Biomedical subjects

G Geraci

Publications and source records attributed to G Geraci.

At least 91 records · Page 5Linked to original sources

PubMedDate not supplied

[The treatment of inguinal hernia in a one-day surgery protocol. Our experience].

BACKGROUND: Personal experience in the treatment of inguinal hernia in "One day Surgery" is reported. METHODS DESIGN: retrospective evaluation of cases treated in a twelve months period. The follow-up has been programmed at 1, 3, 6 and 12 months after the treatment. SETTING: general, thoracic and oncological surgery, Department of Surgical and Anatomical Disciplines. Polyclinic, University of Palermo. SUBJECTS: 54 patients aged between 17 and 86 years (middle age 51.9), 48 male have been treated; in 3 cases recurrent hernias were found. INTERVENTIONS: in every case Trabucco's procedure with local anaesthesia has been performed. Premedication with Midazolam 10 mg i.v. has been associated. MAIN OUTCOME MEASURES: postoperative course and morbidity have been valued. RESULTS: Twice general anaesthesia has been necessary. No case of allergic reactions has been found. All the patients but three have been discharged before the sixth hour. Wound infections, seromas, deep hematomas, neuralgias and short-time recurrences have not been observed. CONCLUSIONS: Tension-free procedures and local anaesthesia, in personal experience, are mandatory to perform the treatment of inguinal hernia in "One Day Surgery".

Adolescent↗

PubMedDate not supplied

[Surgical treatment of varicocele in day hospital. Our experience].

OBJECTIVE: The authors report their experience about surgical treatment of varicocele in Day Hospital (DH). DESIGN: Report of 10 cases; evaluation of effectiveness of the surgical treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: Surgical procedure according to Ivanissevich in all 8 patients. RESULT: 100% successful. CONCLUSION: Surgery in DH is a valid treatment option in varicocele, by the technical and economic point.

Adult↗

PubMedDate not supplied

[Dieulafoy's ulcer: unusual cause of upper gastrointestinal tract. Our experience].

OBJECTIVE: The authors report their experience about the endoscopic treatment of upper gastrointestinal bleeding from Dieulatoy's ulcer (non variceal bleeding). DESIGN: Report of 5 cases; evaluation of mortality and effectiveness of the treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: EGDS + sclerotherapy (emergency room) in all 5 patients. RESULTS: 80% successful (stop bleeding). CONCLUSIONS: Endoscopic sclerotherapy is choice treatment of upper gastrointestinal bleeding from Dieulafoy's ulcer, only in well experienced teams and rapidly.

Aged↗

PubMedDate not supplied

[Endoscopic treatment of a calculous choledochocele. Report of a case].

OBJECTIVE: The authors report their experience about the treatment of choledochocele. DESIGN: Case report and 6-months follow up. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical and Anatomical Disciplines. Policlinico, University of Palermo. INTERVENTIONS: ERCP + ES with complete resolution of pathology. RESULT: Complete resolution of symptoms; 6-months follow up negative. CONCLUSIONS: ERCP is choice treatment of choledochocele, only in well experienced teams.

Aged↗

PubMedDate not supplied

[Scrotal angiomyofibroblastoma. Report of a case].

OBJECTIVE: The authors report their experience about the treatment of a rare case of scrotal angiomyofibroblastoma (AMF). DESIGN: Report of 1 cases; evaluation of effectiveness of surgical treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: The patient was submitted to curative and radical surgery. RESULTS: Resolution of the pathology. Follow up (6 months) negative. CONCLUSIONS: The AMF's treatment is surgical and localized. Is important the complete preoperative evaluation.

Adult↗

PubMedDate not supplied

[Multiple choledocholithiasis].

OBJECTIVE: The authors report their experience about the endoscopic (ERCP) treatment of multiple choledocholithiasis. DESIGN: Report of 5 cases; evaluation of mortality and effectiveness of the treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: ERCP + ES + clearance of bile duct stones in all 5 patients. RESULTS: 100% successful. CONCLUSION: ERCP is choice treatment of multiple choledocholithiasis, only in well experienced teams.

Adult↗

PubMedDate not supplied

[Endoscopic treatment of pancreatic pseudocysts. Our experience in 8 cases].

OBJECTIVE: The authors report their experience about the endoscopic treatment of pancreatic pseudocysts (PP). DESIGN: Report of 8 cases; evaluation of effectiveness, morbidity and mortality. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: endoscopic drainage in all 8 patients. RESULT: 88% successful (7/8). CONCLUSION: Endoscopic drainage of PP is a safe and simple treatment, with high rates of success and low rate of morbility.

