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Biomedical subjects

G Li Destri

Publications and source records attributed to G Li Destri.

51 records · Page 3Linked to original sources
PubMedDate not supplied

Evaluation of the prognostic accuracy of Astler-Coller's and Jass' classifications of colorectal cancer.

AIM: The study aim was to determine whether the Jass classification is superior to that of Astler-Coller (modification of Dukes' stage) in determining prognosis of patients treated for colorectal carcinoma. STUDY DESIGN: The authors used Jass' classification to restage 263 patients who had undergone radical colorectal surgery and classified according to Astler-Coller. RESULTS: The results revealed that: 1) Astler-Coller's classification enables more accurate selection of patient groups where life expectancy can be predicted; 2) Jass' classification enables statistically significant (P <0.05) improved prognostic discrimination of Astler-Coller's B2 patients, for which the probability of nonrecurrence of the disease is around 60%. CONCLUSIONS: Although Astler-Coller's classification is still valid, Jass' classification is useful for the prognostic discrimination of Astler-Coller's B2 patients.

Adult↗
PubMedDate not supplied

Giant esophageal polyp: a rare and benign neoplasm.

Giant esophageal polyp is a very rare neoplasm, usually benign but often demanding both for diagnostic and/or therapeutical procedures and for dramatic symptomatologic onset in the patient (regurgitation and asphyxia). The authors present a brief clinical report of a patient with a 20 cm.-long esophageal polyp removed by left lateral cervicotomy and esophagotomy for 8 cm. below the upper esophageal sphincter (histologic examinations showed a pedicled polypoid fibrolipoma with a remarkable presence of myxoid and vascular components). The authors also describe diagnostic and therapeutic methods to manage this rare disease and they gave a brief review of recent literature.

Diagnosis, Differential↗
PubMedDate not supplied

Multimodal therapy of hepatocarcinoma: personal experience on 90 cases.

BACKGROUND/AIMS: In recent years, surgical and non-surgical options have been developed in the treatment of hepatocellular carcinoma in cirrhotic patients. We review our personal series from 1995-1999, in order to assess the choice of treatment. METHODOLOGY: Of 90 cases of hepatocellular carcinoma observed in the years 1995-1999, 15 underwent curative resective surgery; in 42 cases TAE, PEI or RITA were utilized (9 of them as multimodal therapy). In the remaining 33 patients any kind of therapy was scheduled. RESULTS: The mean survival of the 15 resected patients was 18 months, non-statistically better than RITA survival, compared by Log-Rank test. Perioperative mortality calculated in all procedures was 5.2% (2 pts surgery, 1 pt TAE). CONCLUSIONS: The high percentage of not treated hepatocellular carcinomas in our series is generally due to large tumor size diagnosed in advanced Child's stage. PEI, TAE and RITA have to be considered effective and safe for palliation for HCCs. However, surgical resection represents the curative therapy in selected cirrhotic patients affected by HCC.

Aged↗
PubMedDate not supplied

Stress of routine follow-up in colorectal cancer operated patients.

Postoperative follow-up is the logical consequence of cancer treatment, but colorectal cancer follow-up does not achieve all its goals. These unfavourable findings induced us to assess whether follow-up also causes negative psychological stress in our colorectal cancer patients. In this trial 100 colorectal cancer follow-up patients were asked to compile three questionnaires: 1) the McGil Pain Questionnaires; 2) Profile of Mood Status; and 3) Locus of Control. The questionnaires were handed to the patients at follow-up and were compiled immediately. In addition, the patients were asked to answer the firsts two tests spontaneously 30 days after follow-up and mail the questionnaires. Our results showed that only 41% of the patients complied the tests 30 days after follow-up. The scores for pain and mood disorders were greater in women, especially during the "before follow-up" period. The third test revealed a prevalence of subjects with internal-type reinforcement. Our data revealed that: 1) patients tend to repress the problem; 2) women are affected by greater stress and anxiety; 3) subjects with internal-type reinforcement have a positive attitude during follow-up and this enables the ego to bear the anguish, process it and dilute it to anxiety, thus favouring future life experiences.

Affect↗
PubMedDate not supplied

Carcinoid of the ileocaecal valve: a case report.

The authors present a case of carcinoid of the ileocaecal valve. The patient complained for over one year of mild pain in the right lower quadrant of the abdomen. Colonoscopy had shown hyperaemia on the colic side of the ileocaecal valve which appeared substenotic and biopsy revealed micronodules formed by chromogranin-A-positive neuroendocrine cells. Roentgenography of the small bowel and barium enema revealed a specular filling defect in the caecum and in the terminal ileum near the ileocaecal valve. Right hemicolectomy was performed and the definitive diagnosis was carcinoid of the ileocaecal valve. The tumour had spread to all layers of the intestinal wall and 4/19 lymph nodes were metastatic. The patient refused an oncological examination; however, three years after surgery there are no signs of recurrence. Carcinoids have been included in the APUD system and usually present endocrine activity. The 5-year survival of patients with gastrointestinal carcinoids is 80% when located in the appendix and rectum as against 50% in the stomach, jejunum and colon, because the localisation in the appendix and rectum is marked by clinical signs of appendicitis and rectal bleeding, which suggest diagnostic examinations useful for an early diagnosis. Radical operations according to the rules of oncologically correct surgery are the treatment of choice, while complementary treatments have yet to be codified.

