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F M Frattaroli

Publications and source records attributed to F M Frattaroli.

At least 19 recordsLinked to original sources
PubMed2001

Two-trocar laparoscopic cholecystectomy: a reproducible technique.

Laparoscopic cholecystectomy is usually performed with a four-trocar technique. From December 1998 to March 1999, 25 of 42 admitted patients underwent a two-trocar laparoscopic cholecystectomy. In our technique, after establishing umbilical carbon dioxide pneumoperitoneum, a 30 degree scope was inserted, and a second 5-mm trocar was positioned below and to the left of the xiphoid process. Then two stitches with nonabsorbable sutures were passed: one at the fundus to pull up the gallbladder, and the second through the neck of the gallbladder to expose the structure of the Calot triangle. Intraoperative cholangiography was performed with a percutaneous catheter in 15 patients. Retrograde cholecystectomy was performed and the gallbladder was extracted through the umbilical port. Scars were closed with glue, and bupivacaine was injected to reduce pain. The technique was feasible in approximately 84% (25 of 30) of patients. The mean operative time was 42 minutes, and the mean hospital stay was 1.6 days. We conclude that this method is similar to four-port laparoscopic cholecystectomy in terms of safety and operation time. This technique seems to be well reproducible and offers better results in terms of postoperative pain, hospital stay without considering better cosmetic results, and cost-effectiveness.

Adult↗
PubMed2000

Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions.

BACKGROUND & AIMS: The most effective prophylaxis for colorectal cancer is endoscopic polypectomy. Prompted by the disadvantages of conventional colonoscopy (CC), we assessed the diagnostic ability of a promising alternative technique for detecting endoluminal masses: magnetic resonance colonography (MRC). METHODS: Seventy consecutive patients referred for CC underwent preliminary MRC. The diagnostic ability of this technique in detecting colonic endoluminal lesions was determined, compared with that of CC, and related to the findings from histologic examination. RESULTS: In detecting endoluminal lesions, MRC achieved a diagnostic accuracy similar to CC (sensitivity, 96%; specificity, 93%; positive predictive value, 98%; and negative predictive value, 87.5%). CONCLUSIONS: MRC could be useful in screening programs of patients at high risk for colon cancer. Patients with MRC-detected endoluminal lesions must undergo CC for histologic diagnosis.

Adenocarcinoma↗
PubMed1998

Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports.

OBJECTIVE: To evaluate the outcome after total and subtotal thyroidectomy for the treatment of single and multinodular goitres in two comparable groups of patients. DESIGN: Prospective randomised study. SETTING: University hospital, Italy. SUBJECTS: 141 Patients operated on for benign goitre from 1975-85. INTERVENTIONS: 69 Patients were randomised to have total thyroidectomy and 72 subtotal thyroidectomy by standard techniques. MAIN OUTCOME MEASURES: Temporary or permanent palsy of the recurrent laryngeal nerve, temporary or permanent hypoparathyroidism, recurrence of the goitre, and the incidence of iatrogenic injuries after completion thyroidectomy. RESULTS: Patients were followed up for a median of 14.5 years (range 10-21). After total thyroidectomy 2 patients (3%) developed temporary palsy of the recurrent laryngeal nerve but there were no permanent lesions; and 24 (35%) developed temporary and 2 (3%) permanent hypoparathyroidism. After subtotal thyroidectomy 2 (3%) developed temporary and 1 (1%) permanent palsy of the recurrent laryngeal nerve; and 13 (18%) developed temporary and 1 (1%) permanent hypoparathyroidism. In addition, there were 10 recurrent goitres (14%). After completion thyroidectomy (n = 9) there were 2 cases of temporary and 1 of permanent palsy of the recurrent laryngeal nerve, and 2 cases of temporary and 2 of permanent hypoparathyroidism. CONCLUSION: Total thyroidectomy is the procedure of choice for the treatment of benign nodular goitre.

Adult↗
PubMed1996

Benign biliary strictures: a review of 21 years of experience.

