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Biomedical subjects

M Ortolani

Publications and source records attributed to M Ortolani.

At least 19 recordsLinked to original sources
PubMed2001

[Inguinal hernia prosthetic repair through the anterior approach].

BACKGROUND: Aim of this study is to compare the Lichtenstein's, Rutkow's and PHS techniques of inguinal hernia repair in terms of therapeutical efficacy and grade of acceptability, expressed in function of the complications, compliance and performance status of the patients. METHODS: The preliminary results of an ongoing prospective non-randomized study on the most frequently used techniques of inguinal hernia repair (PHS, Rutkow's, and Lichtenstein's) are reported. Sixty patients with primary inguinal hernia were divided into three homogeneous groups for age, gender, Gilbert's type of hernia, type of anesthesia, ASA class. The three groups underwent PHS, Rutkow's and Lichtenstein's inguinal hernia repairs, respectively. The end-points of the study were: operative time, intra- and postoperative pain, intra- and postoperative complications, patients compliance and performance status. RESULTS: The mean operative time were 40', 41' and 36' minutes for the PHS, Rutkow's and Lichtenstein's procedures, respectively. One of patients of the PHS group, five of the Rutkow's and none of those undergoing Lichtenstein's repair needed mild intraoperative sedation. Mild postoperative pain was recorded in 5% of the patients undergoing PHS repair and 10% undergoing Rutkow's repair. No intraoperative complications, difference in compliance and performance status were detected in the three groups. CONCLUSIONS: The conclusion is drawn that the PHS, Rutkow's and Lichtenstein's procedures for inguinal hernia repair are safe (no complications), effective and well accepted by the patients (85% of the patients expressed a very good judgement) although the Rutkow's repair seems more invasive. The appearance of a better trend, in patient's compliance and performance status when operated with the PHS technique, need to be confirmed in the future but, if it will be, this could became our first choice technique of repair for the medium and large hernia defect.

Adolescent↗
PubMed2000

[Short-stay surgery of inguino-crural hernia].

BACKGROUND: To evaluate the hospital stay, morbidity, and patients' compliance for short stay inguinal hernia repair. METHODS: Retrospective analysis of 669 patients (594 men and 75 women) who underwent short stay inguinal hernia repair (706 inguinal and 45 femoral repairs) at the Institute of General Surgery, University of Ferrara. Mean age was 60.7 years (range, 18-84 years). The anesthesia was: loco-regional in 495 patients (74%) and general or epidural in 174 (26%). RESULTS: Mean hospital stay was 1.2 days. Postoperative complications were: three scrotal hematomas, two ischemic orchitis, three prosthetic infections, one local anesthetic intolerance, and three high fever. Eighty-five percent of patients were satisfied of the surgical procedure in short hospital stay. Mean follow-up was 36 months. CONCLUSIONS: Short hospital stay in inguinal hernia repair is safe, effective, and widely accepted by patients.

Adolescent↗
PubMed1996

[Hernia surgery with short hospitalization].

The hospital stay of 55 patients, 47 males and 8 females, admitted to hospital for surgical repair of inguinal (53 procedures) and crural (4 procedures) hernias was analyzed. The mean age was 60.7 years (range from 25 to 82 years), local anesthesia was the method of choice (55 procedures), it has suppressed post-anesthetic respiratory and urinary troubles. The mean hospital stay was 1.18 days. One superficial skin hematoma and 1 wound infection were found, local anesthetic intolerance occurred in 1 case, and low fever in three cases. Over 90 percent of patients were favourable to short stay surgery for hernia repair at 30 days follow-up. The authors conclude on the feasibility, acceptability, social benefits and usefulness of short stay and day care surgery for hernia repair.

Adult↗
PubMed1995

[Clinical and hemodynamic effects of external valvuloplasty of the sapheno-femoral junction].

