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G Di Matteo

Publications and source records attributed to G Di Matteo.

123 records · Page 7Linked to original sources
PubMedDate not supplied

[Adenoma-carcinoma sequence in the right colon].

Most endoscopically treated colorectal adenomas are found in the sigmoid colon and the incidence gradually diminishes in the proximal districts until we reach a figure of 10% or so in the right colon. The present series of 356 adenomas endoscopically removed in 1980-85 differs from other reports in that 24.4% of the adenomas were located in the right colon. These 87 adenomas were mostly (79%) under 5 mm in diameter, sessile (89%) and histologically tubular with slight dysplasia (95%). Only 3 adenomas over 10 mm in diameter and tubulovillous presented severe dysplasia. This high incidence of right colonic adenomas differs significantly from findings in other endoscopic series but is in line with the findings of an autoptic study of colorectal polyps (21% of the adenomas were found in the right colon). In addition both in the autoptic study and the present endoscopic series the adenomas of the right colon were small, only slightly dysplastic, unlikely to evolve into malignancy and could have been created by the E1 factor hypothesised by Hill et al. These data confirm the low incidence of right colonic cancer and suggest that patients subjected to the removal of small adenomas of the right colon do not require close surveillance.

Adenocarcinoma↗
PubMedDate not supplied

Stapled sutures in digestive tract surgery.

A six-year experience with mechanical sutures in digestive tract surgery is reported. Forty-nine esophageal resections during azygo-portal disconnection were performed since 1979 up to June 1986. Four patients died in the early postoperative course with no evidence of suture-related complication. One patient developed an anastomotic stricture (2.2%), which was successfully dilated. Fifty-three total gastrectomies with stapled reconstruction were performed between 1980 and June 1986. Two patients died soon after surgery for reasons unrelated to the suturing technique. Two strictures of the esophagojejunal anastomosis (3.9%) occurred two to three months after surgery and underwent successful dilation. One esophagojejunostomy (1.9%) leaked and one (1.9%) underwent uneventful remedial surgery (conversion of an omega-shaped loop to a Roux-en-Y procedure). Ten isoperistaltic jejunal interpositions, six Billroth I partial gastrectomies and 14 Roux-en-Y loops for hepatico- or pseudo-cystojejunostomy were performed since 1983 up to June 1986 in the absence of any operative morbidity or mortality. Twenty-three right colectomies were performed from 1983 to June 1986. The only complication reported was one leakage (4.3%) which spontaneously healed. Ninety-eight patients underwent formal colonic resections (anterior resection of the rectum, left hemicolectomy, subtotal and total colectomy) from 1981 to June 1986. Two patients (2%) died for reasons unrelated to the suturing technique. Three colorectal anastomoses (3%) developed a leak, one of which required surgical revision. One stricture (1%) was recorded in a recurrence-free patient three months after surgery. One patient (1%) complained of minor rectal bleeding. Two patients (2%) developed small anal fissures due to forced passage of the instrument.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMedDate not supplied

Thyroid cancer: surgical experience with 322 cases.

From November 1970 to July 1983, a total of 322 thyroid cancers were treated surgically in our clinic. Total thyroidectomy was the treatment of choice. In 131 patients, modified neck dissection (unilaterally in 23 and bilaterally in 108) was added. Of the latter patients, 33 also required upper mediastinal lymph node dissection. There were no operative deaths. No recurrent laryngeal nerve iatrogenic palsy was observed. Permanent parathyroid insufficiency developed in only about 4% of patients. The low morbidity and good long-term results justify the use of this procedure in all patients with thyroid malignancies. Despite conservative arguments in the controversial issue of lobectomy versus total thyroidectomy, skilled surgeons should be able to perform total thyroidectomy safely. It is recommended as the treatment of choice because of the well-documented multicentricity of thyroid cancers and the good prognosis of differentiated cancers associated with a near-normal life expectancy, to permit radioactive iodine therapy of possibly functioning metastases and the easier control of hypothyroidism with thyroid supplement medication.

Adenocarcinoma↗
PubMedDate not supplied

Hepatic echinococcus disease: our experience over 22 years.

BACKGROUND/AIMS: It is important to single out the indications for surgery of hydatid disease of the liver at an early stage. For this, a fully comprehensive diagnostic work up of the patient is required. Surgery represents the most effective therapy and involves resection of the cysts and their outer capsule. This must be as complete as possible. MATERIAL AND METHODS: Between 1970 and June 1992, 95 patients received this combined treatment for hydatid disease although only those presenting from 1985 were followed up. RESULTS: No serious complications were noted apart from pyrexia due to secondary cholangitis or reactive pleuritis. This responded quickly to antibiotics and there was no mortality. No cases of relapse occurred although one case did show evidence of reappearance of the disease on serological testing alone, all other tests being negative. CONCLUSION: The most effective treatment for echinococcus cystic disease of the liver is radical surgery. Results are best when surgery is combined with medical therapy of benzoimidazole drugs given pre- and post-operatively. From our experience, we are now confident that surgical treatment must always be preceded and then followed by treatment with benzoimidazole antihelminthics.

Adult↗
PubMedDate not supplied

[Goiter surgery].

In the course of 26 years at the 3o Surgical Department of University of Rome "La Sapienza" 6,009 patients with thyroid diseases were operated on since 1970 through September 1995. There were 3,473 goiters and in 373 of them a carcinoma was found. The great majority of patients with goiter was treated by subtotal thyroidectomy. Total thyroidectomy was performed in the 373 patients with thyroid cancer and in diffuse nodular goiters interesting the whole gland. No perioperative mortality is reported. No recurrent laryngeal nerve iatrogenic palsy was observed. The incidence of temporary hypoparthyroidism had a percentage of 10% after total thyroidectomy and of 0.1% after unilateral lobectomy plus istmectomy or bilateral subtotal resections.

Goiter↗
PubMedDate not supplied

[Lymphadenectomy and nerve sparing technique in radical surgery of rectal cancer].

The extension that should be given to lateral lymphadenectomy in the surgical treatment of extraperitoneal rectal cancer has not yet been assessed because of the difficulty of realizing randomized prospective clinical trials. The theoretical advantage of an extended lateral lymphadenectomy is represented by an accurate staging of the tumour in patients undergoing surgery for possible curative resection; even if the high percentage (20 per cent) of pelvic node metastasis was already demonstrated, the prognostic impact of lateral lymphadenectomy was not proven until now. The results of the Literature demonstrated that an advanced rectal cancer can not be treated only by conventional surgery: radical surgery (with total mesorectal excision and pelvic lymphadenectomy) or, in alternative, a combined approach-chemo-radiotherapy+surgery-should-be applied in order to improve the 5-year survival and to reduce the percentage of local recurrence. With regard to surgery the main disadvantage for an extended lateral dissection is represented by the high incidence of urinary and sexual dysfunctions. The nerve-sparing technique, when combined to pelvic lymphadenectomy, allows preservation of autonomic innervation to the pelvis. The results of our experience demonstrated that nerve-sparing technique is an effective procedure that reduces the incidence of urinary and sexual dysfunctions when accurately performed.

Adult↗