Cholangiopancreatography, Endoscopic Retrograde↗

PubMedDate not supplied

[Integration of operative endoscopy and laparoscopic surgery in the treatment of cholecysto-choledocholithiasis].

UNLABELLED: Laparoscopic cholecystectomy has become first choice for symptomatic gallstones, but there are not agreement about therapy of supposed synchronous choledocholithiasis. We report our experience about the sequential treatment (endoscopic-laparoscopic) of the gallstone and the associated common bile duct stones. METHODS: During the period Jan. 1992 Dec. 1997 we have evaluated 128 patients that were submitted to ERCP for suspicion CBDS and gallstone. All patients undertook a systematic assessment: Patient age, sex, history of jaundice, history of pancreatitis, levels of serum alanine aminotransferase, alkaline phosphatase, amylase, total and direct bilirubin and CBD diameter on ultrasonography. RESULTS: In the 96 (75%) cases of choledocholithiasis endoscopic sphincterotomy has been performed and combined with laparoscopic cholecystectomy. Thirty-two patients (25%) submitted to ERCP have been negative for stones. Only 4 patients have needed surgery because of big stones inside the CBD after ESWL failure. The incidence of complications of ERCP-ES has been, in our experience, 7.1% and mortality 0.8%. All the complications have been treated conservatively and did not need surgery. CONCLUSIONS: The sequential treatment (endoscopic-laparoscopic) of synchronous CBDS and gallstone, in hands of expertise, is efficient with high rate of success and low rate of complications in order to morbidity and mortality. Finally we believe that it is very important to discover CBDS preoperatively with the non invasive methods as the MRI-Colangiography and to assay the liver tests in order to avoid negative ERCP for choledocholithiasis.

Adult↗

PubMedDate not supplied

[Unusual case of intestinal obstruction at the ileal level: strangulated obturator hernia. A case report].

OBJECTIVE: The authors report their experience about treatment of a rare case of intestinal (ileal) obstruction by strangulated obturator hernia. DESIGN: Report of 1 case; evaluation of effectiveness of surgical treatment, 2-years follow-up and revision of literature about its clinical presentation and treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: The patient was submitted to curative and radical surgery. RESULTS: Resolution of the pathology. Follow up (2 years) negative. CONCLUSIONS: Obturator hernia is a rare pathology, with difficult and delayed diagnosis: all these character make dangerous this hernia, with a risk of high morbidity and mortality (delayed diagnosis and treatment). The only useful treatment is surgery, especially in front of intestinal obstruction, with a wide median laparotomy.

Aged↗

PubMedDate not supplied

[Atypical presentation of a case of Mirizzi syndrome simulating cholangiocarcinoma].

OBJECTIVE: The authors report their experience in the treatment of a case of Syndrome of Mirizzi (SM) that it simulates a cholangiocarcinoma. EXPERIMENTAL DESIGN: Report of 1 case. Evaluation of the effectiveness of the treatment and 2 years follow-up. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTION: Surgical treatment of the suspicious neoplastic lesion. RESULTS: Complete recovery with "restitutio ad integrum". CONCLUSIONS: The SM constitutes one important challenge from the diagnostic and therapeutic point of view, since it is not infrequent that the correct definition of this pathology is only intraoperative. The role of the videolaparoscopic cholecistectomy is not still well defined. To reduce the risks of lesion of the biliary tree during surgical intervention, also in case of diagnostic doubt, we propose an integrated approach of sequential type, with the exploration preoperative through ERCP and following surgical intervention.

Bile Duct Diseases↗

PubMedDate not supplied

[Endoscopic removal of a Dormia basket impacted in the biliary tract during treatment of a difficult residual choledocholithiasis. Report of a case].

OBJECTIVE: The authors report their experience about the treatment of a broken Dormia in CBD in elder with "difficult" residual choledocholithiasis, with T tube. DESIGN: Report of case. Evaluation of effectiveness of endoscopic treatment with 2-years follow-up. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico "Paolo Giaccone"--Palermo. INTERVENTION: Endoscopic removal of Dormia broken and impacted in CBD after 2 session of extracorporeal shock wave lithotripsy (ESWL). RESULTS: Resolution of the pathology with 2 session of ERCP and cholangiographic control. CONCLUSIONS: ERCP and ES are the gold standard in the treatment of choledocholithiasis. Rare complication of this method is the rupture of Dormia Basket in CBD: this occurrence can be solved by endoscopy, but only in well experienced endoscopic teams.

Aged↗

PubMedDate not supplied

[Paraesophageal hiatal hernia. Clinical considerations and report of a case].

OBJECTIVE: The authors report their experience about the treatment about a case of paraesophageal hernia and they redefine nosography. DESIGN: Report of 1 case; evaluation of effectiveness of surgical treatment. 1-year follow up. Review of its clinical presentation. SETTING: Operative Unit of General and Thoracic Surgery. Department of General Surgery, Emergency and Transplantation. Polyclinc, University of Palermo. INTERVENTION: The patient was submitted to surgery with radical and curative intention. RESULTS: Complete resolution of the pathology. Follow-up (1 year) negative. CONCLUSION: Management of patients affected by paraesophageal hernia is difficult, because the physiopathology, anatomic basis and clinical presentation are not yet clear. The aim of surgical treatment is to reduce the hernia, to repair the hiatal gap and to make a correct antireflux procedure. According to us, the open surgical approach is very safe and useful because allows more safe surgical dissection, even if there is a big scar on the abdomen, the postoperative staying in hospital is longer. Finally, we emphasise the role of follow-up in these patients: it's the only way to prevent complications.

Adult↗

PubMedDate not supplied

[Gastric antral vascular ectasia (GAVE) or watermelon stomach syndrome: report of 3 cases and clinical and therapeutic indications].

OBJECTIVE: The authors report their experience in diagnosis, treatment and ambulatorial follow up of 3 cases of obscure upper gastrointestinal bleeding by gastric antral vascular ectasia (GAVE). EXPERIMENTAL DESIGN: Complete clinical report of 3 cases. Clinical and endoscopic indication, evaluation of effectiveness of endoscopic treatment with bipolar electrocoagulation and follow-up. SETTING: Operative Unit of General and Thoracic Surgery. University "Paolo Giaccone" of Palermo. INTERVENTION: Endoscopic treatment by multiple session with bipolar electrocoagulation. No complications were registered. RESULTS: Complete recovery with "restitutio ad integrum". No relapse were recorded at follow up. CONCLUSIONS: The objective of the treatment is to recognize the site of obscure bleeding and then stop it. The choice between pharmacological, endoscopic and surgical treatment is individual for each patient. According to us, the endoscopic treatment is the first step in a gradual clinical approach, to detect the site of the lesion, to treat with bipolar electrocoagulation or with Argon Plasma Coagulator (lower wall penetration and minimal risk of perforation).

Aged↗

PubMedDate not supplied

[Regression of primary low-grade gastric mucosa-associated lymphoma by eradication of Helicobacter pylori infection: case report].

OBJECTIVE: The Authors report their experience in diagnosis and treatment of one case of primary low-grade gastric lymphoma of mucosa associated lymphoid tissue (MALT); recent international literature review. EXPERIMENTAL DESIGN: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of eradication therapy and short follow-up. SETTING: Operative Unit of General and Thoracic Surgery. University "Paolo Giaccone" of Palermo. INTERVENTION: Treatment of H. Pylori infection (lansoprazole, amoxicillin and metronidazole twice a day for 14 days; after that, lansoprazole for another 4 weeks), according to international guide-lines. RESULTS: H. Pylori was completed eradicated. Disappearance and total regression of the lymphomatous tissue was observed. No relapse were recorded at short follow-up. CONCLUSIONS: Our reports confirm the recent anecdotal reports on regression of gastric MALT lymphoma after eradication of H. Pylori and indicates that the growth of these extranodal lymphomas may depend on H. Pylori.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMedDate not supplied

[Fournier's gangrene: case report and review of recent literature].

OBJECTIVE: The authors report their experience in diagnosis and treatment of one case of Fournier's gangrene; recent international literature review. EXPERIMENTAL DESIGN: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of surgical treatment (debridement and necrosectomy) and follow-up; comparison between indications and multidisciplinary approach proposed by international literature. SETTING: Operative Unit of General and Thoracic Surgery. University "Paolo Giaccone" of Palermo. INTERVENTION: Repeated surgical treatment previous multimodal approach, according to international guide-lines. RESULTS: Complete recovery with "restitutio ad integrum". No relapse were recorded at follow up. CONCLUSIONS: Fournier's gangrene is an uncommon and aggressive synergistic fasciitis of the perineum and genital organs, which may bring the patient to death; it is a true surgical emergency. The disease can no longer be considered to be idiopathic; in most cases a urologic, colorectal or cutaneous source can be identified. Despite antibiotics and aggressive debridement, the mortality rate remains high, particularly in the elderly, in patients with renal failure, and in patients with extensive disease. The presentation is highly variable, necessitating a high index of suspicion. High risk patients include diabetics, alcoholics and debilitated and immunosuppressed individuals. As the AIDS population increases, the incidence of Fournier's gangrene may increase as well. In questionable cases, imaging modalities should be performed to allow early diagnosis and to reduce misses diagnosis. Broad spectrum antibiotics (while waiting for the results of culture and antibiogram effectuated on tissue specimens obtained during necrosectomy) and aggressive debridement remain the hallmarks of treatment. Hyperbaric oxygen therapy and improved local wound care may decrease the extent of tissue destruction. The surgical operation has to be performed in emergency to avoid a rapid spread of tissue necrosis and a possible development towards septic shock. Reconstructive techniques afford better cosmetic results. With early recognition, prompt treatment, improved wound care and reconstructive efforts, the mortality rates and cosmetic results should continue to improve.

Debridement↗

PubMedDate not supplied

[Intestinal endometriosis: an obscure cause of cyclic rectal bleeding].

OBJECTIVE: Authors report their experience about a case of intestinal endometriosis that lead cyclic and recurrent rectal bleeding in a fertile-age woman. DESIGN: Report of 1 case with multidisciplinary approach and surgical treatment. Surgical effectiveness evaluation and 2 years follow-up. Brief review on the recent literature and the diagnostic and therapeutic implications. SETTING: Section of General and Thoracic Surgery, Department of General Surgery, Emergency and Organ Transplantation, Policlinico "Paolo Giaccone", Palermo. INTERVENTION: After correct and sure diagnosis, the patient was submitted to sigmoid segmental resection with radical and curative intention. RESULTS: Complete recovery. Follow-up (24 months) negative. CONCLUSIONS: Diagnosis of endometriosis should be considered in women with recurrent monthly abdominal pain and bowel symptoms, especially if accompanied by gynaecologic complaints, even because the significant symptoms overlap with the irritable bowel syndrome (IBS) and makes the differentiation extremely difficult. Treatment of GI endometriosis is best approached in collaboration between gynaecologist experienced and intestinal surgeon. The high accuracy and low complications suggested that EUS-FNA was effective for the correct histologic diagnosis of intestinal endometriosis.

Anastomosis, Surgical↗

PubMedDate not supplied

[Gastric foreign body: bezoars. Apropos of two cases].

OBJECTIVE: The authors report their experience about the treatment of two cases of gastric bezoar, treated in curative mode, the first endoscopically and the second with surgical intervention. SETTING: Operative Unit of General and Thoracic Surgery, Department of General and Emergency Surgery, Organ Transplantation, Policlinico, University of Palermo. INTERVENTION: The patients were submitted to curative treatment, one with endoscopic treatment (mechanical fragmentation of phytobezoar and fragments extraction via-overtube), the second with surgical gastrotomy (stamp trichobezoar). There were no procedure-related complications. RESULTS: The two patients were curative and radically treated. Negative 2 years follow-up. CONCLUSIONS: There is no standardized method for the treatment of gastric bezoars. Endoscopic removal of gastric bezoars after fragmentation and using overtube is effective and safe. Surgical intervention, equally safe, is reserved to huge, stamp, impacted or complicated bezoars.

Adult↗

PubMedDate not supplied

[Aberrant pancreas: a rare cause of epigastralgia].

OBJECTIVE: The Authors report their experience about a case of aberrant pancreas that lead epigastralgia. DESIGN: Report of 1 case and endoscopic treatment (upper endoscopy + EUS + endoscopic polypectomy + endoscopic biopsy of the base. Surgical effectiveness evaluation. SETTING: Section of General and Thoracic Surgery, Department of General Surgery, Emergency and Organ Transplantation, Policlinico "Paolo Giaccone", Palermo. INTERVENTION: After correct and sure diagnosis, the patient was submitted to endoscopic polypectomy with radical and curative intention. RESULTS: Complete recovery. Hematochemical and endoscopic follow-up (1 months) negative. CONCLUSIONS: Diagnosis of aberrant pancreas is very hard and always post-resection. Symptoms are poor and makes the clinical diagnosis extremely difficult, except when the mass attains big dimension (>5 cm). The best treatment of aberrant pancreas is based on correct diagnosis (upper endoscopy + EUS + FNAB) and on a radical treatment that, if the lesion is mucosal, is totally endoscopic (endoscopic polipectomy), without specific risk.

Abdominal Pain↗