Selected patients with primary varicose vein disease and sapheno-femoral reflux as the only point of regurgitation in the affected lower limb and duplex evidence of mobile valve leaflets underwent external valvuloplasty of the sapheno-femoral junction. Operations were performed under local anesthesia in one day-surgery. One PTFE sleeve 0.4 mm thick, in average 1.2 cm long and able to uncircle a circumference in average of 1.7 cm was put around the terminal Long Saphenous vein valve, located in the last centimeter of this vein. If also the subterminal Long Saphenous Vein valve site, located 5 cm below is dilated a second valvuloplasty was performed. In 15 case we used intra-operatory video-angioscopy guide. This examination allowed us to exclude two patients with valve damages not duplex demonstrable. Furthermore angioscopy permitted immediate demonstration of restored valvular function. Follow-up lasted on average 48 months: two early postoperative long saphenous vein thrombosis, and two late sapheno-femoral reflux recurrences were the main complications. We never observed graft infection. AVP was reduced and RT, measured by the means of LRR, had a prolongation after surgery. Both measurements had an highly significant difference from a statistical point of view, comparing pre and postoperative values. 95% of the operated patients have stable varices reduction. Long Saphenous Vein patency was recorded in 37 cases (92.5%). On the contrary, after high ligation, the fate of the saphenous vein in 21% of case is the occlusion. Symptoms of venous insufficiency disappeared completely in 80% of cases and improved in 95% of the operated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Femoral Vein↗
PubMed1993

[The implantation of a heterologous prosthesis in reparative abdominal-thoracic surgery. Experience with the use of clindamycin in preventing prosthesis-related infection].

The authors point out how infection of heterologous prosthesis, widely used in surgery, can be a dramatic event. On the other hand, antibiotic prophylaxis is difficult because of the difference between "in vitro" and "in vivo" activity of many antibiotics, due to the production, by many bacteria, of the so-called glycocalyx. This would allow bacteria to clump and adhere to many surfaces, forming micro-colonies, causing delay in phagocytosis, and reducing the efficacy of antibiotics. On the basis of their, although limited, experience, the authors suggest, for the prophylaxis of prosthesis infection, the use of antibiotics such as clindamycin, able to reduce glycocalyx production.

Abdominal Muscles↗
PubMed1993

Isolated true atherosclerotic aneurysms of the superficial femoral artery. Case report and literature review.

Isolated true atherosclerotic aneurysms of the superficial femoral artery are rare. We report an original case of superficial femoral artery aneurysm (SFAA) not associated with dilatation of the common femoral or popliteal artery. The review of the literature emphasizes the great latency of the disease and the high incidence of complication at presentation, as well as, echosonographic diagnostical advantages over angiography. After surgical treatment the prognosis is favourable. Early recognition and surgical repair are recommended for patients with aneurysms of the superficial femoral artery greater at least twice the normal vessel size. Elective surgical treatment is associated with little risk to the patients and avoids the need for operation in the setting of limb-threatening ischemia.

Aged↗
PubMed1991

[Vascular microsutures with resorbable and nonresorbable sutures. A comparative study].

Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval. The results are discussed in relation to data collected from current literature.

Absorption↗
PubMed1991

[Ultrasonography of the borderline between normal and pathological state of the hip in newborn infants (borderline hip)].

Infant hips are classified, according to Graf, in 4 US types on the basis of the morphologic changes in both the cartilaginous and the bony roofs (type I, II, III, IV). Out of 6,000 examined hips, 170 (2.8%) were considered, which could be classified neither as type I (mature) nor as type II (delayed/immature ossification). These hips were called borderline hips. They exhibited some characteristic US features: good bone modeling, rounded cotyle, and alpha angle 60 degrees +/- 2. They were always observed during the first month of the patients' life. Anamnestic data were not specific (27.5% breech delivery, and 13% oligohydramnios); clinics sometimes overestimated the actual anatomic development (64/170 cases with positivity of Ortolani's sign and/or restricted abduction; 25% of patients presented with no suspicious signs). Dynamic hip examination showed only physiological cranial deflection of the cartilaginous roof. Finally, borderline hips developed into type I hips in 99% of cases, within the third month of the patients' life.

