Search PubMed⌕ Search

Biomedical subjects

M Cagetti

Publications and source records attributed to M Cagetti.

At least 19 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↗
PubMed2004

[Tumoral calcinosis in a Sardinian patient mimicking hydatid disease: a case report].

The aim of this study is to report on a case of tumoral calcinosis (TC) mimicking hydatid cyst, which was diagnosed in a 51-year-old Caucasian woman of Sardinian origin. This lady presented with two symmetrical enlarging masses of soft tissue in the hips. The CT findings were suggestive of hydatid cysts. Grossly the two lesions appeared as unencapsulated firm, rubbery masses extending into the surrounding muscles. On cut surface the two specimens were multiloculated and contained either calcareous material or milky fluid. At histology the main findings were represented by multiple foci of amorphous calcified material bordered by proliferating macrophages, fibroblasts and multinucleated giant cells, separated by fibrous septa. The following characteristics are worth of note: the presentation in adulthood (late onset); the Caucasian race of the patient; the radiological appearances indicative of hydatid cyst; the aggressive clinicopathologic course, with multifocal involvement, rapid growth, infiltrative pattern. Histologically the TC exhibited the typical pattern of stage II according to Slavin's classification of disease.

Calcinosis↗
PubMed2002

Morphological variability and degenerative evolution of human hepatic hydatid cysts.

The findings are presented of a macro and microscopic investigation of 89 hydatid hepatic cysts removed intact from 59 patients by total pericystectomy. Detailed analysis revealed significant morphostructural variability and cysts grouped into 10 types were characterized, providing useful clinical indications. Only 30 cysts resulted fertile (33.7%), probably due to mean age of sample; 7 of these were "classic" cysts, 1 "septated" and 22 "multivesicular" packed with daughter cysts (DC), of varying turgidity or collapsed. Among the remaining 59 sterile cysts, 52 were degenerated and classified as "hyperlaminated" cysts due to the presence of large convoluted sheets of laminar tissue (SLT) surrounded by varying amounts of caseous (40 specimens), granular (6) or gelatinous (6) matrix. Moreover, "multivesicular", "acephalocyst", "caseous" and "serous" cysts were also recovered among the sterile specimens. Some "multivesicular" cysts (14) appeared as "transitional forms" towards the various types of "hyperlaminated" cysts containing all different forms of DC and large SLT intermingled with a variously degenerated matrix. The comprehensive study allows to hypothesize the train of events leading, over the years, to the gradual transformation and degeneration of the larval form Echinococcus granulosus in the human liver.

Adolescent↗
PubMed2001

[Carotid body tumour. Case report and literature review].

The tumour of the carotid body is rare. About 1000 cases had been reported in the literature. It may occur sporadically in 90% of cases and it affects both sexes in the same proportion and in the middle age. This tumour may be misdiagnosed if it is not suspected. Ultrasono-graphy and color-Doppler scan show a hypervascular tumour between the internal and external carotid arteries. CT-scan defines the tumour s extent on the surrounding structures. Angiography is the gold standard for diagnosis, showing a hypervascular mass displacing the bifurcation of the carotid arteries. Sometimes radiotherapy and embolization are indicated but the surgical excision of carotid body tumours is the therapy of choice. The surgical approach through incision like carotid artery operation is performed. If the subadventitial plane between tumour and arterial wall is not identified, resection of carotid artery and insertion of a shunt is required. Although the diagnosis and the surgical technique advances, the incidence of postoperative nerve injury is high in the different series. The clinical suspect and the early diagnosis are very important because low morbidity rate occurs with resection of a small chemodectoma. The surgical excision can be followed by postoperative respiratory depression or dyspnea both with regional and general anesthesia. The authors report a case of a medium size tumour operated on and developing a mild transient weakness of cranial nerve VII. Recent trends in evaluation and therapy are analysed and the literature is reviewed.

Aged↗
PubMed1998

[Continuous cervical epidural with ropivacaine in carotid surgery. Description of a case].

In the light of the recent addition of ropivacaine as a local anesthetic to our pharmacopeia, its effects at the cervical level are examined. A patient undergoing TEAC was given continuous epidural anesthesia with ropivacaine 0.5% (total dose: 167.5 mg in three hours) at C6-C7. No supplementary i.v. anesthetic was administered intraoperatively. The results obtained were compared with those of a similar case as to type of pathology and anesthetic technique, who was anesthetised with bupivacaine 0.375% (total dose: 112.5 mg in three hours-continuous epidural anesthesia) + fentanyl (0.18 mg), supplemented intravenously with ketoprophene (200 mg) + fentanyl (0.15 mg) for analgesic reasons. From this comparison, ropivacaine 0.5% was found to have greater anesthetic potential than bupivacaine 0.375%. However, it did not appear that ropivacaine exerted a protective effect on cardiovascular conditions in the course of carotid surgery. Further anesthesiologic experiences are needed to define the validity of ropivacaine in cervical surgery.

