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Biomedical subjects

R Fornaro

Publications and source records attributed to R Fornaro.

49 records · Page 3Linked to original sources
PubMedDate not supplied

[Surgical treatment of Crohn's disease complications. Our experience].

Thirty-five patients with Crohn's Disease (CD) were observed: 18 have been treated with medical therapy and 17 (48.6%) underwent to surgical treatment : 1) intolerance to the medical treatment in 5.9% (1 case); 2) local complications in 94.1% (16 cases: 6 stenosis, 2 occlusions, 3 abscesses, 3 fistulas, 1 perforation with peritonitis, 1 case toxic megacolon). The operations have been 19: resective interventions 14 (bowel and/or colon resections), conservative interventions 5. The mortality was 0, the morbidity 35,29%. The incidence of the recurrences in a follow up of 5 year was 42,9%. The Authors conclude that the surgery, indicated for the treatment of complications, can be resective surgery (perforating Crohn disease: fistulas, abscess) or conservative surgery (stenosing Crohn disease: stenosis). Recently the conservative intervention are proposed in the treatment of fistulas and abscesses too, but when the inflammation is mild and in patients that underwent to extensive intestinal resection with risk of short bowel syndrome.

Abdominal Abscess↗
PubMedDate not supplied

[A case of small-cell carcinoma of the rectum].

A case of oat-cell carcinoma of the rectum prompted the authors to undertake a review of the literature. The main histological aspects allowing an accurate diagnosis are stressed. This is a rare form of highly malignant neoplasm of uncertain origin (probably similar to that of carcinoids) with a very marked tendency to metastasize, even to distant organs; it is characterized by substantial cellular polymorphism with small-sized elements, very little cytoplasm, a large hyperchromic nucleus, barely visible nucleoli and histochemical reactions typical of neuroendocrine cells.

Carcinoma, Small Cell↗
PubMedDate not supplied

[Treatment of breast carcinoma. Our experience].

The results of a study on 848 patients with breast carcinoma having maximum diameter less than or equal to 2 cm, that underwent a surgical treatment at the Institute of Special Surgical Pathology B (1980-82) and at the Institute of Surgical Clinic I (1980-89) are presented. The study has the purpose of evaluating, by the analysis of ten years surviving curves, the effectiveness of different types of interventions: Halsted radical mastectomy (98 patients), Patey radical mastectomy (245 patients) and Madden radical mastectomy (151 patients), quadrantectomy (260 patients). The age of patients ranges from 29 years to 92 years (average 56 years). The 68.04% of all tumors have resulted invasive ductal carcinoma (NOS) the 9.08% lobular carcinoma. Of the 848 patients included in the study 698 are alive at the end of the follow-up, with a survival rate, calculated with the actuarial method, equivalent to 63.38%. Results show the survival is independent of the type of surgical treatment (71.9% for quadrantectomy; 70.7% for Halsted radical mastectomy, 68.9% for Patey radical mastectomy; 70.7% for Madden radical mastectomy).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Excision of a schwannoma of the neck: surgical technique].

We present a case of schwannoma of the neck in 49 year old man, symptomatic (paresthesia, cervical mass and dysphagia). After ultrasonography and magnetic resonance of the neck, the patient was operated and excision of the lesion was completely performed. The operation was performed through a cervical approach: the nerves and the vascular and muscular structures were carefully isolated and preserved. The tumour arised from the cervical sympathetic chain. The diagnosis of schwannoma was possible only by histopathologic examen. After 48 months no local recurrence or postoperative complication related to intervention were found. These lesions are uncommon. The identification of the nerve is often difficult until the operation, which is the treatment of choice for the schwannoma.

Head and Neck Neoplasms↗
PubMedDate not supplied

[The ileocecal valve as a prognostic factor in extensive resection of the small intestine].

The aim of the study was to examine the role of the ileocaecal valve in relation to the nature and extent of symptoms following extensive bowel resection (EBR) in 13 patients with short bowel syndrome (SBS) referred to our department over the period 1962-1988. The results obtained do not allow us to assess the effective role of the ileocaecal valve in determining the severity of SBS. The factors conditioning the extent of the aftermath of EBR and effectively affecting prognosis are, in fact, multiple and act in various interrelated ways, thus making it difficult to define the precise role of any one of them. The ileocaecal valve, however, does play a substantial role, in that, on the one hand, it performs sphincter and barrier functions against ileocolic reflux of bacteria, while, on the other, its removal involves excision of the right colon (reserve area for reabsorption of water and ions) and of the terminal ileum (a site specialized in absorption of vitamin B12 and bile salts).

Adult↗
PubMedDate not supplied

[Leiomyosarcomas of the small intestine].

The main clinical and anatomico-pathological aspects of small bowel leiomyosarcomas are stressed. These are rarely observed malignant tumours, which sometimes prove difficult to diagnose and have a poor prognosis. Also characteristic is the substantial difficulty often encountered in defining the malignancy grade histologically.

