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Biomedical subjects

F Venuta

Publications and source records attributed to F Venuta.

At least 109 records · Page 6Linked to original sources
PubMed1989

Correlations between histological type, clinical behaviour, and prognosis in thymoma.

Seventy four cases of thymoma were reclassified into three histological categories--cortical (30), medullary (9), and mixed (34) (the remaining patient had an intrathymic thymoma)--for an investigation of the relation between histological type, clinical behaviour, and long term prognosis. There were significant differences between the histological types in the frequency of myasthenia gravis and of the different tumour stages, the mean age of the patients, and prognosis. Myasthenia gravis occurred more commonly in patients with cortical (33%) and mixed thymoma (35%) than in patients with medullary thymoma (11%). Five, 10, 15, and 20 year actuarial survival was 100% for medullary thymoma; 85%, 76%, 65% and 65% respectively for mixed thymoma; and 52%, 45%, 45%, and 45% for cortical thymoma. Medullary thymoma is a benign tumour arising late in life and there was no mortality in this series after surgery alone. Cortical thymoma usually presented in middle age and must be regarded as malignant; mortality was 50% at five years despite a multidisciplinary approach, with surgery and postoperative radiotherapy in all patients and chemotherapy in selected cases. Mixed thymoma had a better prognosis than cortical thymoma, but must be regarded as potentially malignant. One third of the total patients had died by 10 years despite radical tumour resection.

Adolescent↗
PubMed1989

Myxoid chondrosarcoma of the mediastinum.

We report a unique case of primary myxoid chondrosarcoma in the posterior mediastinum. This lesion clinically mimicked a neurogenic tumor due to its location and dumbbell appearance. The histogenesis of this tumor is discussed and a skeletal origin from the thoracic vertebrae is suggested. It is concluded that myxoid chondrosarcoma has to be distinguished for the differential diagnosis among the long list of myxoid tumors arising in the posterior mediastinum.

Chondrosarcoma↗
PubMed1988

Thymoma: a clinico-pathologic study based on newly developed morphologic criteria.

A retrospective study of 28 cases of thymoma classified according to Marino and Müller-Hermelink (cortical, medullary, mixed common, mixed with cortical predominance, mixed with medullary predominance thymoma) was undertaken to determine the existence of correlations between histology and clinical behavior. Cortical thymoma was observed in 11 cases (39.2%), mixed common thymoma in 9 (32.1%), mixed with cortical predominance in 5 (18%), and medullary thymoma in 3 (10.7%). In patients with cortical thymoma the tumor was always invasive (stages II and III according to Bergh), whereas medullary thymomas were noninvasive in 2 cases (stage I) and slightly invasive with a moderate infiltration of the capsule in the remaining case (stage II). Mixed common and mixed with cortical predominance thymomas displayed intermediate behavior. Twelve patients were affected by myasthenia gravis: 1 had medullary thymoma, 6 had mixed common thymoma, 3 had mixed thymoma with cortical predominance, and 2 had cortical thymoma. One patient with cortical thymoma had superior vena cava syndrome and 1 had erythroid hypoplasia; mixed common thymoma was associated with Cushing's syndrome in 1 patient. These data confirm previously reported observations (16) showing a higher degree of malignancy in patients with cortical thymoma.

Adult↗
PubMed1988

Computed tomographic staging of anterior mediastinal neoplasms.

Sixty patients with anterior mediastinal neoplasms undergoing computed tomography before surgical exploration were entered in a prospective study to assess the value of computed tomography in the preoperative staging of anterior mediastinal tumours. Correct prediction of location, size, and tissue density was obtained in all 60 cases. Correct identification of the nature of the tumours was achieved by computed tomography in 37 of the 54 previously undiagnosed cases. Particular attention was given to the evaluation of the relation of the tumour to adjacent mediastinal structures, to predict the feasibility of radical surgical procedures. Overall sensitivity, specificity, and accuracy in identifying resectability were 46%, 85%, and 64%, with positive and negative predictive indices of 78% and 58%. Capsulated or highly invasive lesions were clearly distinguished, and the presence or absence of infiltration of mediastinal vessels, pericardium, and chest wall was correctly recognised in most cases. It is suggested that the evaluation of anterior mediastinal neoplasms should include computed tomography because of its accuracy in predicting size, location, and tissue density of the neoplasm. Computed tomography may suggest, often with good reliability, the histological type of the tumour and its relation to contiguous mediastinal structures, thus contributing to the choice of the appropriate surgical approach or route for biopsy.

