Search PubMed⌕ Search

Biomedical subjects

G P Farina

Publications and source records attributed to G P Farina.

18 recordsLinked to original sources
PubMed2004

[Dysplastic cysts of the liver: our experience].

AIM: Systematic surveys with advanced non-invasive imaging techniques have revealed that hepatic cysts are quite common in the general population. Therefore, we retrospectively examined our case series and compared it with the literature. METHODS: Between January 1990 and December 2000, 228 patients with non-parasitic liver cysts were referred to the outpatients section of the Department of Surgery of the University of Cagliari and 23 were submitted to treatment: 14 patients (60.8%) for solitary cyst and 9 (39.2%) for multiple simple cysts of the liver. One patient (4.5%) had right upper quadrant pain. Eleven (47.8%) patients were asymptomatic: 7 (63.7%) required treatment for other pathologies, 3 (27.3%) for a progressive enlargement of the cyst and 1 (9%) for a suspected hydatid disease. Mean diameter of the treated cysts measured by preoperative CT or US was 8.8 cm (range 7-14). Percutaneous aspiration-injection reaspiration (PAIR) was performed in 5 patients (21.7%), US-guided in 2 cases (40%) and CT-guided in 3 (60%). Twenty patients (86.9%) underwent cysts unroofing, 18 (78.2%) with open surgical fenestration and the latest 2 cases with a laparoscopic approach. Two patients had PAIR as second treatment for recurrence: CT-guided in one and US-guided in the other case. RESULTS: Four (25%) out of 16 patients treated exclusively for cystic liver disease, had fever in 3 cases and nausea and vomiting in 1 case; 8 patients (50%) had an intraperitoneal drainage for a mean of 6-7 days (range 4-11) and of 116 cc of serum-hematic liquid. CONCLUSIONS: In our opinion the choice of an adequate treatment must be based on an accurate evaluation of the clinical aspects of the patients and on the characteristics of cystic lesions such as number, size and location. These data let us to choose a surgical treatment rather than a strict US follow-up and to get the best outcome in terms of absence of recurrence, and less biological and economic costs.

Adult↗
PubMed2004

[Retroperitoneal sarcomas: our experience].

BACKGROUND: Retroperitoneal soft tissues sarcomas (STS) are relatively uncommon and constitute a difficult management problem. Although surgical resection is often difficult or impossible, current chemotherapy is not effective and radiation is limited by toxicity to adjacent structures. Thus, complete surgical resection remains the most effective modality for selected primary and recurrent disease. PATIENTS AND METHODS: Fifteen patients with retroperitoneal STS were admitted and treated between January 1990 and January 2003, and prospectively followed. Nine patients underwent complete surgical resection of 8 malignant and 1 benign tumor. Two patients underwent incomplete surgical resection of 1 malignant and 1 benign tumor. Patient, tumor, and treatment variables were analyzed for disease-specific and disease-free survival. RESULTS: The patients with unresectable disease, incomplete resection, and high-grade tumors presented significantly reduced survival time. In this study, stage at presentation, high histologic grade, unresectable primary tumor, and positive gross margin are strongly associated with the tumor mortality rate. CONCLUSIONS: Patients approached with curative intent should undergo aggressive attempts at complete surgical resection. Incomplete resection should be undertaken only for symptoms relief. Because death often occurs as a result of local progression in retroperitoneal liposarcomas, it is possible that incomplete resection may be beneficial in this histologic type. Complete surgical resection is the most effective modality for the treatment of retroperitoneal sarcomas.

Adult↗
PubMed1999

Visualisation of a paraganglioma by technetium-99m-sestamibi scintigraphy.

A 68-yr-old woman presented to our observation with multinodular goiter and a contiguous right laterocervical mass. In spite of ultrasound, technetium and iodine scan, CT and fine-needle biopsy, the precise origin of the mass remained uncertain. On additional multi-phase sestamibi scan, the neck region showed an early high uptake rapidly decreasing over time in the laterocervical mass, and a persistent inhomogeneous distribution in the thyroid gland. This behavior suggested that the laterocervical mass could derive from an anatomical structure other than the thyroid. Surgical exploration established the extrathyroid nature of the laterocervical mass and the histological examination confirmed that it was a typical paraganglioma. This finding is in keeping with a recent report of positive sestamibi uptake in a cervical paraganglioma, although our case showed a more rapid kinetic. This tumor should be therefore taken into consideration in the differential interpretation of focal sestamibi uptake.

Aged↗
PubMed1991

[Relevance and therapeutic implications of dysplasia in the follow-up of ulcerative rectocolitis].

Long standing ulcerative colitis (UC) is a condition capable of malignant transformation. Even if the rate of occurrence of carcinoma differs considerably among the various series, there is general agreement that it can be detectable in advance through the finding of glandular dysplasia. The Authors examine such a problem in a series of 27 patients submitted to clinical and endoscopic follow-up from 1984 to 1989. During this study a total of 237 rectosigmoidoscopies, 83 colonoscopies and 71 histologic exams were performed. At the outset mild or moderate dysplasia was found in 5 cases (18%). However, in the follow-up no evidence of dysplasia was detectable in 4 of the 5 cases. In the remaining case dysplasia was present only in one control. It was not found in the subsequent two histologic examinations. In our limited experience the incidence of dysplasia was not significant enough to require a prophylactic proctocolectomy. Instead a frequent and thorough endoscopic follow-up is recommended.

