Biomedical subjects

F Zaraca

Publications and source records attributed to F Zaraca.

23 records · Page 2Linked to original sources

PubMedDate not supplied

[Acute biliary pancreatitis. Role of laparoscopy after 30 years of traditional surgery experience].

The authors herein show their own experience in the treatment of acute biliary pancreatitis. Aim of this study is to evaluate the effectiveness and the safety of the "early" laparoscopic approach to the mild to moderate acute biliary pancreatitis. The authors studied sixty cases of laparoscopic cholecystectomy with intraoperative colangiography for acute biliary pancreatitis (M/F 1:1.2; mean age 59.6 yrs, range 29.79). The patients were divided in two groups on the basis of the severity of the pancreatitis, defined through Ranson's score and Balthazar classification. The mortality rate was nil. Intraoperative morbidity rate was 6.6% in the group I (3/45), and 13.3% in the group II (2/15). Postoperative morbidity rate was 6.7% (3/45) in the group I and 40% in the group II (6/15). The authors show an original diagnostic and therapeutic algorithm for the treatment of acute biliary pancreatitis. Early laparoscopic cholecystectomy with I.O.C. is proposed as the gold standard treatment for mild to moderate acute biliary pancreatitis. This approach appears to be effective and safe in their experience. In case of severe acute biliary pancreatitis, further investigations are mandatory to evaluate the role of laparoscopic approach.

Acute Disease↗

PubMedDate not supplied

[A case of intestinal occlusion caused by endometriosis of the cecum].

The purpose of this study is to heighten awareness of intestinal endometriosis, a disease that may mimic other abdominal pathologies (bowel carcinoma, intestinal inflammatory disease, diverticulitis), sometimes found in the emergency setting. The Authors report a case of acute bowel obstruction due to coecal endometriosis with appendix mucocele, peritoneal pseudomyxoma and ovarian endometrioma. The patient was operated on in the emergency setting, a right colectomy was performed and she then received pharmacological suppressive treatment with Gn-RH analogues and danatrol. We remark that preoperative diagnosis is very difficult in those cases that do not have a past history of pelvic endometriosis. An accurate anamnesis regarding the chronology of pain onset (typically only during the menstruation at first), but especially intraoperative histopathologic examination are useful for diagnosis. An increased awareness of intestinal endometriosis in reproductive age women with acute bowel obstruction, associated with an accurate anamnesis of menstrual history may allow pre- or intraoperative diagnosis, which is the clue to a less aggressive operation. Postoperative follow up and hormonal therapy are mandatory.

Adult↗

PubMedDate not supplied

[Benign thyroid disease: 20-year experience in surgical therapy].

This retrospective study compares recurrence and postoperative complication rates after isthmo-lobectomy and subtotal thyroidectomy (group I) vs near-total and total thyroidectomy (group II) for benign thyroid disease. Seven hundred and forty-three patients were operated on for thyroid diseases over the period from 1977 to 1998. We considered 202 patients operated on for benign thyroid disease from 1988 to 1998. The follow-up ranged from 1 to 10 years (mean: 3.4 yrs). One hundred and thirty-two patients (65.3%) were operated on for bilateral nodular goitre, 35 (17.3%) for unilateral nodular goitre, 14 (6.9%) for toxic goitre and 21 (10.4%) for thyroiditis. Over the period 1988-1992, 19 patients underwent isthmo-lobectomy and 71 subtotal thyroidectomy (group I). From 1993 to 1998, 39 patients underwent near-total thyroidectomy and 61 total thyroidectomy (group II). The relapse rate was 14.4% in group I, while there were no recurrences in group II (p = 0.000064). Temporary hypocalcaemia was significantly higher (p = 0.000001) in group II (29%) than in group I (2.2%). Within group II, the rate was significantly higher (p = 0.0013) after total thyroidectomy (37.7%) than after near-total thyroidectomy (15.4%). In our experience, near-total and total thyroidectomy are an appropriate approach for preventing recurrence in patients with benign thyroid disease despite the fact that the risk of temporary hypocalcaemia is higher than after less radical surgery. Near-total thyroidectomy and the exercise of all due care in the surgical technique may help to reduce its incidence.

Adult↗

PubMedDate not supplied

[History of reconstruction following total gastrectomy].

Near a century after the first successful total gastrectomy for gastric cancer, the authors review the various technical proposals for digestive tract reconstruction following total gastrectomy. Following a classification based on duodenal circuit, on the viscerum employed and on the creation of pouches and/or anti-reflux mechanisms, pros and cons of the various classes of reconstructions are clearly depicted, suggesting the reasons that made Roux-en-Y esophago-jejunostomy and jejunal interposition the most used reconstructive procedure in worldwide clinical practice.

Anastomosis, Surgical↗

PubMedDate not supplied

Laparoscopic gastric banding for morbid obesity with expanded PTFE: technique and early results in the first 100 consecutive cases.

BACKGROUND/AIMS: Surgery is the only effective treatment for the truly morbidly obese patient. Gastric banding was demonstrated to be a safe, effective, and easily reversible technique in the open surgical approach. METHODOLOGY: A five-puncture technique, developed by the authors, for laparoscopic gastric banding utilizing an expanded polytetrafluoroethylene (ePTFE) band is fully described and discussed. This technique was utilized in 100 consecutive patients operated on between October 1995 and November 1996. RESULTS: We recorded no mortality, no cases of conversion, a 1% rate of major complications, a low minor morbidity rate (10%), and an acceptable length of operative time (106+/-8 minutes). This was significantly related to body weight, B.M.I. and % of I.B.W. being longer in more obese patients, but not to the experience of the surgical team. Weight loss (35.0+/-5.1 kg), percentage of excess weight lost (55.3+/-5.3%), percentage of ideal body weight achieved (149.1+/-8.4%), and body mass index (33.8+/-2.0) were all significantly improved at 3, 6, 9 and 12-months follow-up. CONCLUSIONS: Early results of this series are promising, showing low morbidity and a rate of weight loss comparable to that achievable by means of open gastric banding or vertical banded gastroplasty. Any statement about long-term results deserves a longer follow-up.

Adult↗