Biomedical subjects
Publications and source records attributed to F Peradotto.
The aim of this article was to review the main indications of laparoscopic colostomy. A series of 9 patients is reported, stressing the technical steps of laparoscopic colostomy. The laparoscopic approach in patients with unresectable colorectal cancer permit to avoidance mayor laparotomy. In conclusion this technique appears safe, feasible and effective.
The work is based on two years studied cases. It consists of 80 patients between 35 and 80 years old with leg ulcers (73.8% women and 26.2% men). In 80% of patients this affection is due to a venous disease. In 10% of cases the cause was an arterial insufficiency of the lower extremity. Lymphatic and extravascular diseases are rarely involved. A group of 54 patients was treated with a traditional method. In the remaining 26 patients we used fibrin glue. Leg ulcers are an evolutive chronic pathology characterized by slow recovery. This means expensive social and therapeutic costs. From this point of view the treatment with fibrin glue, weekly applied, besides reducing pain, has a favourable impact on the outcome, times of re-epithelialization are shortened.
A statistical analysis of 340 patients operated between 1986 and 1991 for inguinal hernia using the Shouldice procedure are reported by the authors. The majority of patients (60%) treated was between 45 and 65 years old. Two-hundred-eighty-one (82%) were controlled with a mean follow-up of 30 months (range 1-6 years) and was executed with physical examination and a medical questionnaire looking for recurring factors of risk. Hundred-twenty-eight patients (45% of controls) were at the high risk, nevertheless hernia recurrences were not noticed. Postoperative course was uncomplicated in 93% of patients. Early or late loco-regional complications had an incidence of 7%. Local infections and edema were reported in 10 of 22 patients. Acute urinary retention, cephalalgia and hypotension correlated with an anesthesiologic method had an incidence of 5% (17 cases). There were no deaths was pulmonary embolisms. A review of literature was performed and compared with our work. From experience in our Division, Shouldice's hospital technique had a high reliability compared to methods utilized in the previous ten years (Bassini, McNealy, Postemskj, Mugnai-Ferrari), in terms of recurrences.
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Analysis of 5 cases of primary breast lymphoma highlights the marked rarity of the lesion and the extreme difficulty of pre-operative diagnosis. It is also shown that the disease generally runs a rapid course and that prognosis is usually unfavourable. The most effective treatment appears to be a combination of surgery and radiation therapy, while chemotherapy--although widely used--still requires further confirmation.
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On the basis of two observed cases and a review of the literature, the extreme rarity of cystic lymphangioma of the spleen is pointed out. The presumed pathogenesis of the condition is described as are its greater frequency among the young, the possibility of dangerous complications and its non-malignity. The superiority of non-invasive instrumental diagnosis (echotomography and CAT) over traditional techniques is reported. Finally splenectomy is identified as the therapy of choice.
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Resection of locoregional recurrences was performed after mastectomy in 50 cases in the period 1961-1974. An incidence of 2% to 35% is reported for such recurrences, which are due to a variety of factors. In the present series, attention was directed to age at mastectomy and at recurrence, size of primary tumour, presence of axillary metastases, and details of menarche, menopause and pregnancy. Mean age at mastectomy was 50 yr and at recurrence 53 yr. Tumour diameter ranged from 2 to 5 cm in 73% of cases. Lympho node metastases were present in 42%. In 80%, the recurrence was paracicatricial, in 13% parasternal, and in 7% axillary. Treatment consisted of resection, radiochemotherapy or endocrino-ablative management.
218 patients examined for localized cancer of the extremities (50% benign, 50% malignant) are reported. The incidence is considered by sex and age. Demolition surgery was carried out in 35 patients and 27 locoregional treatment with antiblastics and radioactive isotopes was employed. Conservative surgery was used in 158. Operative mortality was less than 1% (2 cases out of 218) and did not reach 6% if amputations and disarticulations alone are considered. There were no deaths in cases submitted to radiochemotherapy and inguinocrural hymphadenectomy. The series includes a 15-years survival for giant-cell tumour of the femur treated with radioactive microsphores, an 11-years survival for a popliteal melanoma submitted to radiocolloid infiltration, a 9-year survival for femoral osteosarcoma for which hip disarticulation was carried out and a 4-year survival for a recurrent rhabdomyosarcoma of the hip operated by hemipelvectomy.
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