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Biomedical subjects

M Salibra

Publications and source records attributed to M Salibra.

33 records · Page 2Linked to original sources

[Retroperitoneal neurilemmoma (anatomo-pathologic and clinical considerations)].

After extensively reviewing the literature on primary retroperitoneal tumours, the authors present a case of retroperitoneal neurilemmoma. They stress the rareness of this disease and go on to discuss the related epidemiological, histogenetic and anatomo-pathological problems. Finally, they deal at some length with the symptoms of the disease and the diagnostic strategy they adopt, emphasizing the usefulness of CT and ultrasonic tomography in the study of the retroperitoneal region.

Humans↗

[Liver scintigraphy using 99mTc-HIDA in the study of biliary-digestive anastomosis].

Surgical operations characterised by the creation of a bilio-intestinal anastomosis are becoming an increasingly frequent procedure in bile tract surgery. Just as frequent and well known are the immediate and longer-term postoperative sequelae. Thus, one of the problems which has always interested surgeons and investigators is how best to monitor the functional efficiency of the anastomosis. Traditional x-ray methods, including highly invasive examinations such as PTC and ERCP, as well as the harmless ultrasound procedures do not provide an adequate picture of the functional efficiency of such anastomoses, the only wholly valid and efficacious method being sequential scintigraphy with 99mTc-Hida. On the basis of these principles, the authors describe their experience in this field, stressing the validity of the method, which enables surgeons to study the morphology and, above all, the functional efficiency of bilio-intestinal anastomoses.

Adult↗

[Clinical comments on a case of retroperitoneal lipoma].

The authors show a case of retroperitoneal lipoma, histologically ascertained; they state its origin and the clinical features, and analyse the different diagnostical methods, particularly dwelling upon urography, TC and selective arteriography. They, at last, point out such pathology, although benign, is burdened by a high risk of relapses and by the possibility to turn into malignant. As a conclusion, they assert the importance of the radicalness of the intervention, joined to bioptic drawings in different parts of the tumor extirpated, with the purpose to identify, as precociously as possible, an eventual malignant degeneration of the same lipoma.

Diagnosis, Differential↗

[Clinical considerations on diverticula of the duodenum].

The authors, in the light of the data supplied by the literature, and through a careful analysis of their recent casuistry, based upon the observation of 48 cases of duodenal diverticula, propose a modern reviewing of the topic. After illustrating the etiopathogenetic, anatomo-pathological and clinical features of such disease, the Authors dwell upon the diagnostic and therapeutical problems involved, and point out the importance of a correct diagnostic iter and a consequent exact surgical indication. As a conclusion, they affirm the surgical treatment of duodenal diverticula, not exempt from risks, should be only reserved to cases rebellious to the medical treatment or severely complicate.

Diverticulum↗

[A case of intestinal occlusion caused by a Meckel' diverticulum (etiopathogenetic, diagnostic and clinical considerations)].

The authors show a case of acute intestinal stoppage due to Meckel's diverticulum. After some notices about embryogenesis, pathological anatomy and symptomatology of Meckel's diverticula, they point out the difficulty to reach the diagnosis of such disease, which almost always is only done subsequent to the appearance of complications, such as: intestinal stoppage, inflammation, ulceration, perforation, neoplasms, bleeding. In fact, the diagnosis of Meckel's diverticulum is exceptionally preoperative and difficult on the basis of the symptomatology only, for which the disease can be responsible, whereas it can be more easily placed thanks to the contribution of instrumental methods, such as: barium meal, opaque enema, scintigraphy with 99mNa pertechnetate, selective arteriography of upper mesenterial artery. The diagnosis is more frequently interoperative, in course of explorative laparotomy or performed for other indications. Then the Authors state their orientation about the treatment, which is surgical in all the complex cases of Meckel's diverticulum, with a mention of the different operative techniques, and, as a conclusion, confirm the necessity for the systematic research of the asymptomatic diverticulum, the removal of which represents the only prophylactic measure against a permanent possibility and dreadful complicative evolution of same.

Humans↗

[Results in the use of immunochemotherapy in patients with cutaneous malignant melanoma].

The Authors, after emphasizing melanoma still now represents one of the most aggressive malignant tumours, state the chemoimmunotherapeutic protocol they used in the treatment of this neoplasm. Then, on the basis of the results obtained, they affirm that, although malignant melanoma is considered from long time as a scarcely chemosensitive neoplasm, remarkable advantages can be got through the use of monochemotherapy, especially in association pith the immunotherapy. In fact, by associating both protocols, chemotherapeutic and immunotherapeutic a significant improvement in the prognosis of such neoplasm was obtained, as to both the indices of survival and the gap free from illness.

BCG Vaccine↗

[Anal carcinoma].

