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Biomedical subjects

F Corcione

Publications and source records attributed to F Corcione.

34 records · Page 2Linked to original sources
PubMed1997

Gallstones in cirrhotics revisited by a laparoscopic view.

Surgical literature around 1980 has emphasized the technical challenge and the risks of cholecystectomy in cirrhotic patients reporting discouraging results. The aim of this study is the retrospective analysis of laparoscopic cholecystectomy in cirrhotics. The collected laparoscopic experience of 3 surgical groups for the last 5 years is reported. Cirrhotics were classified according to Child-Pugh criteria. Postoperative complications were classified using Clavien's rules. Forty patients were recruited; 31 received successful laparoscopic cholecystectomy. Liver cirrhosis was preoperatively diagnosed in all Child-Pugh B (n = 11) and in 11/20 Child-Pugh A patients. Compared with 989 noncirrhotics undergoing laparoscopic cholecystectomy, cirrhotics were similar in terms of age (59.9+/-10.3 vs. 58.1+/-10.9) and sex (male: 51.6% vs. 50.1%). Acute cholecystitis has a similar frequence in cirrhotics and noncirrhotics (3.2% vs. 4.1%, respectively). Bile duct stones and acute pancreatitis were significantly more frequent in cirrhotic patients (6.4% vs. 3.7%, p < 0.001; and 6.4% vs. 0.3%, p < 0.001, respectively). Endoscopic papillotomy and stone extraction combined with laparoscopic cholecystectomy was performed in 2 patients. Intraoperatively, technical problems occurred in 5 (16.1%) patients: liver bed bleeding (n = 4) was significatively more frequent in cirrhotics vs. noncirrhotics (p < 0.001). Mean operative time was 90 min, range 50-180, and it was not significantly longer than in noncirrhotics (85 min, range 30-200). Conversion rate was also similar (3%). Seven patients presented 8 postoperative complications (Class II): right side lung effusion (n = 2), ascites (n = 2), temporary worsening of Child-Pugh status (n = 2), hyperosmotic coma (n = 1), and umbilical hernia (n = 1). Mean hospital stay in noncomplicated cases was the same for noncirrhotics (3+/-1). The authors suggest a more liberal use of laparoscopic cholecystectomy for symptomatic gallstones in selected Child-Pugh A and B patients.

Case-Control Studies↗
PubMed1997

Surgical laparoscopy with intraoperative manometry in the treatment of esophageal achalasia.

The aim of this study was to describe and evaluate the laparoscopic treatment of esophageal achalasia in nine patients over a 35-month period. Five trocars were used to perform a Heller's myotomy to completely eliminate the cardial high-pressure zone, under manometric control. Intraoperative manometry also was used to calibrate a pick degrees 360 Rossetti's antireflux wrap. A complete regression of symptoms was observed postoperatively in seven of nine patients (77.8%); in two patients (22.2%) a moderate dysphagia persisted, but it disappeared 3 and 6 months, respectively. Only one intraoperative complication (esophageal perforation, recognized and laparoscopically repaired) occurred. At the present follow-up of 18 +/- 5.34 months (range 6-35), no dysphagia or symptoms related to reflux have been observed. Laparoscopic treatment of esophageal achalasia is considered a safe and effective procedure, and the results of this procedure are comparable with those of the open technique. Advantages common to other laparoscopic techniques are emphasized.

Adolescent↗
PubMed1991

[The use of prostheses and traditional technics in the surgical treatment of laparocele. An experimental study].

The problem of surgical fixing for incisional hernia is still far from a final solution. Over the past few years, prostheses have been used in addition to traditional plastic surgery. The aim of this experimental study was to assess the efficacy of traditional techniques in comparison to modern methods using prostheses. For this purpose, two original experimental models were designed to assess parietal resistance. Ninety-six Wistar rats were subdivided into 4 group: 1) control; 2) "waistcoat" plastic surgery; 3) plastic surgery using a vicryl prosthesis. With the exception of rats in group 1, a lozenge-shaped section of abdominal wall was removed from all other rats and, subsequently, the wall was repaired using the above-mentioned methods. Rats were killed after 30-60-120-180 days and the abdominal walls were subjected to traction and pressure using specially designed experimental models. For the first 30 days, the walls with dacron and vicryl prostheses behaved in a similar way, and showed a greater resistance than the other two groups; but after day 120, the resistance of dacron prostheses was considerably greater than that of the other groups studied. In conclusion, plastic surgery based on the use of nonreabsorbable prostheses is now more efficacious than traditional plastic surgery in the surgical treatment of incision hernia.