BACKGROUND: The treatment of patients with benign biliary strictures remains a challenge for even the most skilled biliary surgeons. Within the wide range of causes of benign biliary strictures, iatrogenic lesions represent one of the major ones. Biliary reconstruction with Roux-en-Y anastomosis remains the treatment of choice for most cases of benign biliary strictures despite recent reports about endoscopic or percutaneous management that have been quite encouraging. STUDY DESIGN: We retrospectively evaluated 194 patients who underwent surgery for benign biliary strictures over a 21-year period. The biliary strictures were classified into eight different types according to their level. The surgical procedures had been tailored mainly to the site and the extent of the structure as well as the overall status of the patient. RESULTS: Postoperative mortality and morbidity rates were 2.6 percent and 20.1 percent, respectively. The results we obtained were 79.6 percent good, 8.9 percent moderate, and 11.5 percent unsatisfactory. The mean follow-up was 9.3 years. In particular, hepati-cojejunostomy performed in low- and mid-level strictures had the best prognosis (good, 85.5 percent), while high and diffuse strictures had worse results (good, 70 percent), although with only hepaticojejunostomy according to Hepp-Couinaud, this percentage increases to 81 percent. CONCLUSIONS: Correct preoperative assessment of the site and extent of the biliary stricture is important in the choice of the gold-standard surgical procedure. Hepaticojejunostomy and hepaticojejunostomy according to Hepp-Couinaud are the treatments of choice in most instances of benign biliary strictures. Cholangiojejunostomy and hepatic resections are rarely indicated and are performed mostly for highly complicated and intrahepatic strictures. Endoscopic or percutaneous balloon dilation should be reserved for high-risk patients.

Anastomosis, Roux-en-Y↗
PubMed1994

Retroperitoneal malignant schwannoma. A case report.

The isolated retroperitoneal malignant schwannoma unassociated with Von Recklinghausen's disease is an unusual neoplasm, representing 0.01% of all retroperitoneal malignant neoplasms, with a poor prognosis, and an average survival at 5 years of 50% in patients treated by radical exeresis. At present, it is impossible, without histologic and immunohistochemical examinations, to differentiate it from other isolated retroperitoneal sarcomatous neoplasms. The authors report a case of retroperitoneal malignant schwannoma 20 cm in diameter in a 62-year-old woman surgically treated by radical exeresis. Postoperative complications were absent, and the patient, discharged from the hospital on the 12th postoperative day, died 8 months later of diffuse metastases, without local relapse. Despite the patient's short survival, the authors believe radical surgery to be the best therapeutic choice. Only surgery can establish a final diagnosis and can offer the best chance of survival and a significant and sometimes prolonged relief of symptomatology.

Female↗
PubMed1993

[Substernal goiter: new diagnostic methods and treatment].

The authors report 47 cases of substernal goiters operated between 1971 and 1990. Forty-five patients had mediastinal-cervical-goiters (g.c.m.) and 2 had ectopic goiter (g.e.). Cervicotomy was performed in the 45 g.c.m., in 3 cases associated with sternal "split". The g.e. were treated with thoracotomy. Computed Tomography (TC) has been performed since 1984 in 26 patients; Magnetic Resonance (RM) since 1987 in 6 patients. The diagnostic accuracy for TC was 84.6% and 100% for MR on anatomical-topographic-definition, and 80.8% and 83.3% for presumptive diagnosis of nature, respectively. Considering the high diagnostic accuracy, the possibility to reconstruct the images in sagittal and coronal planes, the RM seems to be the elective diagnostic procedure for all substernal goiters.

Adult↗
PubMed1993

Historical evolution of the surgical anatomy of the liver.

The authors report the history of the anatomy and surgical anatomy of the liver from the paleolithic age up to now. Particular emphasis has been reserved to the changing anatomical knowledge in these last decades which represents the basis of the modern surgery of the liver.

Anatomy↗
PubMed1991

[Esophageal manometry and pH-monitoring for surgical indications].

The Authors report a review of the data gathered by manometry and pH-metry in the functional esophageal diseases. Manometric and pH-metric patterns of gastro-esophageal reflux, Barrett esophagus, diverticula, achalasia, aspecific motility disorders and non-cardiac chest pain, are analyzed. Data conditioning the choice of surgical treatment in the literature and in the authors' experience are reported in detail.

Esophageal Diseases↗
PubMed1991

Effect of fecal loading with/without peritonitis on the healing of a colonic anastomosis: an experimental study.

