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Biomedical subjects

R Domini

Publications and source records attributed to R Domini.

At least 19 recordsLinked to original sources

[New technic for the treatment of high intraabdominal cryptorchism: testicular autotransplantation with venous anastomosis only].

A new technique in the treatment of high intraabdominal cryptorchidism is proposed: testicular autotransplantation with venous anastomosis only. The technique consists in performing microsurgical anastomosis of the spermatic vein and homolateral inferior epigastric vein only for adequate venous drainage, leaving irrigation of testis to the deferential artery alone. We have utilized this technique in 16 cases and excellent results have been achieved. It has permitted performing surgery in younger patients (2 years). Surgical trauma and the duration of the operation are less compared to the Silber technique. There is a higher success rate and the procedure is easy to perform.

Anastomosis, Surgical↗

[Sex change in children with Morris syndrome].

Eleven boys with Morris syndrome underwent feminizing genitoplasty utilizing a segment of the sigmoid colon for neovaginal reconstruction. Bilateral orchiectomy was performed for cosmetic reasons and to prevent neoplasms. Patient follow-up ranging from 6 months to 13 years have demonstrated good results were obtained. No intra- or postoperative complications were observed. Patient psycho-social-sexual identification and satisfaction were achieved.

Adolescent↗

Prenatal diagnosis and management of fetal ovarian cysts.

Congenital ovarian cysts are a pathological condition which can be diagnosed in utero by ultrasound. We report 14 consecutive diagnoses of fetal ovarian cysts, obtained in the second and third trimesters of pregnancy. Congenital ovarian cysts have almost invariably a good prognosis, and no change in the standard obstetrical management is required. However, the evolution of the disease in utero is extremely variable. The cyst may increase in size, decrease or even disappear, or undergo complications such as torsion and rupture, which may carry some risks to the fetus. When a fetal ovarian cyst is detected, serial ultrasound examinations should be performed. If one of the above complications is suspected, the option of prompt caesarean section should be considered.

Cesarean Section↗

Prenatal diagnosis and obstetrical management of multicystic dysplastic kidney disease.

Multicystic dysplastic kidney disease (MDKD) is one of the most common congenital renal anomalies. We report 16 consecutive cases of MDKD recognized in the antenatal period by sonography. Diagnosis is usually easy as MDKD has in the vast majority of cases a striking ultrasound appearance including enlargement of the kidney and multiple renal cysts. However, differentiation from obstructive uropathy may be difficult, and we made a total of five erroneous diagnoses. Unilateral MDKD has almost invariably a good prognosis. However, severe life-threatening associated anomalies were found in six cases. Therefore, a detailed survey of fetal anatomy and determination of karyotype are strongly recommended.

Diagnostic Errors↗

Genitourinary tract anomalies: neonatal surgical problems.

This paper is based on our experience in managing 79 cases of genitourinary tract anomalies diagnosed in utero and treated after birth. These babies seldom present as emergencies, and the antenatal diagnosis can usually be confirmed in the first few days of life. The surgical correction of these babies requires the services of a surgeon skilled and experienced in neonatal surgery. Surgeons experienced only in adult surgery may find these procedures technically difficult. Magnification is recommended. Postoperatively careful attention to fluid and electrolyte balance and correct functioning of drainage tubes is stressed. Antibiotic prophylaxis is vital, as is long-term follow-up.

Humans↗

Anorectal manometry in the diagnosis of Hirschsprung's disease--comparison with clinical and radiological criteria.

In 34 consecutive patients in whom the diagnosis of Hirschsprung's disease (HD) was suspected, the reliability of clinical symptoms, radiological parameters, and anorectal manometry was retrospectively and blindly evaluated by three independent investigators. In 19 patients the diagnosis of HD was histologically proved, while in the remaining 15 cases the diagnosis of idiopathic constipation was justified by persistent success of medical treatment at regular follow-up. Anorectal manometry was correctly diagnostic in all the patients who were examined. The recto and inhibitory reflex, recorded in all the patients with idiopathic constipation was absent in patients suffering from HD. Moreover, other manometric parameters, peculiar to HD were found: a significant lower anal resting pressure and pain threshold, as well as a decreased frequency of spontaneous rhythmic oscillations. The reliability of radiological and clinical data for these diagnoses appeared to be inadequate. Therefore, the diagnosis of HD can be confidently stated only on the basis of manometric investigations.

Adolescent↗

[Malignant primary tumors of the liver in childhood].

Twenty-one children (16 males, 5 females) with malignant primary hepatic tumors were admitted to the Pediatric Clinic of the University of Bologna between June 1973 and July 2001. The diagnosis was hepatoblastoma (HBL) in 16 cases; hepatocellular carcinoma (HCA) in 3 cases; undifferentiated sarcoma in 1, malignant rhabdoid tumour of the liver in 1. Median age at diagnosis was 1.8 year (1 mounth-13 years). As to intrahepatic tumor's extension, patients were classified in groups (from I to IV) according to International Society of Pediatric Oncology staging. 2 patients were ascribed to group I; 9 to group II; 9 to group III and I to group IV. At diagnosis 3 pts presented lung metastases. Seventeen patients (81%) were treated with surgery, in 11 cases as first approach to the tumor. In 10 patients, initially with unresesectable tumor, chemotherapy was started first. Drugs used were mostly Cisplatinum or Carboplatinum with Doxorubicin. Sussequently 6 patients were submitted to surgery. At a median follow up of 12.5 years, 52.3% of patients is alive without disease. This percentage rises to 58% taking into consideration only HBL and HCA cases (alive 11/19). We conclude that excluding metastases at diagnosis (3 deaths), the main prognostic factor is resectability and radical surgery: in our experience 4 patients with unresectable tumor died, as 2 patients with microscopical residual after surgery.

Algorithms↗