Aged↗
PubMed1994

[Colorectal cancer in old age. Our experience].

Two hundred and thirty-three patients treated for colorectal cancer during the period 1976-1991 were divided into three groups (A: < 65 yr; B: 65-74 yr; C: > 74 yr) in order to perceive possible statistically significant differences in patients older than 75 years. Epidemiological features are similar among the three groups, while a greater diagnostic delay (p = 0.013), a higher incidence of emergency procedures (p = 0.006) and a more advanced AP stage were found in group C. The high anesthesiological risk determined a conservative surgical approach only in 4.1% of patients, while a curative resection was performed on 51% of group C vs 72.7% of group A (p = 0.016). Postoperative complications and mortality for curative resections were 28% and 12% in group C vs 24.6% and 2.9% in group A (p = n.s.); the overall 5 years survival rate was 62.9%, 51.7% and 42.2% in groups A, B, and C. It is concluded that age alone should not be considered as a contraindication to curative surgery for colorectal cancer, for life expectancy and quality are considerably worse in the elderly undergoing derivative surgery.

Aged↗
PubMed1994

[Surgery of the obstructive complication of carcinoma of the left colon. The clinical problems and the authors' personal experience with 56 surgical cases].

A retrospective analysis was carried out on 56 pts., (37 M, 19 F), mean age 64 yrs., operated for moderate to severe obstruction due to left colon carcinoma. Clinical and pathological features, treatment and results were compared with those of 108 pts. with left colon cancer who underwent elective surgery. Mean duration of obstructive symptoms was 5.3 days and mean delay between admission and operation was 1.15 days. Site and nature of the obstruction were assessed pre-operatively in 80.3% of the pts. Distribution of tumor localization was similar in the two groups. ASA risk was statistically higher in pts. with obstruction. Staging according to the Astler-Coller (mod. 1978) classification, showed a greater incidence of more advanced stages in the obstructing tumors. In the group with obstruction a three stage surgery was carried out in 18 pts. (32.1%), a two stage in 6 (10.7%), a primary resection in 6 (10.7%) and a decompressive colostomy in 26 (46.5%). Radicality and resectability rates were 50% and 53.6% vs 69.4% and 82.4% in elective surgery. Mean post-operative stay was 42 and 21 days respectively in the two groups. Overall post-operative death rate was 19.6% vs 9.2%, and 3.3% vs 7.8% after resective surgery. Post-operative complications accounted for 21.4% vs 21.3%. 5-year survival rate after curative surgery was 47.8% vs 76.8%. On the basis of their results and on Literature reports the Authors suggest a reevaluation of a staged surgical treatment for obstructing left colon cancer based on primary decompression following an E.L. when needed. Consequent resection and intestinal reconstruction should be performed after 2-3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Acute complications of pulmonary hydatidosis. Apropos 44 cases].

The authors examine a series of 44 patients with an acute complication of the hydatid disease of the lung. Clinical data, diagnostic features, surgical procedures and short and long term results are compared with those of 80 cases presenting no complications. Acute complication has in many cases a non specific clinical presentation and its evidence can only be found by means of radiology. The basic principles of surgical treatment are the same of the non complicated cysts, even though resection is more often performed (56.8%) since contextual lung and bronchial involvement is frequent. The authors report no significant difference between short- and long-term results in the two series.

Acute Disease↗
PubMed1991

[Embolism of the superior mesenteric artery. A clinical experience].

The Authors report their clinical experience in superior mesenteric artery embolism: 10 arterial embolisms (71%) collected from a series of 14 obstructions of the superior mesenteric artery. The main interval from the beginning of the symptomatology to hospital admission was 48 h. Laparotomy was performed in all ten patients; gangrenous bowel was resected in 2 and 2 had an embolectomy of the superior mesenteric artery without intestinal resection. The remaining 6 patients had laparotomy alone and died. The Authors emphasize the difficulty in recognizing the disease at an early stage and suggest to contemplate in patients at risk with a persistent abdominal pain, the possibility of a superior mesenteric artery embolism.

