Search PubMed⌕ Search

Biomedical subjects

F Feliciotti

Publications and source records attributed to F Feliciotti.

At least 37 records · Page 2Linked to original sources
PubMed1998

Transanal endoscopic microsurgical excision of irradiated and nonirradiated rectal cancer. A 5-year experience.

Transanal endoscopic microsurgery (TEM) allows minimally invasive full-thickness local excision of rectal tumors with perirectal fat dissection. Thirty-seven patients with extraperitoneal rectal carcinoma underwent full thickness TEM resection for T1 (10 patients), T2 (20 patients), and T3 (6 patients) lesions, with associated radiotherapy in the second and third group. One patient, staged as T2, underwent full-dose radiotherapy and TEM and the pathologist did not find cancer cells on the specimen (pT0). Morbidity included would dehiscence and stool incontinence in three and two patients, respectively, that resolved with medical therapy and rectovaginal fistula in one patient that required reoperation. No perioperative mortality was observed. Mean follow-up was 35 months (range 17-60 months), with two local recurrences (5.4%) that were successfully retreated. Cancer-related mortality due to systemic metastases was 8.1%. This is the first clinical study reporting on the application of TEM combined with radiotherapy for the treatment of T2 and T3 rectal cancer in selected patients. This approach is feasible, safe, and appears to be effective at the present duration of follow-up, with preservation of normal and sphincter function.

Adenocarcinoma↗
PubMed1997

A new technique to facilitate laparoscopic resection of low rectal tumors.

To make laparoscopic low rectal resection feasible and technically correct, an articulating stapler made for open surgery was employed during laparoscopic low rectal resection in two patients with rectal tumors whose distal margins were located at 7 and 8 cm, respectively, from the dentate line. The problem with laparoscopic linear staplers is that they do not allow transverse resection of low rectal tumors with a double-stapling technique, placing the suture line in an exactly perpendicular position to the rectum below the tumor. The use of this stapler made for open surgery allows extension of the laparoscopic approach to low-lying rectal lesions following established surgical and oncological principles.

Adenocarcinoma↗
PubMed1996

Laparoscopic colorectal resection. A multicenter Italian study.

BACKGROUND: The aim of the present study was to evaluate retrospectively the experience of six surgical units currently performing laparoscopic colorectal surgery. METHODS: From November 1991 to January 1994, 200 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with locally advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I and IV adenocarcinoma. All surgeons considered obesity a relative contraindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resumption of gastrointestinal function, number of lymph nodes harvested, hospital stay. RESULTS: Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedure (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90-480) for assisted resection and 275 min (54-550) for complete laparoscopic resection. The mortality rate was 1.7%; the overall morbidity was 19.6% (major complications 11.2%). All patients quickly became ambulatory and showed a prompt resumption of gastrointestinal functions, and less postoperative pain if compared with converted cases. The average number of lymph nodes was 12.1 (range 1-32). The mean hospital stay was 8.6 days (range 5-14.5). The mean follow-up was 16 months (range 6-24). The recurrence rate 11.7%. CONCLUSIONS: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-term follow-up is needed to evaluate the efficacy of laparoscopic surgery in the treatment of colorectal cancer.

Adult↗
PubMed1996

Laparoscopic intra-arterial catheter implantation for regional chemotherapy of liver metastasis.

In patients with unresectable metastatic disease confined to the liver, intra-arterial regional chemotherapy with implantable systems in an attractive option. Since April 1992, laparoscopic colorectal resections have been performed in our institution. Within this series of patients, three cases with bilateral liver metastasis from colon cancer were observed and underwent laparoscopic intra-arterial catheter implantation in the gastroduodenal artery for regional chemotherapy. In two patients the metastases were synchronous, and in both cases a laparoscopic colon resection was also performed, for tumors located in the cecum and in the sigmoid colon, respectively. The laparoscopic surgical technique for intra-arterial catheter implantation is described in detail. In this limited experience the procedure, from a purely technical point of view, was not considered difficult and was completed in 70 min on average. No complications were observed and the patient with metachronous liver metastasis was discharged on 3rd postoperative day.

Antineoplastic Agents↗
PubMed1996

Is transanal endoscopic microsurgery (TEM) a valid treatment for rectal tumors?

BACKGROUND: In 1983 G. Buess, in Germany, developed transanal endoscopic microsurgery (TEM), a new minimally invasive technique for the treatment of rectal tumors. METHODS: Rectal lesions are excised through a modified rectoscope of 40 mm in diameter under stereoscopic control in the gas-dilated rectal cavity. Full-thickness excision, partial-wall excision, or mucosectomy can be performed. Seventy-one patients were treated with the TEM technique in our department. Major complications were observed in one patient (1.4%). No mortality was reported. RESULTS: Histological examination revealed 40 (56.3%) villous adenomas, 6 (8.4%) pT1; 17 (23.9%) pT2; 5 (7%) pT3 carcinomas; and 3 ((4.2%) other lesions. The recurrence rate was 2.8% for adenomas and 2.8% for carcinomas. The overall survival at mean follow-up of 17 months was 96.4%. CONCLUSIONS: The advantages of TEM are less or no postoperative pain, unrestricted mobility, short hospitalization, quick rehabilitation, and absence of skin scars.

Adenoma, Villous↗
PubMed1996

Laparoscopic treatment of gallbladder and common bile duct stones: a prospective study.