Adolescent↗
PubMed1988

Successful resection of a thymoma in an elderly patient.

The case of an 83 year-old male patient undergoing resection of a bulky thymoma situated in the anterior mediastinum is presented. A standard mid-line sternotomy approach was chosen and the left pleural space was widely opened in order to control the left edge of the tumor bulging in the left hemithorax. Macroscopic and histologic examination of the resected specimen evidenced a medullary thymoma without infiltration although tight adhesions between the tumor and the left brachiocephalic vein were present. Postoperative course was uneventful and the patient was discharged in good general condition nine days after surgery.

Aged↗
PubMed1987

En bloc resection for T3 bronchogenic carcinoma with chest wall invasion.

From January 1960 to January 1986, 77 patients with lung cancer invading the chest wall underwent operations in the Department of Thoracic Surgery at the University of Rome. Chest pain, alone or with other symptoms, was the presenting complaint in 52 patients (67%). All patients underwent thoracotomy (25 pneumonectomy, 5 bilobectomy, 23 lobectomy, 2 wedge resection, 22 no pulmonary resection), with an operative mortality of 7.8%. At thoracotomy, mediastinal lymph node dissection was performed in 36 cases; after the operation 10 patients were classified as T3 N0 M0, 11 as T3 N1 M0, 15 as T3 N2 M0; 19 patients (34.5%) were staged T3 Nx M0 because mediastinal dissection was not performed. En bloc resection of the chest wall was performed on 37 patients. The actuarial 5-year survival of 55 patients following potentially curative resection was 15%. Five-year survival was 22% for N0, 12% for N1 and 8% for N2 patients. Five-year survival for squamous cell, large cell, and adenocarcinoma was 22%, 10% and 14%, respectively. T3 N0 M0 patients with squamous cell carcinoma had a 5-year survival of 32%. Pain relief was achieved in 45% of our patients. Resection of pulmonary parenchyma and part of the thoracic wall for lung cancer yields palliation of pain in a fairly large number of patients and may result in long-term survival in selected cases.

Adult↗
PubMed1987

Surgery of bronchogenic carcinoma invading the chest wall.

A series of 77 patients affected by lung cancer invading the chest wall who underwent surgery is reported. They were selected from 5236 lung cancer patients observed over a 25-year period. Chest pain was the presenting complaint, alone or with other symptoms, in 52 patient (76%). All patients underwent thoracotomy (pneumonectomy 25 cases, bilobectomy 5, lobectomy 23, wedge resection 2, no pulmonary resection 22), with an operative mortality of 7.8%. At thoracotomy, mediastinal lymph node dissection was performed in 36 cases; after surgery, 10 patients were classified as T3 NO MO, 11 as T3 N1 N0, 15 as T3 N2 M0; 19 patients (34.5%) were staged T3 Nx M0 because mediastinal dissection was not performed. "En bloc" resection of the chest wall was performed in 37 patients. The actuarial 5-year survival of 55 patients receiving potentially curative resection was 14%. 5-year survival was 22% for N0, 12% for N1 and 8% for N2 patients. 5-year survival for squamous-cell, large-cell and adenocarcinoma was 22%, 10% and 14% respectively. T3 N0 M0 patients with squamous-cell carcinoma had a 5-year survival of 32%. Pain relief has been obtained in 45% of patients. Resection of pulmonary parenchyma and attached chest wall for lung cancer, yields palliation of pain in a fairly large number of patients and can result in long-term survival in selected cases.

Actuarial Analysis↗
PubMedDate not supplied

Evolving techniques and perspectives in lung transplantation.

Lung transplantation is currently a suitable option for patients with end-stage lung disease. Since the early 1980s the surgical technique and immunosuppressive protocols have been progressively modified to improve results and favor long-term survival. The original heart-lung transplantation under cardiopulmonary bypass is now rarely performed and single or bilateral lung transplantation is the procedure of choice. Bilateral transplantation is performed with two single lung transplants performed in sequence. Extracorporeal support is rarely employed and in most cases it is instituted through the femoral approach. Also, the surgical approach has been modified and the original clam shell incision has been replaced by two small anterior thoracotomies. The use of marginal donors has been increasingly proposed to enlarge the number of organs potentially available for transplantation. Immunosuppressive protocols have evolved to patient-specific regimens that can be quickly modified if required by the clinical status. Induction is now more aggressive and also rescue protocols for obliterative bronchiolitis can contribute to improved outcomes. Overall, lung transplantation is now performed with encouraging long-term results.