The authors, want to demonstrate the operation of abdominal perianal rectum amputation, and it is considered absolute, even 80 years, in the treatment of the anal neoplasia, it is superseded by alternative methods represented by protocols radio-chemo-therapeutic associated or less to the surgery treatment. They make then a retrospective valuation since 1963 till our days on 54 patients. In the 6 patients (stadium I-II) treated after 1982 with protocols of freemall, it is was obtained disappearance of the neoplasia about 50% the cases. On overcoming of the results there was in a second group of 8 patients (1987) treated always with protocol of Greenall, in 5 of these (62.5%) could observe absence of remaining of disease. In the third group (1993) on 8 patients treated with therapy fixed radio-chemo, it was registered the absence of the residual of illness in 6 patients(75.5%). Finally, from the analysis of patients observed in the last seven years, 5 of which suffered by Ca squamous in different evolutive stadium (one I stadium, three II stadium and one stadium III-B), the stadium I and II were treated with the protocol radio-chemotherapeutic obtaining total remission of the disease in the 100% of the cases. In the follow-up of 45 patients, 12 of whose were treated with the therapy combined radio-chemo and of these 10 were valuable for survival to 5 years which was about 70% superior to patients treated with only surgery therapy.

Anus Neoplasms↗

[Clinical considerations of jejunal carcinoma].

The carcinoma of the jejunum represents 3-6.5% of gastric intestinal tumors and 33-50% of small intestine carcinomas. The observation of a case of jejunum carcinoma has offered the authors the idea for a critical revision on the subject. After an examination on the diagnostic, anatomopathological, clinical and therapeutic problems, the authors underline the importance of the precocious diagnosis of neoplasia; in fact the jejunum carcinoma is characterized by a hidden and aspecific symptomatology and by dangerous evolution; besides the site is difficult for an organic study with the common methods of investigation. Therefore, in all patients in whom the suspicion of a jejunum pathology exists, it is indispensable to carry out a precise diagnostic iter which is based on radiological endoscopic and tomographic investigation: in fact the small intestine and the jejunum in particular are intestinal tracts that are explored with difficult and therefore at times only an accurate effecting of the radiological study can permit a precocious diagnosis the only valid supposition for the carrying out of a truly radical surgical therapy and for the acquiring of a batter prognosis.

Adenocarcinoma↗

[Care and rehabilitation of colostomized patients].

The enterostomies represent the result of a surgical operation that we have been carrying out more frequently in the last few years both on account of the neoplastic and inflammatory pathology of the large bowel; in fact about 40,000 colostomies are effectuated in Italy every year. On the basis of what has been said, the problem of assistance and of rehabilitation of the patients with colostomy assumes great importance. Therefore the authors have examined the various phases of the assistance (pre, intra and post-operatory) and they have underlined the rehabilitation of such patients. They conclude by affirming that it is indispensable to have a multidisciplinary collaboration to insure a correct assistance and rehabilitation, which involves the surgeon, the radiotherapist, the enterostomist, the psychologist and the oncologist; only in this way will they be able to restore to society these patients capable of living the rest of their lives if not happy at least serenely.

Colon↗

[Barrett esophagus. The diagnostic and therapeutic aspects].

The authors, after a dissertation on the aetiopathogenesis of "Barrett's oesophagus", dwell on the precancerous nature of this pathology involving the oesophageal-gastric junction. Its frequent association with cancer explains the necessity for an accurate follow-up in these patients: many investigations can be useful, the radiological study of oesophagus and stomach, manometry, pH-metry, but an irrefutable diagnosis can only be achieved through endoscopy, which makes possible a histological examination of the bioptic fragments. The authors also deal with the ideal therapeutic strategy and differentiate the cases in which the pharmacological therapy is more appropriate from those that need a surgical approach.

Adenocarcinoma↗

[Laparoscopic cholecystectomy: the complications].

The authors report their experience of 48 consecutive cases of colecystectomy performed using a videolaparoscopic technique. Laparoscopic surgery was not successful in only two patients in whom it was necessary to resort to laparotomy; bile duct injury occurred in one patient. On the basis of their experience the authors conclude by affirming that this videolaparoscopic technique may be applied to almost all patients requiring cholecystectomy since it offers considerable advantages over traditional techniques.

Biliary Tract↗

[Carcinoma of the gastric stump].

After having emphasized that carcinoma of the gastric stump represents a "major" risk in patients undergoing gastric resection, the authors describe the physiopathology of the new anatomical and functional status of the gastroenteric apparatus and underline the probable etiopathogenetic stages attributable to carcinogenesis. They then describe the treatment of this neoplasia with a marked aggressive character and conclude with the affirmation that the surgeon's efforts must be focused on the correct execution of gastroresection and the follow-up of gastro-resected patients in order to allow the early identification of precancerous conditions and therefore the commencement rational oncological prophylaxis.

Adult↗