Biomedical subjects

G Modica

Publications and source records attributed to G Modica.

49 records · Page 3Linked to original sources

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

[Surgical treatment of epiphrenic diverticulum based on associated functional changes: report of a case].

OBJECTIVE: The authors report their experience about the surgical treatment of a epiphrenic diverticulum (ED) associated with motor disfunctions and gastroesophageal reflux. DESIGN: Report of 1 case; evaluation of effectiveness of the treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: Thoracotomic diverticulectomy + esophageal extramucosal myotomy + antireflux procedure. RESULTS: Resolution of syntomatology. Negative the follow up. CONCLUSIONS: ED is the epiphenomenon of esophageal motor disfunctions. The surgical procedure is based on their comprehension and on the study of this factors.

Diverticulum, Esophageal↗

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

The role of thymidylate synthase levels in the prognosis and the treatment of patients with colorectal cancer.

Inhibition of Thymidylate Synthase (TS) by the 5-Fluorouracil (5Fu) active metabolite Fluoro-deoxy-uridine-monophosphate (FdUMP) is considered to be the main mechanism of action of 5Fu. TS level from tumors and normal mucosa of 62 untreated patients who underwent surgery for primary colorectal adenocarcinoma was performed. The aim of this study was to evaluate the possibility of considering the TS level as a prognostic factor of the disease. A large variation in the level of the enzyme was found among tumors. Our data demonstrate that there is no association with age, sex, and tumor size; however there are significant relationships between TS levels and staging and histological grading. In fact the TS values are higher in Dukes' A and in G1 than in Dukes' D and G3 tumors (p < 0.05). Another significant association has been found between the TS level and tumor site: pts with right colon neoplasias had higher TS levels than pts with left and rectum ones. An interesting trend was found between the TS levels and survival parameters. Pts who had lower TS levels had a significantly increased risk of death (p < 0.05) over pts with a higher outcome. Our data support the hypothesis that a high TS level is a favourable prognostic factor in human untreated colorectal carcinomas according to our previous preliminary data (1).

Adenocarcinoma↗

PubMedDate not supplied

Prognostic significance of proliferative activity, DNA-ploidy, p53 and Ki-ras point mutations in colorectal liver metastases.

Paired colorectal liver metastases (CLM) and normal tissue samples from a consecutive series of 36 patients were studied prospectively. MIB-1 expression was studied by immunohistochemistry on paraffin-embedded sections. DNA ploidy and S-phase fraction (SPF) measurements were performed by flow cytometry on frozen tissues. Mutations within the p53 (exons 5-8) and c-Ki-ras (codons 12 and 13) genes were detected by PCR single-strand conformation polymorphism analysis followed by sequencing. A high correlation was observed between the MIB-1 LI and SPF value (rho=0.81; P<0.01). Moreover, p53 gene mutations were associated with either high MIB-1 LI and high SPF. In univariate analysis, SPF and MIB-1 levels were related to risk of death. The association between overall survival and DNA-ploidy or p53 mutations did not reach statistical significance, but a slightly better survival was observed for patients either with DNA-diploid tumours or without mutations (P=0.05 and P=0.06, respectively). SPF was shown by multivariate Cox model analysis to be an independent prognostic variable and thus it might be a useful prognostic factor in patients with CLM.

Adult↗