An experimental randomized prospective study was carried out in 64 dogs to evaluate the effect of intraluminal fecal matter at the anastomosis with/without peritonitis on the healing of a colonic anastomosis. The animals, none of whom had bowel preparation, were randomized in four groups: group I sigmoid resection and anastomosis, group II sigmoid resection and intraluminal fecal diversion from the anastomosis, group III induced fecal peritonitis, sigmoid resection and anastomosis and group IV induced fecal peritonitis, sigmoid resection and intraluminal fecal diversion from the anastomosis. Forty-eight hours before sacrifice at 5, 10 and 15 days, 10 microCi/kg C14 proline was given intravenously. Specimens were analyzed for hydroxyproline content, tissue counts and specific activity. The tissue counts and specific activity were analyzed by three-way analysis of variance. Overall, regardless of the groups, there was a statistically significant decrease in specific activity and tissue count from day 5 to day 15 and day 10 to day 15 at the anastomosis (p less than 0.05). When comparing groups II and IV to groups I and III, there was a significant increase in specific activity and tissue count at the anastomosis of group II and IV (p less than 0.05). This experimental study demonstrates that early anastomotic healing can occur even in presence of treated peritonitis as long as the fecal matter is diverted and prevented from coming in contact with the anastomotic site without disrupting the bowel continuity or function.

Anastomosis, Surgical↗
PubMed1990

The value of endoluminal ultrasonography and computed tomography in the staging of rectal cancer: a preliminary study.

A prospective study was carried out in 14 patients with rectal cancer. Tumors were staged preoperatively by endoluminal ultrasonography (EU) and computed tomography (CT). Patients were followed postoperatively for 2 years by the same modalities. Extramural spread was 100% (9/9), accurately assessed by EU and 77.8% (7/9) with CT. Lymph node sensitivity was 87.5% for EU and 37.5 for CT (P less than 0.05). Overall accuracy of lymph node metastases was 85.7% for EU and 57.1% for CT (P less than 0.1). In conclusion, the study shows EU to be statistically more accurate for nodal metastases than CT; therefore, its routine use can be recommended in the preoperative staging of rectal carcinoma in those patients for whom a sphincter-saving procedure is considered.

Female↗
PubMed1988

Secondary sclerosing cholangitis: an experimental study.

An experimental study on rabbit sclerosing cholangitis (SC) secondary to direct injection into the biliary tract of the chemical substances commonly employed for intraoperative sterilization of the hydatid cyst content is reported. Among the various substances utilized, 10% formalin and 30% hypertonic solution caused gross and microscopic lesions compatible with less advanced forms of sclerosing cholangitis. The authors present their hypothesis on the development of SC in operated hydatid cysts of the liver.

Alanine Transaminase↗
PubMed1988

[Somatostatinoma].

Explore the source record for details and available documents.

Duodenal Neoplasms↗
PubMed1987

Combined medical and surgical therapy: a new approach to abdominal hydatidosis.

The experience with 28 patients affected by hepatic and abdominal hydatidosis and treated by combined medical and surgical therapy is reported. All the patients were subject to preoperative and postoperative medical therapy with mebendazole (50 mg/kg/daily). The percentage of living scolices in hydatid fluid obtained during surgery, evaluated microscopically and by mice inoculation, was lower in patients treated medically than in patients operated on without pre and postoperative medical therapy. These data support the efficacy of the preoperative medical therapy in order to decrease the biological activity of the parasite and, consequently the risk of secondary localization due to intraoperative dissemination. Two ultrasound proved recurrences (7.1%) were observed only in patients with multiple or diffuse hydatidosis. In these cases it is uncertain whether it was a relapsing or residual disease. No toxic or collateral effects, following the schedule of dosage and timing of the drugs used, were observed in these patients. It is concluded that, at the present time the combined medical and surgical therapy, is considered the most effective therapeutical approach to abdominal hydatidosis.

Abdomen↗
PubMed1987

Lingual thyroid. A case report.

Lingual thyroid is a rare example of ectopic thyroid involving major problems in diagnosis, surgical approach and operative procedure. A case is presented with wide review of the literature. The personal operative procedure performed through the oral route is described.

Adult↗