Search PubMed⌕ Search

Biomedical subjects

G Tiberio

Publications and source records attributed to G Tiberio.

136 records · Page 8Linked to original sources
PubMedDate not supplied

[Indications and short and medium time results of crossover bypasses in the treatment of obstructive arteriopathies of the lower limbs].

The authors evaluate the indications, the hemodynamical aspects, the short and medium term results over their track record of 49 crossover bypass (44 dacron and 5 PTFE grafts) performed between 1981 and 1993. Crossover bypass grafts were mainly inserted for unilateral iliac arterial disease in order to avoid aortic manipulation. This procedure was particularly selected when in presence of: young patients (< 60 years old), high surgical risk, poor run-off, high risk of prosthetic infection, thrombosis and/or infection of orthotopic grafts. 3 ilio-iliac, 27 iliofemoral, 18 femorofemoral and 1 femoropopliteal bypass have been performed. The postoperative resting pressure Index increase was highly significant in recipient limbs. There wasn't perioperative mortality; during the follow up (mean 24.4 months) no amputation of recipient limb was observed. 4 patients died of A.M.I. and 1 of neoplastic disease. Late cumulative patency rate was 81% at 2 years and 67.3% at 3 years. These values rise to 97.2% and 86.1% respectively when considering patients with "ideal" indication (excluding 7 patients operated on for complications of previous bypass grafts and 6 with extremely poor run-off). An accurate evaluation of the lesion topography and haemodynamic pattern of donor and recipient iliofemoral districts are stressed as key points for a correct surgical indication.

Adult↗
PubMedDate not supplied

[Pancreatic and duodenal injuries. Considerations on 40 observed cases].

Traumatic lesions of the pancreas and duodenum are uncommon. The anatomic situation of the viscera makes early diagnosis of such lesions difficult to be achieved; this fact, together with the high incidence of associated lesions, justify the high morbidity and mortality of duodeno-pancreatic traumas. In the present paper we report the two-decades experience (40 traumatic lesions of the pancreas and/or the duodenum) of the Department of Emergency Surgery, University of Milan. The overall mortality (32.5%), even if correlated with the importance of the duodeno-pancreatic lesions, was strictly dependent to the presence of associated injuries which lead to most of the morbidity and mortality.

Adolescent↗
PubMedDate not supplied

[Surgical therapy of perforated duodenal ulcers: suture versus highly selective vagotomy. Immediate and remote results (case series from 1978 to 1990)].

The aim of this study was to compare the results of high selective vagotomy and simple suture in the treatment of perforated duodenal ulcer. Among 150 patients admitted in our institute from 1978 to 1990, 96 were treated with simple suture while 54 underwent high-selective vagotomy (42 with pyloroplasty). In our study with high-selective vagotomy we had no surgical mortality and low morbidity. The overall clinical results according to the Visick evaluation, were recorded as excellent or good, in 90.9% cases in the group of patients treated with high-selective vagotomy versus 40% in the group with simple suture, after a similar period of follow-up. The recurrence of ulcers after high-selective vagotomy was of 6%, compared with 32.6% in simple suture patients. The results of high-selective vagotomy performed for perforated duodenal ulcers were compared with those of a group of duodenal ulcers not complicated treated with high-selective vagotomy too; the better results of this last group may be due to higher technical difficulties in presence of peritonitis. High selective vagotomy is therefore a safe procedure in the management of perforated duodenal ulcer, and moreover obtains good long-term results in the control of peptic disease.

Adolescent↗
PubMedDate not supplied

[Gastric leiomyoblastoma: report of our case load].

Leiomyoblastoma of the stomach is a rare nosological entity (0.3% of all gastric tumors). During the last 13 years, the authors observed 7 of such tumors. In this paper, our cases are presented: these are discussed (together with a revision of the literature), particularly focusing on anatomo-pathological, diagnostic and therapeutic problems.

Aged↗
PubMedDate not supplied

[Simultaneous multiregional embolization from a cardiac myxoma. Case report].

Atrial myxoma is the most frequent cardiac tumor. Distal embolization occurs in about one third of the patients with this nosological entity; a simultaneous embolization to three different arterial districts, however, is a rare event. Of particular interest is also, in our opinion, the evolution of the clinical picture and the surgical treatment performed.

Adult↗
PubMedDate not supplied

[One-stage curative treatment of neoplastic colonic obstruction: long-term results, comparison with elective surgery and therapeutic implications].