Aged↗
PubMedDate not supplied

Splenic trauma following colonoscopy.

A case of splenic trauma after colonoscopy is reported. After description of their experience, the Authors report a review of the literature and some considerations about clinical diagnosis and surgical or medical therapy for this pathology.

Aged↗
PubMedDate not supplied

[Rare malignant tumors of the thyroid].

The incidence of rare malignant tumors of the thyroid is about 4 cases/100,000 people and represent only 1.8% of all the thyroid cancers. When we talk about "rare" tumors, obviously, we do not refer to the most frequent cancers (papillary, follicular), or less frequent tumors (medullary, anaplastic), but to some types of thyroid tumors that have been almost always sporadically observed. Mucoepidermoid carcinoma and squamous carcinoma have been described in the literature. They present occasional papillary formation so that, according to some authors, could be considered as variants of the papillary carcinoma. Teratoma is another rare tumor which in the paediatric age is benign, but its prognosis could be unfavourable because it causes an important respiratory distress, while in the adult it presents a very aggressive clinical course like the anaplastic carcinoma. Lymphoma is the most frequent of the "rare" tumors of the thyroid (1-5% of all the thyroid cancers). It arises often in a setting of a long history of goitre and Hashimoto thyroiditis. Fine-needle aspirate is important to make diagnosis and to start a correct treatment which allows a 5-year survival up to 85% in the favourable cases.

Carcinoma, Mucoepidermoid↗
PubMedDate not supplied

[Correlation between positive lymph nodes and metastasis of colorectal cancer. Personal experience].

The authors, in a group of 190 patients treated with curative surgery for colorectal cancer, have studied the correlation between lymph nodes positive of primary tumor and rising of liver metastases. Even if the B2 stage nodes were negative, liver metastases were found in 6.25% of the patients probably due to an understaging; in C1 + C2 stage the rate of liver metastases was 28.1%, however in this group has not been demonstrated a statistical correlation with the number of positive nodes as a predictive negative prognostic factor.

Adult↗
PubMedDate not supplied

[En bloc lymphadenectomy for colorectal cancer, number of lymph nodes and ratio as prognostic factors: personal experience].

The authors have re-evaluated the lymph node status of 221 patients operated on for colorectal cancer and submitted to a five years follow-up in order to evaluate the role of the number of positive nodes and its "ratio" as negative prognostic factors of recurrences. In the patient classified as B2 stage, the recurrences occurred in spite of adequate number of negative nodes, in C1 + C2 stage the lymph node "ratio" could be considered an appropriate prognostic factor.

Aged↗
PubMedDate not supplied

Microsurgical treatment of varicocele.

The authors report their experience of the surgical treatment of varicocele. After having performed modified Palomo's method for many years, recent pathogenetic data have induced them to adopt a microsurgical technique. This technique involves vascular anastomoses which allow drainage of the testicular blood into an area with lower venous pressure. They used Fox's technique (anastomosis between 2-3 veins of the pampiniform plexus and saphena vein) and Belgrano's technique (anastomosis between internal spermatic vein and inferior hepigastric vein). The authors report their series of 30 patients treated with these techniques between 1984 and 1987. The results obtained from 20 who were followed-up one year after surgery demonstrated an improvement in the physical examination in 70% of cases and a decreases in hyperthermia in 75% of patients. A spermiogram improvement has been obtained in 66.6% of 18 patients, as two of them were of pediatric age.

Adolescent↗
PubMedDate not supplied

[Cancer of the extrahepatic bile ducts. Clinical experience and anatomic/surgical considerations].

Cancer of the extrahepatic biliary tract is a rare disease related to a severe prognosis. The resection of the extrahepatic biliary tract is a complex procedure and the preoperative assessment of resectability is made difficult because of the malignancies. Biliary cancer resection can be curative in some patients but in some cases a liver resection has also to be performed. The authors retrospectively analyzed their recent cases closely examining some anatomical and technical aspects of biliary cancer resection. Eight patients were treated, three had distal cancer, two a central and three a proximal one (Klatskin tumor). In seven patients (87%) the cancer had spread to the liver. In one patient there was a favourable anatomical variation. All eight patients underwent laparotomy and in two (25%) the biliary cancer could be resected but curatively only in one case. Six patients underwent palliative procedures with a maximal survival of 8 months. The only curatively resected patient is well, without recurrence, 13 months after surgery. These results are similar to those reported concerning resectability and survival but a higher rate of liver metastases strongly reduced the amount of possibly curative resections. The experience shows the importance of laparotomy and of the knowledge of anatomy for a correct approach to resection and palliation of this cancer.

Aged↗
PubMedDate not supplied

[Advantages of reabsorbable intradermal sutures in general surgery. Experience on 201 sutures].

Surgical wound suture is often considered of minor importance compared to the whole surgical operation. The aesthetical result of a wound suture is still hardly considered in general surgical practice compared to other "traditional" wound sutures. The Authors carried a prospective study an 201 intradermal absorbable sutures in clean general surgery. The results clearly show that with a limited increase of the mean operation time of 90 seconds, for a 10 cm suture, there are such positive clinical, and aesthetical results that it is advisable to use routinely this type of suture in elective clean surgery.

Absorption↗