The aim of this study was to investigate prospectively the feasibility, success rate, safety, and short-term results of single-stage laparoscopic treatment of gallstones and ductal stones in 100 consecutive, unselected patients. Common bile duct (CBD) stones were diagnoses at routine intraoperative cholangiography and choledochoscopy in 100 of 950 patients with gallstones undergoing laparoscopic cholecystectomy (LC). Unsuspected CBD stones were present in 39 patients (4.1% of 950; 39% of 100); 26 patients were referred for surgery after failed endoscopic sphinctertomy (ES) performed elsewhere. Transcystic duct CBD exploration (TC-CBDE) was the procedure of choice. When it was not feasible, choledochotomy and direct CBD exploration (D-CBDE) was performed. Use of biliary drainage was liberal. A completion cholangiogram was obtained for all patients. Laparoscopic treatment of CBD stones was successful in 96 patients: after TC-CBDE in 63 and after D-CBDE in 33. Four operations were converted to open surgery (4%). Retained stones, observed in five patients, were treated by ES in two cases and by percutaneous endoscopic/fluoroscopic lithotripsy in three. Minor morbidity included biloma (n = 2), port site infection (n = 2), and subumbilical hematoma (n = 1). Major morbidity was bile leakage from the cystic duct stump in two cases due to clips or transcystic duct drainage displacement, respectively. One elderly, high risk patient died after being referred for several failed attempts of endoscopic clearance; she died from cardiogenic shock 3 days after successful laparoscopic treatment. Laparoscopic CBD exploration is feasible and safe in most patients, with short-term results that compare favorably with the results of sequential ES/LC reported in the literature.

Adolescent↗
PubMed1996

Laparoscopic adjustable silicone gastric banding (LASGB) for the treatment of morbid obesitiy.

Morbid obesity is a serious disease that is responsible for several co-morbid conditions. Increased risks of hypertension, adult onset diabetes mellitus, dyslipidemia, pulmonary disease (Pickwickian syn- drome), musculo-skeletal disorders, gallbladder disease, deep vein thrombosis, venous stasis ulcers, and increased prevalence of certain types of cancers (uterine, breast, colon carcinoma) have been reported, ( together with severe psychological and social disability.' Nonsurgical treatment options including various combinations oflow-calorie or very-low-calorie diets, behavior modification, exercise, and drug therapy may achieve acceptable transient weight reduction but fail to maintain reduced body weight in most patients.'

Journal Article↗
PubMed1996

Technique of transanal endoscopic microsurgery (TEM).

Early stages of rectal cancer, well and ~oderately differentiated, have a l~w r~te of regional spread a~d therefore may be treated by conservative therapy. 1-3 Transanal Bnrloscopic MIcrosurgery (TEM)was In- troduced into clinical practice' by G. Buess in 1983.This technique allows for the local treatment of be- nign lesions and the early stages of rectal cancer through a modified rectoscope, yielding good exposure of the operative field with-three-dimensional vision; mucosectomy and full thickness excision procedures can be performed. TEM benefits are the same as other minimally invasive techniques: less pain, reduced morbid- ity, faster recovery time, and an absence of skin scars. In the present paper, the authors report the technique and the results of the experience of 89TEM procedures for the treatment of rectal tumors.

Journal Article↗
PubMed1996

Conservative ultrasound-guided laparoscopic treatment of posttraumatic splenic cysts: report of two cases.

Recently, laparoscopic splenectomy has been reported by various authors. Further advancement of this minimally invasive surgery is the conservative treatment of nonneoplastic lesions of the spleen. The authors report two clinical cases in which the laparoscopic approach has been employed to treat a large posttraumatic cyst of the spleen. Using a specifically developed ultrasound probe for laparoscopic surgery, the authors identified the thinnest area of the wall in two large intraparenchymal posttraumatic splenic cysts (diameters: 11 and 8 cm). After an explorative puncture, the orifice was enlarged using electrocautery scissors. The opening of the cyst was further enlarged and a 35-mm ELC stapler with vascular cartridges was applied in order to resect as possible the cyst wall and to obtain an adequate hemostasis of the splenic parenchima. Both postoperative courses were uneventful, and the patients were discharged on day 5 after a negative ultrasound examination of the abdomen. This is the first report of successful conservative treatment of a large posttraumatic cyst by laparoscopic surgery.

Cysts↗
PubMed1993

Laparoscopic suture technique after common bile duct exploration.

Performing both laparoscopic cholecystectomy and choledocholithotomy during the same operative procedure for both suspected and unsuspected stones is an attractive alternative to preoperative endoscopic retrograde cholangiopancreatography and stone removal or to conversion of the laparoscopic procedure to open common duct exploration. During laparoscopic exploration, intracorporeal suture and knot-tying may be tedious. We thus developed a technique of suture of the choledochus that avoids the use of knots and avoids placing metal clips in contact with the common bile duct. This technique was accurate, fast, and easily controlled in eight of 21 patients, and no major complications or mortality occurred.

Cholecystectomy, Laparoscopic↗
PubMed1990

Gastric duplication communicating with a pancreatic duct. Report of a case.

A case of gastric duplication communicating with the pancreatic duct system is reported. The clinical presentation consisted of abdominal pain with recurrent acute pancreatitis. The histopathological examination showed that the duplication was lined with normal pyloric mucosa. In the tubular structure, connecting the duplication to the pancreatic ducts, an increase in the number of serotonin-positive cells was found. The pancreas showed dilatation of the duct system and chronic pancreatitis.

Female↗