Over a period of ten years (1980-1989) 528 patients with colon cancer were treated at one institution. One hundred seventy nine (33.9%) were obstructed (O) and underwent emergency surgery, while 349 received elective (E) treatment; of these 363 had one-stage curative treatment. Operative mortality was 10.3% (O) and 3.5% (E) respectively (p < .0.5). Three hundred forty three patients survived surgery and entered follow-up: 96 were O (M:F, 54:42) and 247 E (M:F, 119:128, p = N.S.). Their mean age was 69.5 and 64.4 (p < .001), respectively. Dukes' stage and histological grading were evenly distributed within the two groups, but sites of the primary were not (p < .001). During the follow-up local recurrence occurred in 40 patients (13 O, 27 E, p = N.S.) and metastatic disease in 78 (28 O, 50 E, p < .05, Life Table Analysis) including liver recurrence in 17 O and 30 E (p = .063). Five year crude survival (51%) was significantly worse in obstructed patients. Multivariate analysis showed that Dukes' stage and obstruction were the only prognostic factors of recurrent disease, while survival was affected by the same variables and age over 70. When recurrent disease was introduced in the model survival depended on Dukes' stage, site of the primary and age over 70 and the variable obstruction disappeared as prognostic factor. Right sided tumours showed a better and those at the splenic flexure a worse prognosis. Despite one-stage curative treatment obstruction carries a significantly higher risk of developing metastatic disease, suggesting that obstruction enhances cancer cell dissemination. These patients might benefit from per-operative intra-portal and post-operative systemic adjuvant chemotherapy.

Adult↗
PubMedDate not supplied

[Carcinoma of the pancreas].

The extensive use of diagnostic tools has made possible easier diagnosis of pancreatic cancer. Nevertheless, sometimes histologic diagnosis is still lacking at the operation. However, it is not necessary for resection. Therapeutic management depends on surgeon's evaluation of anatomic situation, patient's age and general condition. Similarly, sometimes only surgical evaluation can show if cancer can be resected or not. Laparoscopy seems useful to detect small peritoneal metastases which can not be seen with other procedures. In the last years, reduction of morbidity and mortality is the main goal achieved. Excluding some selected surveys, long term survival is still disappointing.

Carcinoma↗
PubMedDate not supplied

[Neoplasms of the head and tail of the pancreas].

The majority of cancer of the pancreas-about 70%-arise in the head of the gland and only 20-30% in the body and tail. The latter usually have grown to a large size by the diagnosis is made, due to absence of symptoms. Jaundice is seldom present and pain is the main symptom. We reviewed recent literature, which present homogeneous data. Cancers of the body and tail are rarely resectable, with 30% morbidity and a much lower morbidity-0-10%-in specialized centres. If the lesion is localized and the patient in good physical condition, a laparotomy can be performed, with or without a preliminary laparoscopy to detect distant metastases. Distal pancreatectomy and splenectomy is the treatment of choice. In our experience, only tumors different from ductal adenocarcinoma have a good prognosis. Pain can be managed by surgical or chemical splanchnicectomy and, in selected cases, thoracoscopically.

Adenocarcinoma↗
PubMedDate not supplied

[Pyogenic hepatic abscesses: 16 years experience in its diagnosis and treatment].

BACKGROUND: The aim of the present was to know the epidemiologic characteristics and clinico-biological variables presented by pyogenic hepatic abscesses and to evaluate the different therapeutic alternatives with special emphasis on percutaneous drainage. METHODS: A historical retrospective review of the hepatic abscesses diagnosed and treated in the authors' hospital over a 16.5 year period was carried out. RESULTS: A total of 44 cases of pyogenic hepatic abscesses were collected representing a rate of 0.088% of the hospital admissions. The mean age of the patients was 61.8 years. Thirty-four percent were cryptogenetic, being followed in frequency by those of biliary, post abdominal surgery and venoportal origin. Fever and right hypochondrial pain were the most frequent clinical manifestations, accompanied by an elevation in VSG and leucocytosis being the most common analytical alterations. Ultrasonography and CAT were found to be valuable in the diagnosis and treatment. The microorganism responsible was identified in 48% of the cases, with enterobacteria being the greatest number isolated. Fifty-two percent of the abscesses were treated with percutaneous drainage (73% if only patients post 1984 are considered), with minimum complications and a reduction in the number of days of hospitalization in comparison with surgical treatment. CONCLUSIONS: The presentation of a pyogenic hepatic abscess may be unspecific. Imaging techniques (echography and CAT) provide the main support in both the diagnosis and treatment. Percutaneous drainage plus early empiric antibiotherapy are the treatment of choice in pyogenic hepatic abscesses.

Adolescent↗