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R Bassi

Publications and source records attributed to R Bassi.

112 records · Page 7Linked to original sources
PubMedDate not supplied

[Surgical treatment of varicocele. Our experience in the last 10 years].

UNLABELLED: Varicocele means a varicose dilatation with stretching of the veins in the pampiniform plexus. In the last years the problem of varicocele has emerged again in all its importance for the increasing of couple sterility which, in Italy, is certified to 13%. It is known that this problem is connected to anomalies of the spermiogram, even in the subclinical forms located with the ultrasound method, and that the surgical operation allows to correct in a high percentage of cases. MATERIALS AND METHODS: For treatment of varicocele we use a technique with inguinal approach of 5-6 cm and isolation of all the dilated veins intra- and extrafunicular. After their ligation and section we transpose the funiculus proximally with a little traction on the testicle and we fix it to the great oblique muscle fascia, using margin of cremasteric muscle prepared in advance and distal stumps of resected veins. This manoeuvre forms a short ansa of the funiculus that, in the orthostatic position, helgs to stop the hematic column which weighs on the testicle. This operation has been performed in 54 patients. In 18 (60%), oligoastenospermia was present and 10 (33%) had consulted their physician for sterility problems (4 of them with a sub-clinical varicocele). The patients have been recalled for clinical and echo-doppler control as well qualitative evaluation of the sperm. The follow-up goes from 8 months to 7 years. RESULTS: We have noticed the presence of six relapses (13.3%) so divided: 4 relapses with a first grade reflux; 1 relapse with a second grade reflux and 1 relapse with a third grade reflux. Only in two patients with first grade reflux was the spermiogram normal, while in all the others oligoastenospermia persisted. Seric evaluation of testosterone and androstenedione have excluded hormonal causes of sterility. Among the 10 sterile patients 6 (60%), had a normalization of the spermiogram and 4 of them (2 of which with preceding subclinical varicocele), had a partner pregnancy in periods within 7 and 18 months after the operation. CONCLUSION: On the basis their experience, the authors confirm the validity of the selective varicocelectomy by inguinal approach, with probable further advantage using funicular transposition. To agree with other authors there isn't any very important advantage, in the cost/benefit ratio, between microsurgical diversion and laparoscopic surgery, and traditional varicocelectomy in local anesthesia. The incidence of relapses noticed (13.3%), lower than that rated at the high ligature (29%), is the expression of the anatomic complexity of the spermatic venous drainage, in such a way to think right a phlebographic anterograde intraoperative evaluation. We also confirm the importance of ultrasonographic and ecographic methods in the pre and postoperative evaluation, we underline that, in the subclinical cases, it is possible to verify spermiogram alteration corrected, in a high percentage, by varicocelectomy.

Adult↗
PubMedDate not supplied

[Biopsy with large diameter needle in breast lesions].

INTRODUCTION: Breast cancer is the most ordinary cause of death by cancer in women whose ages range from 40 to 50. A primary prevention is impossible, so early diagnosis to improve the prognosis of the disease is necessary. A great importance is given to clinical examination and mammography that, however, has a limited specificity; so a biopsy is required for diagnosis. Surgical biopsy achieves this objective but isn't well accepted by patients and the costs/benefit ratio isn't always advantageous. That's why, in recent years, the use of fine needle aspiration has spread widely. However it is invalidated by an incidence of false negatives (5%-20%) and by a percentage of "inadequate", results of around 10%. The authors report the results of a technique of macrobiopsy with a needle to a large diameter in 60 women with radiologically suspect breast lesions. MATERIALS AND METHODS: Since April 1990 to the present we have subjected 60 women with radiologically suspect mammary nodules with a diameter from 1 to 3 cm (means 1.2 cm) to a needle biopsy. The technique used is extremely simple and it requires the use of a needle with a diameter of 14 gauges, 114 mm long and with an automatic mechanism that grants an extremely precise taking. RESULTS: 35 (58%) of the tested women have been subjected to an operation and the histology confirmed the diagnosis. Other 25 (42%) women whose negative biopsy was followed by semestral clinical examination and with mammography once a year. None of them has developed a neoplastic disease. DISCUSSION AND CONCLUSIONS: Surgical biopsy is the only safe test for the radiological suspicion of mammary lesions. In our experience large diameter needle biopsy that we have used combines the advantages of surgical biopsy with less invasivity. As a consequence we have better patient tolerability and lower incidence of false negatives in comparison with the cytological examination on fine needle aspiration that is often limited by inadequacy of the material. The proposed technique can be used in the out-clinic and could be made even more precise by the TRC mammotest or echography that enables to lead the needle into the lesion with a greater precision.

Adult↗