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Biomedical subjects

V Mastroianni

Publications and source records attributed to V Mastroianni.

16 recordsLinked to original sources

[Acute intestinal ischemia. Diagnosis and surgical treatment].

The authors report their experience of 32 patients operated for acute intestinal ischemia. A massive intestinal infarction was diagnosed in 24 cases. The overall postoperative mortality rate was 72%. The postoperative survival rate was 20% after mesenteric infarction and 42% in patients with limited acute intestinal ischemia. The need for early specific diagnosis is stressed, because the therapeutic options vary widely in relation to different types of acute intestinal ischemia. Furthermore, the basic role of parenteral nutrition in postoperative treatment of short bowel syndrome is underlined.

Acute Disease

[Anti H2 receptors and perforated peptic ulcer. Review of 442 cases].

H2 blockers have accelerated the reduction in elective peptic ulcer surgery but appear to have had no equivalent effect on the incidence of perforated ulcer success. A 13 year (1975-1987) review of perforated peptic ulcer is presented. The mean annual number of operations for perforation fell from 8.21% to 4.93% after 1980, while the number of operations for perforated gastric ulcer in this period was almost unchanged. A significant reduction was found in mean annual rates for perforated duodenal ulcer from 6.86% to 3.82% after 1980, while the number of operations for perforated gastric ulcer in this period was almost unchanged.

Cohort Studies

[Biliary ileus. Review of the literature and report of 22 further cases].

A critical review of the world literature of the main authors in the past twenty years (871 cases) and the personal series (1975-1987: 22 cases) shows that biliary ileus is a rare, serious pathology with an emergency surgical indication. The numerical data collected confirm the need for a conservative surgical attitude, limited to the removal of the obstructing cause. Some authors have maintained that it is possible to treat the occlusion and the bilio-digestive fistula and carry out the cholecystectomy contemporaneously. Personally it is considered that the latter possibility can be confined to carefully selected patients who are not too elderly, do not present associated pathologies and for whom the diagnostic opinion is one of preoperative biliary ileus. Cholecystectomy is therefore programmed and this is followed at a later stage by repair of the biliary fistula, the occlusive pathology being corrected immediately so as to eliminate as far as possible the immediate risks of prolonged emergency surgery on the bile ways and digestive tract at the same time.

Adolescent

[Tumors of the large intestine in acute phase].

A retrospective study was carried out on 406 patients operated on for tumours of the large bowel in the acute stage between 1975 and 1985. 285 cases were operated immediately, 53 for acute perforations and 232 for complete occlusions, whereas 121 were operated on with deferred urgency. The surgical approach was generally conservative in 230 cases while in 159 immediate tumour resection was carried out. In the event of conservative operation, a second resection was possible in 94 cases (51.36% of survivors). Immediate resections had a five year survival better than those carried out in several stages (27.50% against 18.28%). However, the immediate postoperative course reported lower mortality. The present study and reported data show that surgical treatment of obstructions and neoplastic perforations of the large bowel is not completely standardised.

Acute Disease

[The polysaccharide components of the ground substance of the connective tissue in retraction of the palmar aponeurosis (Dupuytren's disease)].

Histochemical methods were employed to study the behaviour of connectival glycoproteins in Dupuytren's disease. Increases were observed in glycoproteins and acid glycosaminoglycans in the sections with higher cell intensity. In segments where fibrosis was more marked, a prevalence of neutral polysaccharides was encountered. A possible role of these alterations in the development of palmar aponeurosis retraction is discussed.

Adult

[Surgical technics indicated for spontaneous pneumothorax. Personal experience in 266 operations].

The surgical techniques best suited for timely management of spontaneous pneumothorax are described. Results in 266 cases are discussed and compared with the recent literature. Reference is also made to a little known technique: photothermostimulation, and the results it offers are illustrated. Encouraging results have been obtained from rapid frottage of the parietal pleura and this is described. Emphasis is placed on the advisability of early operation to forestall possible surgical and anatomofunctional complications, to ensure good recovery of respiratory capacity, and to prevent mechanical sequelae involving the cardiorespiratory system.

Adolescent

[Surgical indications in aspecific pneumopathies].

A degree course lecture based on a review of the relevant literature and experience gained at a 1000-bed lung hospital (S. Luigi Hospital, Orbassano) is presented in a shortened form. Attention is drawn to the revival of discarded techniques due to anaesthesiological and medical advances. This has considerably extended the surgical indications.

Arteriovenous Malformations

[Indications for laparoscopy in the diagnosis and treatment of abdominal trauma].

The use of laparoscopy as a diagnostic method dates back to the first decades of this century. Laparoscopic surgical techniques were first used by gynecologists and later, in 1989, Dubois performed the first cholecystectomy using a laparoscopic approach. Since then, in the space of a few years, there has been an overwhelming spread of videolaparoscopic operating methods, extending the therapeutic possibilities to gastroenterological surgery, as well as to thoracic, oncological, urological, and of course, gynecological surgery. The use of the laparoscope as a diagnostic method in abdominal trauma was proposed in the 70s by a number of authors, but only now, due to technological progress and the constant use of elective laparoscopic surgery, have surgeons been able to use this method for the diagnosis and treatment of patients with blunt or penetrating abdominal trauma. The experience accumulated to date includes a restricted number of cases, but preliminary results are encouraging and it is expected that this method will also be extended to emergency traumatology. The authors' preliminary experience consists of 7 laparoscopic examinations in subjects with abdominal trauma and hemoperitoneum. In 6 patients the examination confirmed hemoperitoneum caused by splenic lesion in 5 cases and hepatic lesion in 1 case. A hematoma of the left mesocolon was observed in one patient and the authors refrained from other treatment. In one subject with a splenic rupture at the ileum it was necessary to convert the operation into splenectomy. In a further 5 cases repeated washing and aspiration were used, using biological necks when necessary, until bleeding had completely ceased.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries