these cases, postoperative complications were studied in relation to various respiratory parameters evaluated differentially and as a whole prior to surgery. This study enabled the investigators to establish that patients with CV, FEV1, FEF25-75 and Tiffffeneau Index values below 60% of the respective theoretical reference values run a very substantial risk of postoperative complications, with a post-surgical morbidity rate of more than 60% in such patients. Similar risks are run by patients with VR values below 60% or above 120% of predicted values or with Emphysema Index values above 120% of predicted values. The author's experience with fractional bronchospirometry revealed that, in the high-risk patient sample, a predicted postoperative FEV1 value of only 800 ml/sec is a poorly selective limit.

Adolescent↗
PubMed1987

[Primary lymphoma of the breast (apropos of a clinical case)].

Taking as their starting point the observation of a case of primary lymphoma of the breast, the Authors point out that this tumour constitutes a rare disease in the context of non-Hodgkin lymphomas arising in sites other than the lymph nodes. They emphasize the clinical and instrumental diagnostic difficulties which the disease poses, as well as the uselessness of radical surgical therapy and the need for radio-chemotherapeutic management along with periodic follow-up. The Authors go on to explain how difficult it is to formulate a reliable prognosis for this type of tumour in view of the lack of homogeneity and the limited numbers of cases reported in the literature.

Breast Neoplasms↗
PubMed1986

[Nd-YAG laser disobstruction of esophageal endoprostheses occluded by neoplastic development in the palliative treatment of esophageal cancer].

Since August 1984 18 patients suffering from inoperable esophageal cancer have been treated by Nd. Yag Laser therapy under endoscopic control in the Verona University Institute of Clinical Surgery. Three patients, all males ranging in age from 68 to 80 years, had endo-esophageal prostheses which were occluded as a result of the neoplasms. Occlusion of the prostheses had been ascertained by both x-rays and endoscopy. The symptoms consisted of severe dysphagia of solid foods in 2 cases and of solids and liquids in 1 case. The original sites of the tumors were the lower 3rd in two cases and the mid 3rd in 1 case. Histologically, the tumors were identified as 2 squamous-cell carcinomas and 1 adenocarcinoma. Laser treatment was given on average once every 7 days. Patients were admitted to the day hospital, thus avoiding negative repercussions in terms of quality of life or length of hospital stay. In 2 cases there was an improvement in symptoms with the possibility of semi-solid nutrition after a single treatment with 6000-5032 Joules. In the third case, to obtain the same result, 2 treatments were necessary at an interval of 7 days with a total of 9396 J. One patient died of cardiorespiratory failure 24 days after the first treatment. A second patient was treated a further 3 times with a total of 12356 J and is now on a liquid and solid diet 5 months after the first treatment. The third patient was treated 4 times with a total of 15769 J; this patient was on a liquid and solid diet, but died of cardiorespiratory failure 3 months after the first treatment. In the light of our experience, Nd. Yag Laser disocclusion of endo-esophageal prostheses occluded by neoplasms presented no complications and was an appropriate indication in these cases with satisfactory long-term results.

Adenocarcinoma↗
PubMed1986

[Gastric metastasis of melanoma (report of a clinical case)].

The Authors report a case of gastric metastasis from melanoma of the skin, occurring 6 years after removal of the primary neoplasm. The metastasis, which was characterized by conspicuous alimentary tract haemorrhage, called for emergency surgery consisting in a total gastrectomy with oesophago-jejunal anastomosis according to Roux. The Authors then go on to review the literature on the subject, stressing the frequency of gastrointestinal metastases in skin melanomas with an incidence affecting up to 60% of cases in autopsy series. After examining the main clinical aspects, endoscopic appearances and r-ray findings, the Authors deal at some length with prognosis, pointing out that isolated metastases may constitute a surgical indication in view of the cases of fairly good long-term survival reported in the literature.

Adult↗
PubMed1985

[The ND-Yag laser in the treatment of non-resectable esophageal neoplasms: evaluation and results].

The Authors show a set of 9 cases of patients suffering from oesophagus flaky carcinoma, judged radically non-operable, and treated with endoscopic laser-therapy by N.D. Yag Laser. They illustrate the patients' main clinical data, method followed, complications observed and results obtained. What seems to emerge from the analysis of the data is: the effectiveness of laser-therapy in the control of disphagia, simplicity of the technique and its acceptability by the patient, as well as the rareness of complications. Three are the clinical parameters used for the checking of patients before and after the laser treatment: disphagia, odynophagia and thoracic ache. The intenseness of symptoms was classed from 0 up to 3. Before the treatment, six patients out of nine showed class 3 disphagia; after the treatment, two could assume fluids (class 2), two fed also on minced foods (class 1), and two fed normally; in the two cases with initial class 2 disphagia a normal feed could be adopted; in one case no initial disphagia was present. Odynophagia was initially present in one case only at class 3, in three cases at class 1, and in all the other cases it was absent (0). After the treatment, odynophagia disappeared totally, except in one class 1 case, which remained unchanged. The presence of thoracic ache before the treatment was class 1 in four cases, class 3 in one case, and absent in four cases. After the treatment, the class 3 ache turned into class 1: in one class 1 case it was not modified; in the remaining cases the ache, if present, disappeared. Some questions remain opened, concerning the effect on survival, even in relation to other palliative methods, to the duration of the palliation obtained and to the eventual associability of lasertherapy to radiotherapy.

