Biomedical subjects
Publications and source records attributed to G Navarra.
Since 1959, when mediastinoscopy was introduced by Carlens, the practice has been technically unchanged. The authors suggest how the new video technologies could be very helpful to this procedure leading to an ergonomic position for the operator and a faster performance. Initial experience is reported.
Up until now the problem of surgical infections has been one of the most important which surgeons must confront daily. In 1989 our Institute began programs for control and surveillance of surgical infections; these include, among others, the use of chemo-antibiotic prophylaxis protocols applied to all of the patients hospitalized for surgery. The authors report two years application of three protocols of chemo-antibiotic prophylaxis related to 1722 patients, in which we pointed out the passage from 27.6% of infected cases in the control group to 10.2% infected cases in one of the groups subject to prophylaxis. In these cases the antibiotic prophylaxis also acted reducing in a spectacular manner the incidence of clinically not significant infections.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Stapling techniques are considered the safer alternative for esophageal anastomosis in the Authors experience. In order to further improve results they suggest stapled esophageal anastomoses should be constructed avoiding purse-string sutures and the use of purse-string devices or Satinsky forceps.
Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval. The results are discussed in relation to data collected from current literature.
Among the anomalies of internal carotid artery, agenesis and aplasia recur with a low rate: only about sixty cases are reported in literature. We observed a case of aplasia of the left internal carotid in a 49 year old male suffering from hypertension and showing cerebro-vascular symptoms due to TSA pathology: it was studied with arterial angiography and duplex scanner. The angiographic examination raised a suspicion of left internal carotid thrombosis; on the contrary the duplex scanner revealed a correct diagnosis of carotid aplasia.
The cost/benefit ratio of stapled anastomoses in colorectal surgery has been retrospectively evaluated on the basis of a 8 year experience taking into account the overall costs in surgery as well as short term and long term benefits. With this aim, our experience was divided in two periods: 1st period: November 1970-January 1981: 598 hand sutures; 2nd period: February 1981-December 1988: 787 stapled sutures. Mechanical suturing was found to be superior based on the following: a) the average postoperative hospital stay decreased from 20.2 days to 14.7 days; b) temporary stomas decreased from 62.2 to 25.1%; c) abdominoperineal resection for rectal cancer decreased from 60.7 to 41.6%.
The Authors, on the basis of their personal experience and supported by more significative data from the international literature, underline the validity of the screening in detecting non palpable lesions of the breast. They conclude by asserting that mortality for breast cancer may be further reduced if more and more women undergo screening programmes.
Pathophysiological mechanisms of Fournier's gangrene are reported. Variety and progression of clinical manifestations are stressed as well. The importance of an accurate therapeutic protocol in the treatment of this peculiar and serious disease is therefore underlined.
The reasons that led to subcutaneous mastectomy in some initial stage breast cancer patients are reported. After removal of the mammary gland, this surgical technique provides for prosthetic reconstruction and should therefore be confined to women with initial stage cancer who for psychological or aesthetic reasons refuse more destructive operations. The technique is described and results obtained discussed, recalling that this type of non-destructive operation will be increasingly in demand in the future but needs preclinical diagnosis of the local disease and its systemic diffusion.
After discussing the classification of the various types of gastric volvulus, the aetiopathogenetic factors that occur in this rare stomach pathology are reviewed. The personal series is reported and the clinical, radiological and above all therapeutic aspects connected with the pathology discussed. It is concluded that, in these cases too, the aims to pursue are the formulation of early diagnosis and implementation of quick, correct treatment for the purpose of eliminating the basic pathology and preventing necrosis of the gastric wall setting in.
After recalling the various therapeutic aids proposed for the treatment of hydatid disease, personal experience in the use of mebendazole in patients suffering from pulmonary hydatidosis is reported. On the basis of the results obtained, it is concluded that mebendazole represents a useful therapeutic approach provided it is administered in full doses and for a long period in well selected cases, namely patients with cysts of limited dimension and, probably, of comparatively recent onset.
The Authors though in theirs' opinion medical treatment is the primary therapeutical approach to Acute Necrotizing Haemorrhagic Pancreatitis (A.N.H.P.), state that the surgical treatment is indicated as soon as the necrotizing haemorrhagic evolution of the disease is strongly suspected. It should be conservative in type acting on the evolution of the disease and saving the anatomic integrity of the pancreas. The surgical technique adopted is described which consists in removing cellular debris as well as highly toxic necrotic pancreatic apparatus and it is completed by the endo-retroperitoneal perfusion for a continuous washing of the peritoneal cavity. In conclusion, they report their personal experience with 16 patients affected with A.N.H.P.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.