Biomedical subjects

Paolo Bianchi

Publications and source records attributed to Paolo Bianchi.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Gastric bezoars after adjustable gastric banding.

BACKGROUND: Gastric bezoars may develop in the proximal pouch after gastric restriction. METHODS: Of 299 patients who underwent laparoscopic adjustable gastric banding (LAGB), 4 developed gastric bezoars at different intervals after surgery (24 days, 8 months, 18 months, and 6 years). RESULTS: Symptoms of high dysphagia and vomiting occurred in all 4 patients. Removal of the bezoars via endoscopy was uneventful, and all patients have maintained their gastric band. Patients were emphasized to avoid rapid intake of high-residue cellulose foods, and to achieve complete mastication. No bezoar has recurred in these patients at 7 to 75 months further follow-up. CONCLUSION: Gastric bezoar should be considered after LAGB if the patient complains of persistent high fullness and vomiting.

Adult↗

PubMedDate not supplied

Perspectives and drawbacks of minimally invasive surgery for hepatocellular carcinoma.

The need for an accurate intrahepatic staging is crucial for patients with hepatocellular carcinoma candidates to an aggressive surgical or ablative treatment. Currently available data indicate that laparoscopy with laparoscopic ultrasound provides information similar to that obtained by intraoperative ultrasound and it is able to identify small intrahepatic lesions not diagnosed by preoperative imaging techniques. Furthermore, laparoscopy with laparoscopic ultrasound also allows performance of ultrasound-guided biopsies or interstitial therapies as ethanol injection, cryoablation or radiofrequency thermal ablation in the same session. A laparoscopic segmentectomy or subsegmentectomy is technically feasible and safe in selected patients with small peripheral tumors. Combinations of resection and ablation may be required in certain cases, extending the indications for the laparoscopic approach to hepatocellular carcinoma in liver cirrhosis. The AA review the technical issues and the preliminary results of their experience in the field of minimally invasive approach to hepatocellular carcinoma. On the basis of these preliminary findings, laparoscopy with laparoscopic ultrasound seems to be useful to identify unsuspected new nodules and to help in choosing the most suitable treatment. In case of hepatocellular carcinoma not amenable to surgical resection, laparoscopic radiofrequency represents a safe and effective treatment above all when the percutaneous approach is difficult or impossible. Furthermore, laparoscopy with laparoscopic ultrasound could represent a sound preliminary examination in patients who are candidates to liver transplantation in order both to improve the staging and to guide an interstitial therapy as a bridge to the transplantation itself.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

A prospective comparison of endorectal ultrasound and pelvic magnetic resonance in the preoperative staging of rectal cancer.

BACKGROUND: The development of new surgical modalities (local excision, coloanal-anastomosis) and the diffusion of preoperative neoadjuvant therapy, has increased the importance of an accurate preoperative staging in patients with rectal cancer. The aim of this study was to compare the accuracy of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) in the local preoperative staging of rectal carcinoma; moreover the two methods were assessed with a concordance K test. METHODS: Twenty-nine patients with rectal carcinoma were staged with EUS and body coil MRI and then underwent radical surgery. The preoperative staging was compared with the histologic findings of the operative specimen. RESULTS: EUS was more accurate (79.3%), with better sensibility (90%), positive predictive value (PPI9 (85.7%) and negative predictive value (NPV) (25%) than MRI in the evaluation of T parameter. MRI was more accurate (72.4%), with better specificity (81.2%), PPV (72.7%) and NPV (68.4%) than EUS in the evaluation of N parameter. The concordance test obtained a K value of 19.8% for the T parameter and 34.2% for the N parameter. CONCLUSIONS: EUS and MRI are complementary methods in the preoperative staging of rectal cancer. EUS is more accurate in determining bowel wall penetration of the tumor, while MRI is more accurate in the evaluation of lymph node involvement. The low value of the K index confirms the complementarity of the two examinations. Further studies with new imaging techniques such as endocoil MRI, external phase-arrayed coil MRI and three dimensional ultrasound are needed to identify the most effective single examination in the preoperative staging of rectal cancer.

Adult↗

PubMedDate not supplied

Carotid body tumours. A 20-year single-institution experience.

The aim of this single-institution retrospective study was to review the surgical outcomes of resection of carotid body tumours over the last 20 years in our hospital. From January 1985 to December 2004, 17 patients were admitted to our institution with carotid body tumours. All patients were treated by surgical resection of the tumour. No perioperative deaths occurred. Perioperative comorbidities were more frequent in patients with large carotid body tumours intimately associated with the carotid vessels. Surgical excision of carotid body tumours is safe and effective even in the long term.

Adult↗