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Biomedical subjects

G P Ferulano

Publications and source records attributed to G P Ferulano.

At least 19 recordsLinked to original sources
PubMed2000

Influence of the surgical treatment on local recurrence of rectal cancer: a prospective study (1980-1992).

BACKGROUND AND OBJECTIVES: The incidence of locoregional recurrences (LR) following radical surgery of rectal cancer varies from 5% to 30% according to the literature. The purpose of this prospective study was to compare the outcome of the Abdomino-Perineal Excision (APE) vs. the Anterior Resection (AR) in a consecutive series of 188 patients who underwent surgery for cure from 1980 to the end of 1992 (81 APE and 107 AR), followed for 5 years, evaluating their influence on the incidence of the recurrences. METHODS: The patients were enrolled at random in the two surgical groups, provided that a radical excision of the tumour, with only two limits: the level of the lesion from the anal verge and the presence of a severe incontinence instrumentally proven. TNM, Dukes staging, grading, and tumour location were statistically evaluated. Further primary suture vs. packing of the perineal wound in APE and handsewn vs. stapled anastomosis in AR were compared in relation with the incidence of LR. RESULTS: The overall local recurrence rate was 19.2% (32/167), in details 19.7% for APE and 18.5% for AR. Similar recurrence rates were observed following both procedures, matching the patients according to the Dukes stage and different details of techniques. A slight statistically significant difference was found as far as the tumour location is concerned in the group treated with anterior resection (p = <0.05) because of the higher recurrence observed in AR performed for tumours of the lower third of the rectum in comparison with the more proximal level. CONCLUSIONS: The AA conclude that the choice of the right surgical procedure in the rectal carcinoma depends on the characteristics of the tumour and the conditions of the patients, provided that the oncologic indications were respected, because recurrence and survival rate are independent from the surgical approaches.

Abdomen↗
PubMed1991

[Anorectal sphincter function after mechanical anterior resection in cancer of the rectum].

Out of a total of 365 operations for colo-rectal disease performed during the period 1980-1989 at the III and V Division of General Surgery of the 2nd Faculty of Medicine and Surgery of Naples, 181 (49.6%) patients had rectosigmoidal cancer: 95 (52.5%) underwent anterior resection and 86 (47.5%) Miles' operation. In 46 patients who underwent mechanical anterior resection during the period 1986-1989, pre and postoperative sphincter function was studied through a complete anamnesis, physical examination, sigmoidoscopy or colonoscopy and balloon manometry. All data were analyzed considering both the distance of the anastomosis from the anal verge and the patient age in order to stress possible relations with incontinence. The low incidence of incontinence registered after 12 months (6.5%), confirms the importance of manometry and rehabilitation, both necessary to improve the quality of life in old patients who undergo low anterior resection.

Adult↗
PubMed1986

Survival and locations of recurrence following abdomino-perineal resection for rectal cancer.

Records of 134 patients treated by abdomino-perineal resection (1971-1979) were reviewed. One hundred and thirteen had curative operations. Mortality was 2.6% and morbidity was 51%. Ninety-three were evaluable and were followed for 5 to 8 years; they were evaluated for survival and pattern of recurrence. Five-year survival for Dukes' A, B, C, and D lesions was 86, 62, 31, and 0%, respectively. Thirty-seven had recurrence: Four pelvic, nine pelvic and distant, and 24 only distant lesions. The overall incidence of failures was 47%, failure rates by stage were 11% for stage A, 27% for B, 48% for C, and 70% for D. Incidence of local recurrence was significantly higher in stage C compared to stage B. Irrespective of stage, after detection of local or distant recurrence, survival did not differ. Furthermore, radiotherapy for local recurrence and chemotherapy for distant lesions did not improve survival time.

Abdomen↗
PubMed1985

[Validity of diagnostic studies in thyroid pathology. Retrospective study].

In view of the growing number of examinations proposed and employed for the diagnosis of diseases of the thyroid, a retrospective evaluation was made of their validity in a series of 2500 patients (1500 operated). Attention was paid to scintiscanning, oncotropic indicators, echography, needle biopsy, thyrolymphography and thyroid hormones as aids to determining the nature of thyroid lesions and the planning of their treatment. Scintiscanning and needle biopsy proved of primary importance in determination of the nature of a lesion. Echography supplied additional, though not necessarily indispensable information. Oncotropic indicators and thyrolymphography do not appear to be useful. They do not provide data enabling a diagnostic problem to be solved, but can only help to increase any doubts that may exist. Determination of thyroid hormones is clearly indicated when planning the management of hot lesions (single, multiple or disseminated nodes), in cold lesions where thyroiditis is suspected, and in all cases where the clinical evidence suggests hypothyroidism. In euthyroid subjects requiring surgery with no objective signs of hypofunction, preoperative determinations appear to be unnecessary, where as post-operative values are of assistance in assessing the functional efficiency of the residual thyroid tissue. The conclusion to be drawn, therefore, is that diagnostic examinations should be employed in a more selective and discriminating manner.

Biopsy↗
PubMed1985

Surgery of toxic goiter: indications and long-term results.

Treatment of hyperthyroidism is still debated, surgery in particular is conceived as the last step of a multidisciplinary approach. 130 patients were reviewed in a follow-up based on a double cell at fixed dates, after subtotal thyroidectomy for multinodular and diffuse toxic goiter. Clinical and laboratory tests (T3, T4, TSH) showed a rate of 9.1% of recurrent toxicity and 20.7% of hypothyroidism. These data confirm that surgery offers satisfactory results in the management of hyperthyroidism if indications are carefully followed. It is also shown that TSH has a predictive role in the screening of patients at risk of developing postoperative hypothyroidism.

Adolescent↗
PubMed1984

Effects of CO2 laser on the healing of experimental colon anastomoses.

Anastomotic leakage after colonic resection still remains a troublesome complication of major clinical significance. Systemic (nutritional status, blood viscosity) or local factors (contamination by local germs, suture technique) seems to be implicated in the healing process of the suture line. The CO2 laser as a cutting procedure in colonic resection should provide a useful tool for its accuracy and the bactericidal properties. We have tested the strength of an end-to-end anastomosis of rat colon resected by CO2 laser, scalpel and diathermy, respectively, by measuring the bursting pressures at different postoperative days. The present study shows that the use of CO2 laser resulted in a significant increase of colonic bursting pressure at the anastomotic site.

Animals↗