Computer-aided locoregional assessment of soft tissue sarcoma and three-dimensional simulator surgery.
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Biomedical subjects
Publications and source records attributed to E Raposio.
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Ten patients with primary or recurrent cancer of the chest wall underwent full-thickness resection and immediate reconstruction of the defect by placement of an alloplastic implant and transposition of a latissimus dorsi (n = 5) or transverse rectus abdominis (n = 5) myocutaneous flap. When up to three ribs were removed, these were replaced by a reabsorbable mesh sutured to the residual rib stumps. Larger skeletal defects were stabilized by placement of a permanent mesh or polytetrafluoroethylene (PTFE) sheet. In only one case the PTFE reconstruction was reinforced by metallic implants, but that caused dehiscence of the overlying flap suture, leading to major complications and eventually death. Both the latissimus dorsi and the rectus abdominis myocutaneous flaps were ideally suited to soft tissue reconstruction. There were no appreciable complications concerning viability of the flaps, and the operating time needed for the transposition of the two flaps was similar. The rectus abdominis flap showed a distinct advantage when an absorbable mesh was to be covered, as its superior thickness minimized the risk of creating a 'flail' reconstructed chest wall. This advantage was in part counter-balanced by the more limited arc of rotation compared with the latissimus dorsi flap.
We report a case of a large Merkel cell skin tumor (left cheek) in an 83 year-old woman treated by a combination of radiotherapy and hyperthermia. A complete response to the treatment was observed and without side effects. The patient has now been followed for 12 months without signs of recurrence, nodal disease, or distant metastasis.
Although harelip, cleft palate, or both, are by far the most common major facial malformations, the mechanisms underlying their embryogenesis are only now beginning to be understood; this is due to the complexity of primary and secondary palate development and the fact that appropriate methods for study have only recently been developed. The authors present a review of the most significant data regarding the etiology of hare lip and cleft palate, both in their physiopathogenic aspects and in their clinical morphology. The peculiarity of these malformations is outlined, supported by literature data and personal experimental experience.
The limb developmental program is comprised of processes of cell multiplication and of cell determination, differentiation and morphogenesis. Many of these processes depend on cell-cell communications within tissues and between different tissue types. The Authors present a review of the more significant data about the etiology of the syndactylies of the hand, both in their physiopathogenic aspects and in their clinical typology. The peculiarity of these malformations is outlined, supported by literature data and personal experimental experiences.
The authors report the results of a randomized clinical trial of antibiotic prophylaxis of postoperative infection following breast reconstruction by transposition of rectus abdominis myocutaneous flap (TRAMF). The aim was to evaluate the efficacy and tolerability of a short-term parenteral prophylaxis with Teicoplanin and the end-point of the study was the evaluation of wound contamination assessed by means of microbiologic culture of drainage fluid. From October 1990 to March 1992 38 patients were recruited: 20 patients in the antibiotic prophylaxis arm and 18 patients in the control group. Analysis of drainage fluids showed a higher contamination rate (15/18 = 83%) in the control group as compared to the prophylaxis arm (2/20 = 10%) (p < 0.0001). Moreover, 11 patients in the control arm suffered from fever > 37.5 degrees C for at least 3 days as compared to 1 patient in the antibiotic prophylaxis group; the postoperative stay was 13.3 +/- 4.3 and 9.0 +/- 1.6 in the control and antibiotic arm respectively. No antibiotic related side effects were evidenced through the study. These results seem to confirm the value of parenteral short-term antibiotic prophylaxis of postoperative infection in such kind of "clean" operative procedure.
The clinical features of 10 cases with the adjunct of a literature review of primary neuroendocrine carcinoma of the skin (Merkel cell tumor) are reported. This cancer arises in the dermis and subcutaneous tissue of elderly individuals. Natural history is characterized by local recurrences (40%), regional lymph-nodes metastases (50%), and distant metastases (60%). Surgery is the elective treatment of primary and locoregional disease and subsequent radiotherapy prevents local recurrences and prolong disease-free survival in literature reports. Chemotherapy and radiotherary resulted in only a short-term palliative response in the metastatic setting.
The clinical features of 10 cases of primary neuroendocrine carcinoma of the skin (Merker cell tumor) are reported. This cancer arises in the dermis and subcutaneous tissues of elderly individuals. Natural history is characterized by local recurrences (30%), regional lymph node metastases (65%) and distant metastases (40%). Surgery is elective treatment, chemotherapy and radiotherapy resulted only to short-term palliative response.