Abdominal Muscles↗
PubMed1990

Choledochal cysts in adults: a case report.

We examined a case of choledochal cyst in an adult having congenital dilatation of the bile duct classified, according to Todani's, as type I and treated by excision with hepatic-jejunostomy Roux-en Y. This procedure is recommended as the best treatment for eliminating pancreatitis by pancreaticobiliary disconnection and thus for reducing the risk of malignancy.

Adult↗
PubMedDate not supplied

[The timing in differential diagnosis of cystic tumors of the pancreas: clinical report of three cases of cystadenocarcinoma].

The Authors analyze their own twelve-years experience about the Cystic Tumors of the Pancreas, considering the data existing in the literature. In particular, after a description of anatomo-pathological and clinical characteristics, they set out the problems in the differential diagnosis between the Cystadenocarcinomas and the other benign cystic lesions of the Pancreas. The solution of this problem is often reached only during the operation with multiple biopsies. Moreover they pay attention to the therapeutic choices, determined by the symptomatology of the patients and the localization and the histological kind of the lesions.

Aged↗
PubMedDate not supplied

[Abdominal actinomycosis and retroperitoneal fibrosis. Considerations on a clinical case].

Abdominal actinomycosis is a rare disease which often resembles an acute suppurative infection or/and abdominal tumour causing abscesses, fistulas and massive fibrosis. The preoperative diagnosis is difficult and surgical exploration is always needed because of major involvement of visceral and retroperitoneal structures. The disease can be diagnosed with certainty only on the basis of findings of bacterial colonies in histopathologic sections and typical sulphur grains in secretions from fistulas. The authors describe a case of abdominal actinomycosis involving the caecum and right colon, causing extensive retroperitoneal fibrosis and a fistula tract with an external cutaneous orifice at the level of the right iliac crest. These features resembled an acute appendicitis at first, and several surgical explorations were required before a correct diagnosis could be achieved. Abdominal actinomycosis can be treated by simple administration of antibiotics. With a correct diagnosis, medical therapy alone has proved effective in a substantial percentage of patients, thus avoiding the need for surgery, if important visceral or retroperitoneal structures are not involved. Abdominal actinomycosis always requires a careful differential diagnosis and must be considered in patients presenting abdominal tumours associated with abscesses and/or fistulas since early and efficient medical therapy, along with surgical intervention, where necessary, can lead to definitive recovery. Useful diagnostic tools are abdominal CT and selective FNAB.

Actinomycosis↗
PubMedDate not supplied

Treatment of parotid gland tumors.

A clinical review has been made of 55 patients who underwent surgery for parotid tumors between 1972 and 1987. The incidence of pleomorphic adenomas was 61.8%. The F.N.A.B. permitted us to reach a correct preoperative diagnosis in 94% of the cases. The surgical procedures we used were: enucleation in eight cases, enucleoresection in five cases, superficial parotidectomy in seven cases, total conservative parotidectomy in 28 cases, total parotidectomy sacrificing the facial nerve in four cases, extended surgery in three cases. For these last three patients a cycle of postoperative radiotherapy for a total of 6000-6500 R. was carried out. As regards complications and sequelae, we must report: temporary lesions of the facial nerve (12.76%), permanent lesions (17%), Frey's syndrome in 10.61%, while a salivary fistula arose in 6.38% of the cases. The follow-up of 47 patients allowed us to observe three recurrences in cases of pleomorphic adenomas (two after enucleoresection and one after superficial parotidectomy), three recurrences in malignant tumors treated with surgery and one recurrence after combined treatment surgery and radiotherapy.

Adolescent↗