Adolescent↗
PubMed1990

[Immediate complications in thyroid surgery].

The Authors report the results of a series of 502 thyroid operations (bilateral in 322 cases [64%] and unilateral in 180 cases [36%]), with the aim to evaluate the incidence of early complications and to establish when they were more likely to occur. Preoperative diagnosis was based on scintigraphic scan recently combined to ultrasonography with fine needle biopsy. In all patients a pre and postoperative control of vocal cords motility was performed. Intraoperative identification of recurrent laryngeal nerve was the rule. Complications include a single case of mortality due to cerebral haemorrhage, 2 cases of monolateral recurrent laryngeal nerve paralysis, 4 cases of transient dysphonia, 8 cases of temporary hypoparathyroidism, 5 cases of postoperative bleeding. In three patients a temporary tracheostomy was needed. Thyrotoxic storm did not occur and wound infections were negligible. The various thyroid diseases and their different biological behavior are responsible of the risk factors, local and general ones, which the surgeon must recognize. Diagnostic accuracy, meticulous surgical technique and the best treatment at the first approach are the main factors to prevent complications in thyroid surgery.

Humans↗
PubMed1980

[Indications and results of thrombo-embolectomy in acute ischemia of the extremities].

A personal series of 176 thrombo-embolisms in the extremities, 157 of them operated, observed at the Surgical Clinic of Cagliari University in the period 1969-1977, is reported. The results of surgery are discussed in relation to the factors which most affect prognosis: age, time and degree of ischaemia, anatomo-pathological condition of the arteries and site of obstruction. Severe ischaemia poses the problem of indication for disobstruction: the possible onset of the revascularization syndrome, which almost always causes the death of the patient, should be borne in mind. Recently proposed local wash-out techniques do not complete solve the problem because although they manage to prevent the revascularization syndrome, they do not always save the extremity, which has to be amputated at a later stage after pointless risks to the patient. On the other hand, the poor functional results obtainable from an extremity that has suffered severe ischaemia must be considered. It is therefore preferred to forgo disobstruction when the ischaemia is so serious that revascularization syndrome is probable.

Adult↗
PubMed1978

[Diverticula of the esophagus. Etiopathogenetic aspects and principles of surgical treatment].

On the basis of the new knowledges recently acquired with the manometry on the esophageal physiology, the Authors first consider both etiologic and pathologic problems then emphasize the essential principles for correct surgical treatment of esophageal diverticula. With this purpose is confirmed the importance of careful and systematic preoperative study of esophageal pressure. In this way the etiologic role of functional disorders is cleared and a correct surgical treatment, particularly as regards the indication of extramucosal esophagomyotomy, can be performed. Nevertheless the diverticulectomy, performed alone or combined with myotomy, still maintains its role in the treatment of large-size diverticular pouches.

Diverticulum, Esophageal↗
PubMedDate not supplied

[Therapeutic strategies in differentiated cancer of the thyroid: total thyroidectomy].

Differentiated thyroid cancer is peculiar for its prognosis often excellent. The Authors report their experience about 78 patients affected with differentiated thyroid carcinoma, operated between 1976-1999 at the Institute of Surgical Pathology and Surgical Clinic of Cagliari University. 70 (89.7%) patients underwent total thyroidectomy, 6 (7.5%) subtotal thyroidectomy and 2 (2.5%) thyroid lobectomy. In 11 patients total thyroidectomy was performed in two times within 60 days after initial lobectomy. Tumor was found in 2 (18%) of 11 of the reoperations. Lymphadenectomy was performed only in presence of cervical lymph nodal metastases. Following 70 total thyroidectomy the incidence of recurrent nerve palsy was 4.2% and permanent hypoparathyroidism 11.4%. 79% patients received adjuvant postoperative radioiodine therapy to ablate residual functioning tissue or distant suspected metastases. After a mean follow up period of 5.8 years, recurrences developed in 10.2%. Any local recurrences, 5 (6.4%) cervical nodal recurrences, 3 (3.8%) distant metastases were encountered. Two (2.5%) of the three patients with recurrence distant metastases died from thyroid carcinoma. The Authors identify total thyroidectomy as the minimal procedure. Surgical management of the cervical nodes is recommended only in the presence of metastatic lymph-nodes. Post surgical ablation with I131 of microscopic remnants optimize detection and treatment of the recurrence and distant metastases.

Adolescent↗
PubMedDate not supplied

[Papillary microcarcinoma of the thyroid. Clinical implications and therapeutic strategy].

The Authors examine their experience about clinical implications and therapeutic strategies on Papillary MicroCarcinoma (PMC) of the thyroid gland. Clinical charts of 412 patients, who underwent thyroid surgery, were analyzed. The Authors stress "incidental diagnosis", benign associated lesions and frequency of population presentation; they conclude that the total thyroidectomy is the procedure of choice with oncology validity.

Adult↗