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Biomedical subjects

G Navarra

Publications and source records attributed to G Navarra.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Retroperitoneal neurilemmoma (anatomo-pathologic and clinical considerations)].

After extensively reviewing the literature on primary retroperitoneal tumours, the authors present a case of retroperitoneal neurilemmoma. They stress the rareness of this disease and go on to discuss the related epidemiological, histogenetic and anatomo-pathological problems. Finally, they deal at some length with the symptoms of the disease and the diagnostic strategy they adopt, emphasizing the usefulness of CT and ultrasonic tomography in the study of the retroperitoneal region.

Humans↗
PubMed1983

[Corrected transposition of the great vessels associated with severe pulmonary stenosis in a 59-year-old man].

The case of a 59-year-old man with corrected transposition of the great arteries (CTGA) is reported. This anomaly is rare in adult patients, uncommon in patients over 50. Most of the cases with CTGA are diagnosed in childhood because of associated cardiac abnormalities. When isolated or complicated by other mild anomalies, CTGA can cause no symptoms until adult life or can even go unrecognized. However, most of these patients present with congestive heart failure when they are 40 or 50 years old. Our patient was admitted to the hospital because of heart failure. Cardiac catheterization and selective angiography demonstrated a CTGA associated with severe pulmonary valve stenosis. The case here reported shows that CTGA even when associated with other cardiac abnormalities, can be a relatively benign lesion, and can be revealed in adult life by signs of cardiac failure.

Humans↗
PubMedDate not supplied

Mucinous adenocarcinoma in chronic anorectal fistula.

Adenocarcinoma in association with chronic anal fistula is a rare disease which gives rise to difficult problems of diagnosis and treatment. A case of mucinous adenocarcinoma arising on a long standing fistula in ano is described. A patient with a long history of mucinous discharge, pain and perianal induration underwent a biopsy of the external opening of the fistula that showed mucinous infiltrating adenocarcinoma. After a colonoscopy and a preoperative abdominal CT scan, she underwent a successful abdominoperineal resection with adjuvant chemoradiation therapy. Diagnosis of this condition is often difficult; deep and multiple biopsies of the fistulous tracks or perianal mass are necessary to establish the diagnosis. An accurate staging of the neoplasm, using endorectal ultrasound, NMR or CT scans is needed to plan the appropriate treatment. Recent studies have shown that locally advanced anal adenocarcinomas could benefit from pre or postoperative chemoradiation therapy. However, an accurate and complete removal of the tumor, which usually entails abdominoperineal resection, is often necessary to achieve radicality. Despite new therapy protocols, the prognosis of mucinous adenocarcinoma is still poor, mostly due to its advanced nature at the time of diagnosis. This reinforces the importance of biopsy of all perianal abscesses and fistulas for early detection and treatment.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

[Colonic pouch versus direct colo-anal anastomosis in the reconstruction after total resection of the mesorectum: review of the literature].

Good results in terms of control of the disease and 5 years survival have encouraged the use of the sphincter-saving technique for the treatment of cancers of the lower rectum. However, after this operation a percentage of patients complains of functional abnormalities such as increased bowel frequency and modification of continence especially within 12-18 months after surgery. This review analyzes the results of coloanal anastomosis following rectal excision trying to evaluate if the construction of a colonic pouch allows to limit or to prevent the functional anorectal abnormalities that usually follow a straight colo-anal anastomosis.

Anal Canal↗
PubMedDate not supplied

[Laparoscopic appendectomy versus open appendectomy in suspected acute appendicitis in female patients].

INTRODUCTION: The aim of the study is to analyse the own data and try to discuss if laparoscopic appendectomy offers any advantages in treating young women suffering from pain in right lower abfdominal quadrant. MATERIALS AND METHODS: The study was conducted on 148 patients admitted from October 1993 to December 1998 with diagnosis of of pain in right iliac fossa and operated on with a laparoscopic (LA group: 75 cases) or open approach (OA group: 73 cases). Patients were prospectively randomized on the surgical approach adopted, following a randomized list. RESULTS: The operative time in LA group was significantly (p < 0.001) longer (87.2 minutes) than for OA group (65.2 minutes). In 2 patients (2.7%) the operation had to be converted. Diagnosis had remained unknown in 16 patients (21.9%) of OA group, in spite of only one case (1.4%) with laparoscopic technique. We didn't observed intraoperative complications. Pain in the first and second postoperative days, evaluated on the use of pain medication, was significantly less in patients in group LA (p < 0.01). There were no deaths. Postoperative complications occurred in 4 patients (5.5%) of group LA, and in 8 patients (10.9%) of group OA. Hospital stay was significantly shorter for those having laparoscopic appendectomy (p < 0.001). DISCUSSION: The main advantages of laparoscopic appendectomy consist more in diagnostic accuracy, than in less postoperative pain, less hospital stay and less postoperative complications. CONCLUSION: Laparoscopic appendectomy is a safe and accurate approach.

Acute Disease↗
PubMedDate not supplied

A new device for sutureless skin closure "the zipper".

