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Biomedical subjects

M Bezzi

Publications and source records attributed to M Bezzi.

98 records · Page 6Linked to original sources
PubMedDate not supplied

Rectal cancer: restorative surgery with the EEA stapling device.

In the surgical treatment of tumors of the middle third of the rectum, we have been performing low colorectal anastomoses, with the EEA stapler introduced transanally, as a sphincter-saving operation, during the last three years. Our experience covers 134 patients; in 89 of these, manual reconstruction was found to be technically impossible. In such cases, the alternative sphincter-saving operation, in our department, would be a pull-through operation. In 16.4%, anastomotic dehiscence with stercoraceous fistula was observed; the operative mortality was 1.4%. At follow-up, there were no colon problems, in 85.2%; in 13.7%, three or four defecations of formed stools occurred daily; in 6.8%, there was a reduction in the calibre of the anastomosis. In these patients, dilation was performed. Loss of the capacity to discriminate between feces and flatus and a poor control of flatus with occasional fecal incontinence were present in six and three patients, respectively. Clinical and functional results, when compared with those of other sphincter-saving operations, confirm that the use of the EEA stapler allows the construction of anastomoses so low in the rectum that it would be difficult, risky or impossible to perform them manually. A reduction in the incidence of anastomotic dehiscence and length of hospital stay was also obtained.

Colon↗
PubMedDate not supplied

[Primary hyperaldosteronism caused by monolateral adrenal hyperplasia].

We have reported two patients with unilateral adrenal hyperplasia as a rare cause of primary aldosteronism, and discussed the literature on this subject. When diagnosed by NMR-CT imaging and selective sampling from adrenal veins, the treatment of this disorder appears to be surgical. Whether its pathogenesis is related to the more common varieties of primary aldosteronism is open to speculation according to metabolic findings.

Adrenal Glands↗
PubMedDate not supplied

[Laparoscopic ultrasonography in laparoscopic surgery and diagnosis].

The authors report their experience with 101 patients examined with laparoscopic ultrasound (LU) using a dedicated 7.5-MHz linear probe which can be introduced through the 10-mm surgical trocars. In the patients undergoing laparoscopic cholecystectomy (77 cases), LU adequately demonstrated gallbladder wall and contents in all cases and visualized the main bile duct in 93.5% of cases; stones of the CBD or cystic duct were demonstrated in two cases. The liver was studied in 18 patients undergoing diagnostic laparoscopy or laparoscopic colonic resection: secondary lesions were identified in two cases, while benign lesions (cysts or angiomas) were seen in 6 cases. In the patients operated on for colonic resection (8 cases), LU was successfully used to localize the enteric tract affected by the tumor and to mark safety margins for excision. The technical features of the exam are reported and the main imaging findings discussed. The authors conclude that LU is a safe method which is easy to perform and does not significantly increase the operating time; the indications of this laparoscopic application of ultrasound are not yet defined but the application area will certainly widen in the future, as operative and diagnostic laparoscopy are more and more frequently used by surgeons.

Adult↗
PubMedDate not supplied

Emergency transjugular intrahepatic portosystemic shunt in patients with active variceal bleeding and hepatocarcinoma.

Variceal hemorrhage is a leading cause of death in patients with hepatic cirrhosis. We report the case of two cirrhotic patients with hepatocarcinoma in whom oesophageal varices bled repeatedly. Because the bleeding was not controlled by sclerotherapy, vasopressin or Blakemore balloon, the patients were evaluated for emergency transjugular intrahepatic portosystemic shunt. After the procedure, portal vein pressure decreased from 45.5 mmHg to 18 mmHg and from 44 mmHg to 19 mmHg respectively and no filling of varices was evident at venogram or endoscopy. After 16 and 8 months respectively, bleeding had not recurred, and no episodes of encephalopathy were referred. Transjugular intrahepatic portosystemic shunt should always be considered an effective emergency therapeutic alternative to shunt surgery in patients with active variceal bleeding when traditional management fails.

Aged↗
PubMedDate not supplied

[Non visible carcinoma of the gallbladder. A strategic problem after video laparoscopic cholecystectomy].

A formal contraindication to laparoscopic cholecystectomy is gallbladder cancer. Sometimes its first appearance is intraoperative finding or microscopic examination of gallbladder removed for presumed benign disease. These patients with "inapparent carcinoma" may be long-term survivors if definitive and curative therapy is performed. We present the case of 56 y. woman which presented a T2 unsuspected carcinoma that was reoperated and cured by wedge liver resection, extended lymph node dissection and large excision of tissue of trocar wounds.

Adenocarcinoma↗
PubMedDate not supplied

[Intestinal perforation caused by a chicken bone: apropos of a clinical case].

Ingestion of foreign bodies (FB) seems to be a relatively common occurrence in certain classes of people. The majority of ingested objects reach the stomach end 80% of these pass spontaneously without complications. However nearly 20% of FB that pass from the stomach result in complication distally such to required a surgical operation. The authors report a case of chicken bone perforation of the ileus, which was diagnosed by surgical operation. The case reported is of interest for several reason. The lack of condition that can predispose patients to accidental ingestion of FB, no specific history of FB ingestion and the impossibility to detect chicken bones on plain radiography.

Aged↗