Aged↗
PubMed1991

[Recovery after amputation for arteriosclerosis. Follow-up study].

Clinical follow-up of 71 patients subjected to major amputation of the lower extremities for atherosclerotic arteriopathy has been analysed for the purpose of ascertaining real possibilities of functional recovery and quality of life. Research results show that only a small number of patients (38%) can achieve an acceptable quality of life. The reasons have been identified in the objective difficulty of adequate physical and psychotherapeutic rehabilitation owing to structural shortcomings or the presence of associated pathology or the advance in the basic condition which does not permit application or frustrates results.

Adult↗
PubMed1991

[Local recurrence caused by direct implantation from cancer of the colon; findings of a case report].

The Authors report the case of a 60 year old woman who developed a local recurrence 3 months after a right hemicolectomy for a cancer of the ascending colon. The site of the recurrence along the suture line, the huge size of the tumor, the short interval from the first operation with its apparent radicality strongly support the origin of such recurrence from implantation. Pathogenetic mechanisms of local recurrence due to implantation metastases as well as current methods to prevent tumor seeding in colorectal surgery are reviewed. The importance of early endoscopic follow-up after colorectal resection is also stressed.

Carcinoma↗
PubMed1990

[Complementary profundoplasty. Clinical experience].

The Authors report a 68% overall success rate in a three years follow-up study of 45 "complementary" profundoplasties. The key factors with a significant prognostic effect on the clinical surgical results are the early postoperative increase of the resting ankle pressure index (I.W.) and the angiographic preoperative patency of the tibial arteries. An early postoperative increase of I.W. has been always associated with good results whereas an unchanged postoperative I.W. has always been associated with poor results; an angiographic tibial run-off (one or two or three patient tibial arteries) has been associated with significant better clinical results (p less than 0.001).

Aged↗
PubMed1990

[Endarterectomy of the internal carotid. Clinical experience].

The authors report a clinical experience on 37 internal carotid endarterectomies of 33 patients classified as: group A (asymptomatic patients); 4 patients (13%), group B (RIA); 9 patients (27%), group C (stabilized neurological lesions); 19 patients (56%), group D (acute cerebral ischemia): 1 patient (3%). Sixteen thromboendarterectomies (43%) were carried on for the prophylaxis of neurological lesions, 20 (54%) to increase and balance the cerebral blood flow in patients with stable neurological lesions, 1 (3%) for acute cerebral ischemia. The overall operative mortality was 6%, the operative morbidity was 22%. The clinical follow-up concerned 26 patients: the overall mortality was 19%: in survivors the late results were excellent. The rate of postoperative stenosis was 18%: 80% of these arteries had been treated without a patch angioplasty.

Aged↗
PubMed1989

[Primary lymphoma of the rectum].

Observation of a case of primary rectal lymphoma (123 cases described) led to a discussion of certain aspects of the condition. Although the clinical picture points to a straightforward general diagnosis of cancer, it is possible to achieve correct diagnosis using deep and multiple perendoscopic biopsy, considering the submucous origin of the lymphomas. The therapeutic approach should allow for correct staging which is only obtained by means of diagnostic studies aimed at excluding multicentric localisations. Surgery must be considered elective in stage I and II or in cases of need. Sensitivity to radiotherapy has led some authors to propose it as a primary treatment. Chemotherapy is indicated alone or in association with radiotherapy or surgery. It is also pointed out that treatment modalities are still debated because data are not homogeneous and so few cases have been reported.

Aged↗
PubMed1989

[Long-term evaluation of the treatment of perforated gastroduodenal ulcer using a median suture].

Simple suture associated with treatment using H2-antagonists has replaced gastroduodenal resection in the treatment of peptic ulcer. Forty-four patients were submitted to rafia suture for perforated gastric or duodenal ulcer (1972-1986). Fourteen were treated in the pre-H2-antagonist period and 30 in the post-H2 antagonist period. Patients were followed up: Vissick classes I and II represent 58.3% of cases in the pre-H2-antagonist period and 95.8% in the post-H2-antagonist period. Two patients from the first period were subjected to gastroduodenal resection. In no patient of the second period was further ulcer therapy necessary. In patients of the first period, oesophagogastroduodenoscopy evidenced duodenal ulcer in one case and erosive duodenitis in two cases; erosive duodenitis was present in one patient of the second period. The choice of rafia would appear to be a valid one. Follow-up after a longer period should provide confirmation.

Duodenal Ulcer↗