Follow-Up Studies↗
PubMed1991

[Diagnostic errors in the echography of the hip in newborns].

Neonatal hip sonography according to Graf employs a standardized image in a frontal section plane ("3-point system") and a good scanner adjustment (the femoral head must be anechoic, like the hyaline cartilage roof triangle). Pathologic conditions can change some of these parameters. The authors examined 6,000 neonatal hips in order to point out the commonest causes of diagnostic error. Two types of error were considered: method errors and interpretation errors. Method errors: they are due to the choice of transducer and frequency, to scanner adjustment and definition of the standard section plane. Their incidence was 2.25% and supported by an uncorrect definition of the standard section plane. Interpretation errors: they come from the wrong localization of some reference points--i.e., lower iliac margin, labrum--, uncorrect evaluation of increased echogenicity of the cartilaginous roof, infant age, application of radiographic criteria and uncorrect measurements of alpha and beta angles. Interpretation errors had 5.5% incidence; they were all due to the uncorrect measurement of alpha (3.18%) and beta (2.33%) angles, especially in pathological hips (68%). To reduce the number of errors, the authors suggest to strictly apply Graf's method, to make a diagnosis based on the morphological changes of the cartilaginous and osseous acetabular roof and, only later on, to measure alpha and beta angles to confirm the diagnosis or in the follow-up.

Diagnostic Errors↗
PubMed1990

[Our experience in vascular trauma of the limbs].

Progress in the management of complex vascular injuries of the limbs has not eliminated the necessity for amputations. Physicians' failure to suspect vascular injury on admission in traumatized patients causes delay in the diagnosis and management of arterial injury that ultimately leads to limb loss. High index of suspicion, early recognition by clinical evaluation, routine use of Doppler flowmeter and broad indication of preoperative angiography result in prompt repair of these lesions in the majority of cases. In managing the lower popliteal or trifurcation vessels, distal radial and ulnar artery as well as nerve injuries, the Authors believe microsurgical techniques should always be employed.

Accidents, Occupational↗
PubMed1990

[Primary gastric lymphoma].

Primary gastric lymphoma (P.G.L.), though rare, is nevertheless the most frequent non-epithelial neoplasm of the stomach. The Authors report their experience based on 18 cases of lymphoma observed from 1975 throughout 1989. Diagnostic and therapeutic problems related to the disease are stressed, uncertain in the results the former, still discussed the latter. The crucial role of surgery, either diagnostic or therapeutic, even in advanced stages, is underlined.

Adult↗
PubMed1980

[Simultaneous and independent multifocal neoplasms of the large intestine].

The Authors report the presence of two simultaneous neoplasms of the large bowel which are independent of each other from the histological point of view. The Authors point out the more interesting aspects of this particular neoplastic pathology, which creates different clinical syndromes; diagnosis and therapeutic possibilities were investigated. The frequency of these neoplasms is not exceptional, and, therefore, the possible existence even in subjects having a single tumor of the colon or rectum should not be neglected.

Adenocarcinoma↗
PubMed1980

[Geriatric surgery: a clinical and statistical contribution based on five years' experience (author's transl)].

The Authors offer a critical review of their own five-year experience in the field of geriatric surgery, with special attention to actual results obtained. From these data they conclude that the progressive improvement of said results, such as it emerges from the documentation, owes partly to the surgeon's greater ability to cope with geriatric problems in his domain, and partly to increased awareness of the resources of geriatric surgery by the lay population.

Aged↗
PubMed1980

Open reduction (Ludloff approach) of congenital dislocation of the hip before the age of two years.

The results are presented of experience in early surgical treatment of congenital dislocation of the hip, using the anteromedial approach described by Ludloff. Surgery was performed in 20 hips of 18 children, aged between 3 and 23 months, in whom conservative treatment had failed. Eleven cases were followed up for five to seven years after surgery. In 50% of the hips, additional surgery was required to correct deformities of the femoral neck or of the acetabulum. Early open reduction with the Ludloff procedure has many advantages over more traditional treatment.

Female↗