Humans↗
PubMedDate not supplied

[Single lung transplantation: experimental technique and functional results].

Single lung transplantation was performed in 22 pigs. The first 10 experiments were devoted to settle the surgical technique: in these cases we employed small animals (8-12 kg); technical difficulties and the high incidence of perioperative complications induced us to utilize bigger animals (greater than 20 kg) in the subsequent experiments. In the recipient, after left pneumonectomy we prepared the right pulmonary artery and encircled it with an inflatable silicon cuff connected to a reservoir positioned outside the chest cavity of the animal. The inflation of the cuff allows the complete occlusion of the right pulmonary artery and thus the functional evaluation of the isolated transplanted lung. Perioperative functional evaluation has been performed at different times till the third postoperative day, documenting the good status of the transplanted lung. This study confirms the possibility to employ pigs for experimental single lung transplantation to settle the surgical technique with economic and organizing advantages. Furthermore, it confirms the good results achieved in the dog, in which the occlusion of the contralateral pulmonary artery by means of an inflatable silicon cuff allows to evaluate the isolated transplanted lung function.

Anesthesia↗
PubMedDate not supplied

Superior pulmonary sulcus tumors: radical resection and palliative treatment.

Between 1963 and 1987, 56 patients with Superior Pulmonary Sulcus Tumors (SPST) were seen at our Institution. Fifteen inoperable patients were treated by radiotherapy. Forty-one patients underwent surgery: 32 received preoperative irradiation and in four of these postoperative radiotherapy was also administered: in nine cases (non radical resection) radiotherapy was administered postoperatively only. Paulson's approach was employed in 30 cases and Dartevelle's procedure in 11. The resection was considered curative in 22 patients (53.7%) achieving complete palliation of pain in 68.2% of cases. In non-resectable patients 2-year survival was 6%. Five-year survival was 11.1% for patients with non radical resection and postoperative irradiation and 34% for patients undergoing preoperative irradiation and radical resection. Four patients underwent pre- and postoperative irradiation and they are alive 23, 20, 15 and six months after operation. Five-year survival for N0, N1 and N2 patients was 38.1%, 14.3% and 0% respectively. In conclusion, SPST can be radically resected, with the appropriate surgical approach and after preoperative radiotherapy, achieving good long-term survival and pain relief. Postoperative irradiation is advisable for prevention of local recurrence and longer pain relief.

Abdominal Muscles↗
PubMedDate not supplied

[Early diagnosis of pulmonary tumors in patients treated for laryngeal cancer].

Multiple primary malignant neoplasms occur relatively frequently today and are quite important. If the primary tumor ("index tumor") develops in the upper aero-digestive tract, the incidence of these neoplasms ranges from 10 to 20%, especially in males. The most common second primary site is again in the upper aero-digestive tract and, less frequently, in the lungs or thoracic esophagus. Among head and neck tumors laryngeal cancer is certainly one of the neoplasms most often playing the role of index tumor in association with malignant cephalic and extracephalic tumors. Among the most frequent associations of multiple primary malignant tumors one finds: larynx-lung and larynx-esophagus. As a high incidence of metachronous primary pulmonary cancers were observed during follow-up of patients who had undergone laryngeal surgery, a preventive flexible bronchofiberscope study was performed in 101 patients who had undergone surgery for laryngeal cancer over the ten years period from 1978 to 1987. The patients had a median age of 58.7 years (range 42-81) and were prevalently males (98 males, 3 females). The incidence of second primary neoplasm in the lung was 3%. During this bronchoscopic study the chest x-ray for 2 of the 3 patients with second primary neoplasm in the lung was normal, all 3 had an evident familiar neoplastic predisposition, one had been treated for colon carcinoma prior to laryngectomy. The authors report some personal opinions regarding the larynx-lung neoplastic association and emphasize the application of bronchoscopy in following-up laryngeal cancer patients.

Adult↗