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Biomedical subjects

O Terranova

Publications and source records attributed to O Terranova.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Irrigation vs. natural evacuation of left colostomy: a comparative study of 340 patients.

A comparative study of two methods of managing left colostomy (irrigation and natural evacuation) was carried out on 340 patients who were examined and interviewed at the Stoma Rehabilitation Clinic of the Institute of Surgical Pathology of the University of Padua. Ninety-two per cent of patients who irrigated their colostomies gained fecal continence. No patient who irrigated his colostomy had any cutaneous problem, and this group had significantly better results in preventing leakage of gas and odors compared with those patients using natural evacuation. For most patients who irrigated, the ability to predict or control bowel movements overcame fears of "being dirty" and related psychological problems. These patients also had more normal social and working lives than did those patients not irrigating their colostomies. Only one patient in our series had a colonic perforation, and any chance of a repeat incident will probably disappear with the cone-shaped catheters now available. The authors conclude that in properly selected patients, irrigation is the method of choice for management of left colostomy.

Aged↗
PubMedDate not supplied

Management of the perineal wound after rectal excision for neoplastic disease: a controlled clinical trial.

Two methods of management of the perineal wound after rectal excision for neoplastic disease were compared in a prospective randomized clinical trial in 65 patients. Twenty-eight patients (Group A) were treated by partial closure of the perineal wound and cigarette drainage of the pelvic space, according to the method proposed by Gabriel. Thirty-seven patients (Group B) were treated by complete suture of the perineal wound and suction drainage of the pelvic space according to the method proposed by Altemeier. Immediate and late results were better in patients in Group B. They achieved healing per primam in 62.82 per cent of cases and had significantly shorter hospital stays than patients in Group A. Three months postoperatively, 91.42 per cent of patients in Group B and 59.25 per cent of those in Group A had complete healing of the perineal wounds, with a statistically significant difference (chi2 with Yates correction = 7.27, P less than 0.01). The development in 10 patients of Group B of perineal abscesses or hematomas necessitated reopening of the perineal wounds: however, the postoperative courses were similar to those of patients in Group A. It is concluded that healing by primary intention with use of the method described herein is the treatment of choice for managing the perineal wounds in patients undergoing rectal excision for neoplastic disease.

Abdomen↗
PubMedDate not supplied

[Usefulness of chromogranin A determination in the diagnosis of neuroendocrine neoplasia].

Neuroendocrine gastroenteropancreatic tumor diagnosis is a very difficult and expensive procedure. This study compared Chromogranin A (CgA) to Neuron-specific enolase (NSE) in 55 patients affected by neuroendocrine tumors. Advanced local or metastatic neoplasia was found in 43 patients. Radical operation was performed in 12 patients. Seventeen cases of lung microcystoma, 23 cases of other intestinal tumors and 19 patients affected by irritable bowel syndrome were used as controls. CgA sampling demonstrated sensitivity of 73% and specificity of 66%, a positive predictive value of 77% and a negative predictive value of 61% while NSE sampling showed sensitivity of 100%, specificity of 36%, a positive predictive value of 15% and a negative predictive value of 100%. CgA values demonstrated a statistically significant difference between patients with neuroendocrine tumors and tumor-free resected patients (p = 0.0015), microcystoma patients (p = 0.0087), other types of neoplasia (p = 0.01) and irritable bowel syndrome patients (p = 0.0004). No significant difference was found among the same groups when NSE values were analyzed. The high diagnostic accuracy of CgA sampling renders it very useful in early neoplastic detection, even in cases of nonfunctioning neoplasms or absence of liver metastases. In addition, CgA sampling may be an effective screening test in patients with irritable bowel syndrome or with liver or lung metastases when there is no evidence of the primitive tumor.

Adult↗
PubMedDate not supplied

[Surgical risk in the elderly].

In our Country 16% of population is over 65 years old and on 2010 a quarter of people will be over 70 years old. More over the percentage of patients over 70 years admitted in surgical departments is triple than 10 years ago and the percentage of octgenarian patients is ten times. In the last years new methods of diagnosis and care have been introduced to reduce morbility and mortality; the preoperative evaluation to define the risk factors is complex. The surgeon should respect some primary points: the patient interest, true surgical treatments, multimodal management, valid pain therapy, discharge as soon as possible, ambulatory or day hospital management, expecting and quality of life.

Adult↗
PubMedDate not supplied

[Intestinal infarction in the elderly].

The bowel infarction is till affected by high mortality in spite of new diagnostic methods and therapy. In our experience was observed about 45 patients with bowel infarction by different etiology; fast diagnosis and therapy are necessary for a good prognosis. The arteriography, at the light of this experience, is the gold standard but it is still performed in a low number of patients. The laparoscopy, in the advanced pathologies, is able to avoid an ineffectual laparotomy and permits a better diagnosis in borderline cases.