BACKGROUND: We have done a prospective, controlled, randomized study to investigate the role of the "zipper", a new device for skin closure. We have also analysed morbility and advantages with the use of the "zipper" compared with sutures. METHODS: 610 consecutive patients underwent surgery for abdominal thoracic endocrinologic and post traumatic pathologies. In 203 cases we used the zipper a new device for skin closure. RESULTS: 6/203 Morbility: in six cases it was necessary to substitute the zipper with sutures or leave the wound healing by second intention. The patients were operated for inguinal hernioplasty, axillary lymphadenectomy, appendicectomy and cholecystectomy. These patients developed complications after surgery as hematoma, lymphorrhea, wound infection and a reintervention. The correction has been done removing the zipper and positioning sutures or leaving the wound healing by second intention. CONCLUSIONS: The use of the zipper permits to achieve an efficient seal, a simple application, an aesthetic comfort; it can be applied in local anaesthesia and for its painless, application it is indicated in pediatric surgery.

Age Factors↗
PubMedDate not supplied

[Our experience with early gastric cancer].

Authors assert that, in Early gastric cancer diagnosis, anatomicomedical characteristics expressed on the basis of canons formulated by Endoscopy Japanese Society and by Lauren's unexipered classification are of particular interest. After having referred on characteristics observed on a group of patients, in the light of data given from medical Literature, they try to extrapolate aetiopathogenetic factors. These, together with anatomicopathological characteristics of the lesion, are the premises for a wise radical therapeutic choice.

Follow-Up Studies↗
PubMedDate not supplied

[Anatomo-clinical considerations on early gastric cancer].

After having asserted the still rising interest for an as early as possible diagnosis of gastric cancer, authors refer on a group of patients who are carriers of Early gastric cancer. After having touched upon localization and histological characteristics of neoplasms, linger on the rules that leaded their therapeutic choice and they report the results of a follow-up dragged ten years long. They terminate affirming only a timeliness diagnosis can consent a really decisive therapeutic approach.

Aged↗
PubMedDate not supplied

[Evaluation of prognostic parameters in colorectal carcinoma. I. Histopathological variability].

A careful histopathological analysis was performed on a series of 244 unselected surgically removed primary colonic and rectal cancers. Tumours were staged according to the TNM system. Tumour type (adenocarcinoma or mucinous carcinoma), grade of differentiation, character of invasive margin, degree of peritumoural lymphocytic infiltration, venous and neural invasion were found to be correlated with the clinico-pathological stage and in some ways interrelated. As a whole our results seem to suggest that histological evaluation of the variables examined may provide information of clinical relevance in the management of patients with large bowel cancer.

Adenocarcinoma↗
PubMedDate not supplied

[Radiofrequency-assisted hepatic resection--first experience].

AIMS: Intra-operative blood loss during liver, resection remains a major concern due to its association with higher postoperative complications and shorter long-term survival. The aim of this study was to assess the feasibility and safety of a novel concept for liver resection using a Radio-Frequency energy assisted technique. METHODS: From January 2001 to January 2002, 27 patients were operated on using Radio-Frequency energy assisted liver resection. Radio-Frequency energy was applied along the resection edge to create a 'zone of desiccation' prior to resection with a scalpel. RESULTS: Median resection time was 47.5 minutes (range 30-110). The median blood loss during resection was 30 mls (range 15-992) and mean pre-operative and post-operative haemaglobin values were 13.5 g/dL (SD+1.7) and 11.6 g/dL (SD+1.4) respectively. No blood transfusion was registered, nor was any mortality observed. There was one post-operative complication: a sub-phrenic abscess. Median post-operative stay was 8 days (range 5-86). CONCLUSION: Liver resection assisted by RF energy is feasible, easy and safe. This novel technique offers a new method for 'transfusion-free' resection without the need for sutures, ties, staples, tissue glue or admission to Intensive Care Unit.

Adult↗
PubMedDate not supplied

[Idiopathic ischaemic infarction of the stomach. Case report].

Idiopathic ischaemic infarction of the stomach is an extremely rare condition since only 2 other cases have been published in the Literature so far. The Authors report a case of such entity on a 75 year old male patient, admitted from the accident and emergency department because of a upper digestive tract haemorrhage with clinical signs of hypovolemic shock. The patient subsequently underwent an upper gastro-intestinal endoscopy that suspected an ulcerated gastric neoplasm. The patient therefore underwent a total gastrectomy and was discharged home on p.o. day X. The pathology report showed an Ischaemic infarction of gastric mucosal tissue with pomphoid Oedema of submucosal layer. Ulcerative superficial necrosis with venous haemorragic swarm and focal acute pseudomembranous inflammation. Not neoplastic features. Etiopathogenetic, pathophisiologic ipoteses and clinical implication of Idiopathic ischaemic infarction of the stomach are discussed.

Aged↗
PubMedDate not supplied

[Wilms' tumor in adults].

The Authors report a case of Wilms' tumor in a 38-year-old woman. Through a review of such neoplastic condition some etiopathogenetic and clinical considerations are made. It is concluded that postsurgical adjuvant therapy in adulthood must not differ from that of childhood.

Adult↗