Aged↗
PubMed1985

[Respiratory function after traumatic rupture of the diaphragm].

In eight patients who underwent surgical treatment for diaphragmatic rupture, pulmonary function and differential ventilation of the lungs were evaluated four months-one year after surgery. The results of the study show that diaphragmatic rupture produces only a small reduction in total ventilatory function. Moreover our data indicate that the ventilation estimated to be contributed by the side injured, is decreased in a larger extent in abdominal than in thoracic trauma.

Adolescent↗
PubMed1985

Leiomyomata of the oesophagus: report of four surgically-treated cases.

Four patients with leiomyoma of the upper or middle third of the oesophagus treated by surgical excision are reported. All operations were performed through a right thoracotomy with simple enucleation of the lesion. Two patients were asymptomatic. In one the tumour had a spiral configuration almost completely surrounding the lumen. No complications occurred. Early surgical treatment is advised although the tumour grows slowly.

Adult↗
PubMed1985

[Surgical treatment of pulmonary metastases of colorectal cancer].

The pulmonary metastatic locations due to colorectal cancer were considered, in not remote times, not worthy of surgical treatment. At present, according to our experience and some other Authors' one, the surgical removal of metachronal pulmonary metastases should be considered suitable to improve the period of life free from symptoms and the survival. The surgical treatment has improved the survival in the single or double pulmonary locations, whereas the monolaterality of multiple pulmonary lesions, in respect of the bilaterality, was not significantly bettered the prognosis (Hiroshi Takita, Francis Edgerton). The survival, moreover, seems to be affected by the interval free from illness and by the doubling time of the metastatic location. The surgical indication to the pulmonary metastasectomy is done on condition of the absence of any metastases in other organs. In our experience, out of 742 interventions with radical purposes for colorectal cancer, we documented 15 cases where lung appeared as the first and sole metastatic filter (many patients were lost for their non-cooperation in the follow-up). In 7 cases pulmonary resections were performed, in patients selected and free from secondary locations in other organs, with a satisfactory result. Casuistry and personal results are reported.

Adult↗
PubMed1984

[Our experience in the use of "traction" endoprosthesis as a palliative treatment of cardial carcinoma].

The Authors review the methods of palliative treatment of cardial carcinoma, and particularly report some results obtained through the application of oesophageal endoprostheses (by Celestin and by Haring), following the traction method, in 38 patients. The global mortality amounted to 8 cases (21%). In 12 patients (31%), complications such as stoppage or dislocation of the prosthesis were observed. In two cases the perforation of oesophageal wall occurred, with spontaneous resolution in one of the two patients and serious mediastinitis and exitus in the other. The Authors' present trend is toward the use of push type endoprosthesis, because of the lower mortality reported in literature.

Adenocarcinoma↗
PubMed1984

[Surgical treatment of colovesical fistulas (our experience)].

The Authors study the statistics of the Verona Surgical Centre, concerning 5 cases of colovesical fistula. They support the two-time operation, that is, the colon resection with colo-colic anastomosis sheltered by a decompressive transversostomy and stitching of the vesical breach. They affirm the usefulness of the operation according to Hartmann in patients facing a greater operative risk.

Colonic Diseases↗
PubMed1984

[Surgical therapy of gastric carcinoma in an advanced stage (clinical cases)].

The Authors study the casuistry of the Verona Surgical Clinic concerning the interventions for gastric cancer; they particularly study 35 cases of plurivisceral demolition for neoplasm in advanced phase. After a discussion of the data supplied by the literature; the Authors, as a conclusion, suggest not to consider the overcoming of the gastric barrier in multivisceral sense as a rigid element for the exclusion of these patients from surgery, although they exclude widely demolitive interventions in seriously weakened patients, or in bearers of such spreadings as to involve tremendous operative risks, not rewarded with a satisfactory advantage.

Aged↗
PubMed1984

[Primary seminoma of the mediastinum: diagnostic and therapeutic approach].

The Authors show three cases of mediastinal seminoma, and discuss the epidemiologic, etiopathogenetic and clinical aspects of such neoplasms; they dwell upon the criteria allowing to define as primitive an extragonadal germinal tumour, and emphasize the importance of the multidisciplinary therapeutical approach in controlling these neoplasms, characterized anyhow in the pure forms by a remarkable sensitiveness to radium; promising looks the use of the tumoral markers (beta-HCG and AFP) for a diagnostical specification, for the choice of the treatment and for the evaluation of its effects.

Adult↗