Humans↗
PubMedDate not supplied

[Obstructive jaundice caused by residual and/or recurrent choledochal lithiasis: endoscopic and surgical treatment].

Results of surgical and endoscopic treatment in 79 patients (58 females and 21 males, age 40-89, mean 62), affected with jaundice, due to secondary choledochal lithiasis, are reported. Thirty-four patients (43%) underwent surgical operation: choledochotomy and T-tube 12, choledocho-jejunostomy 4, choledochoduodenostomy 3, papillosphincteroplasty 15. In 45 patients (57%) EST has been performed. Comparison of results has been obtained after 30 days and after 3-105 months (mean 49). Optimal results have been achieved in 94.9% of patients: 100% after surgery and 94.1% after EST. Morbidity and mortality outcomes in patients who underwent EST (11.1% and 0% after 30 days respectively, 8.1% and 8.1% after several months) are better compared to those ones after surgical treatment (17.6% and 5.8% after 30 days, 20% and 16% after several months). We conclude that EST is nowadays the therapy of choice in patients with jaundice due to choledochal lithiasis, either relapsing or residual.

Acute Disease↗
PubMedDate not supplied

The Angelchik prosthesis in the surgical therapy of reflux oesophagitis. Short and long term results.

The authors report the results acquired from 1981 to 1985 using the Angelchik prosthesis in 22 patients with reflux oesophagitis resisting medical therapy for more than 6 months. Clinical evaluation has been done using Visick scale, as modified by Deakin. Clinical and instrumental controls have been done at 1 month, 12 months and 5-10 years after the operation. Intraoperative mortality and morbidity were zero. Complications directly related to the operation were: transitory dysphagia in 4 cases, persistent dysphagia in 3 cases, transitory gas bloat syndrome in 1 case and persistent gas bloat syndrome in another, persistent stenosis in 1 case and prosthesis dislocation in 6 cases. Clinical results were satisfactory (success rate: 90.9%) only in patients with a short term follow-up (30 days). The full rate of success has come down to 84.2% and 66.6% in patients having follow-ups respectively of 1 year and 5-10 years. The results are truly disappointing and the authors conclude that this procedure is not to be employed.

Adult↗
PubMedDate not supplied

[Hepatic cysts: a case report and anatomicopathological and clinico-therapeutic considerations].

The recent observation of a case of non-parasitic cyst of the liver brought the authors to a literature review. A 62 year old male, affected by type 2 diabetes and hypertension, after a CT scan and ETG, underwent resection and "capitonnage" of the cyst. Three months after surgery a CT scan showed a complete repletion of the cavity previously occupied by the cyst as a consequence of regeneration and reorganization of the hepatic parenchyma. In conclusion, hepatic cysts are rare and clinically relevant only when huge. The diagnosis is possible with the use of ETG and CT scan of the abdomen, however, in some cases angiography is also useful. The intervention of choice is the "capitonnage" of the cyst.

Cholecystectomy↗
PubMedDate not supplied

[Carotid surgery and its monitoring in our experience].

Carotid endarterectomy (CEA) is the elective surgical procedure to prevent stroke due to stenosis of the carotid bifurcation. During a period of 17 years the Authors performed 215 operations on the carotid arteries of 168 patients. The average age was 64.6 and the male/female ratio was 3/1. Patients were symptomatic in 75.8% of cases and asymptomatic in the remaining 24.2%. Preoperative investigations consisted of echo-Duplex scanning, arteriography, cerebral CT or MRI. Indications for surgery were: stenosis wider than 70% in 173 cases, ulcerated or "high-risk" stenosis in symptomatic patients in 37 cases, and carotid malformation in 5 cases. The intraoperative use of shunt (12% of the operations) was selective, depending from the results of our monitoring system: stump pressure and transcranial Doppler (TCD) of the middle cerebral artery (MCA) ipsilateral to the procedure. The global major stroke/mortality rate was 3.3% (7/215), the minor morbidity was 8.8% (19/215). Mortality rate was 0.5% (1/215). The major stroke/mortality rate for symptomatic patients was 4.2% and for asymptomatic patients was 0%. The average follow up was 58 months (range 1-192) for 200/215 patients, with 15/215 patients (7%) lost. The postoperative incidence of stroke after 4 years was 8.5% (17/200), with an annual mortality rate of 1.6% (min. after 2 months, max. 118, average 55 months). CEA is a safe procedure to prevent cerebral infarctions, but it still carries an operative risk. A better monitoring would allow to understand the mechanisms of clamp-induced ischaemia and prevent it, therefore decreasing the operative risks and extending the surgical indications to a higher ratio of asymptomatic subjects. TCD is becoming essential for our goal: it is useful in deciding to insert an intraoperative shunt, check the carotid flow, recognize embolic events, and also during the initial phase of carotid preparation.

Adult↗