Age Factors↗
PubMedDate not supplied

[Septic shock: surgical and medical problems in the elderly].

The sepsis is a bacterial invasion of the organism producing many manifestations which are able to amplify themselves. In the United States of America there are 100,000 death per year and the incidence is among 300,000-500,000 cases. The major surgery in the elder (especially if it is in emergency) has a great percental of risk because the preoperative study isn't often complete. Fever, agitation, panting, bullation, abdominal splinting, enteroplegia, are signals of evolving inflammatory situation. Moreover there are disorders of biochemical values: leukocytosis, thrombocytopenia, increased levels of VES, PCR, amylase and biliribinaemia. The more common radiological examinations are the straight radiography of abdomen and horax, abdomen ultrasonography, CT or MRI. In the last years pro-calcitonin, interleukin-6 , C-reactive protein, and nitric oxide from endothelial and muscularis cells have been evaluated as prognostic factors in the septic shock.

Aged↗
PubMedDate not supplied

[Treatment of the early form of rectal carcinoma in the elderly].

The early rectal cancer which needs conservative surgical treatment should present some pathological characters: intramucosal site without muscularis invasion (pT1), high or moderate differentiated grading (GI-G2), no lymph node metastasis or vascular invasion. Total mesorectal excision is the gold standard for these neoplasms and permits very low resection or colo-anal anastomosis with sphincter function preserving. However, this type of surgery has still a high percentage of postoperative morbidity and mortality (some authors report respectively 40% and 5%). Therefore the local excision in selected cases is able to preserve the sphincter function and to reduce the postoperative complications with high probability of recovery.

Aged↗
PubMedDate not supplied

[Therapeutic strategy in neoplasia of the pancreas and ampulla].

The major symptoms of periampullary neoplasia are jaundice, lowering of weight, abdominal pain extending behind; diabetes, pancreatitis or exocrine pancreatic failure are uncommon. In the last years, surgery has been considered as the gold standard of the therapy because new technologies are able to reduce morbility and mortality. In the too advanced neoplasia, palliative surgical care permits better survival and quality of life. The duodenopancreatectomy today has a low perioperative mortality (0-3%) and an acceptable survival (15.25%). Good results were found for palliative surgery in unresectable neoplasms while in the inoperable patients we consider endoscopic and radiological treatments better than chemotherapy because they are able to correct the jaundice, improving quality of life (but not survival).

Aged↗
PubMedDate not supplied

Anal fistulas with recess above the anal levators.

The Authors present their experience with anal fistulas with recess above the levators. They mainly analyze the diagnostic, clinical, instrumental and therapeutic problems which this type of anal fistula may present.

Humans↗
PubMedDate not supplied

Perforations of the extraperitoneal rectum during barium enema.

Rectal injuries during barium enema are uncommon but not unusual complications. Radiologists and surgeons must be able to recognize them, as early diagnosis is essential for effective treatment. The Authors discuss various aspects of problems arising from rectal perforation, and report their experience on seven cases.

Aged↗
PubMedDate not supplied

Local recurrence of rectal cancer: anterior resection versus abdomino-perineal resection.

Local recurrences of rectal cancer after surgical therapy are a mainly diagnostic and therapeutic problem. The Authors report their experience in local recurrences of rectal cancer. They consider anterior resection versus abdomino-perineal resection, the type of anastomosis and the stage of primary disease. Follow-up is discussed emphasizing early diagnosis for local recurrences.

Adult↗
PubMedDate not supplied

[Local anesthesia in hernia surgery].

After a short historical outline, the advantages of, the indication for, and the contraindications for local anaesthesia in hernial surgery are considered. The principal pharmacological characteristics of the most widely-employed local anaesthetics are set out. Preoperative preparation of the patient, intraoperative monitoring and the technique of local anaesthesia employed by the authors are described in detail.

Anesthesia, Local↗
PubMedDate not supplied

[A proposed classification of inguinocrural hernias. The classification of hernias in the inguinal and crural regions in the adult as a function of their surgical therapy].

Surgery for the treatment of inguinal and femoral hernias has recent years acquired numerous increasingly modern, innovative techniques. This has been possible thanks modern, innovative techniques. This has been possible thanks to the introduction of prosthetic material which is better tolerated by the tissues and to the utilization of new ways of approach. A new method of hernia classification, no longer based on anatomical criteria but on a broader evaluation which takes multiple aspects into account, is now needed to decide on valid criteria for choice of operation, at the same time expressing themselves in a common language which will allow the results to the verified.

Adult↗