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1.
Surg Endosc ; 32(5): 2340-2344, 2018 05.
Article in English | MEDLINE | ID: mdl-29101555

ABSTRACT

BACKGROUND: Minimally invasive video-assisted thyroidectomy (MIVAT) has been introduced into clinical practice by Miccoli in the late 1990s (Miccoli et al., Am J Surg 181(6):567-570, 2001) and it has become a widespread technique used and welcomed worldwide. In this paper, we present our experience of the last 2 years; we also describe tips and techniques derived from over 460 cases performed in the last 10 years by the same surgical team with the same single operator. METHODS: In the last 10 years, we did about 460 MIVAT procedures. In the last 2 years, we performed MIVAT on 156 consecutive patients at Sant'Andrea University Hospital of Rome "Sapienza" University. of 156 cases performed, we were able to monitor the follow-up in 110 patients. RESULTS: On 110 cases, the mean surgical time was 74 ± 7.2 min. In our data, we reported: transitory hypoparathyroidism 11 (10%), definitive hypoparathyroidism 4 (3.60%) (this value is inclusive of patients treated with central neck dissection. The value referred only to MIVAT is 1.05%), 2 (1.81%) transitory monolateral nerve palsy, 16 (14.50%) transitory, and 1 (0.9%) definitive nerve palsy. 4 (3.60%) cases of transitory dysphagia and 0 (0%) cases of definitive dysphagia (Table 4). We also had 1 (0.9%) case of surgical scar infection, 0 (0%) postoperative bleeding, and 2 (1.81%) cases of subcutaneous surgical adhesion. Cosmetic results were: 0 (0%) insufficient, 0 (0%) sufficient, 6 (6.30%) passable, 17 (15.50%) good. and 86 (78.20%) excellent. Conversion rate 0 (0%). CONCLUSION: MIVAT is a good and safe technique, with similar short-term outcomes and similar costs compared to traditional total thyroidectomy. We hope that the tips and techniques reported in this paper as well as the advices in the use of instruments in MIVAT and open surgery will be useful to improve the skills of young surgeons and make thyroid surgery less invasive.


Subject(s)
Thyroid Diseases/surgery , Thyroidectomy/methods , Video-Assisted Surgery/methods , Adult , Female , Follow-Up Studies , Hospitals, University , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies , Thyroid Neoplasms/surgery , Treatment Outcome
2.
Int J Immunopathol Pharmacol ; 26(1 Suppl): 3-9, 2013.
Article in English | MEDLINE | ID: mdl-24046944

ABSTRACT

Mesenchymal stem cells (MSC) and adipose-derived stem cells (ASC) were recently proposed for bone maxillofacial reconstruction in association with biomaterials. For this application MSC must be ex-vivo expanded in order to obtain, for a given volume of implanted biomaterial, a relevant number of bone forming cells. Previously conducted pre-clinical studies suggested that a concentration of 6 x 10(8) ASC associated with 900 mg of anorganic bovine bone (ABB) could be effective for human maxillary sinus floor elevation. A keystone issue to guarantee the quality and safety of Advanced Therapy Medicinal Products containing expanded MSC and ASC is their chromosome stability in culture: this topic has been widely investigated and conflicting results have been published. Abnormal karyotype of human ex-vivo expanded MSC and ASC was found by some authors, while, at the same time, several other studies showed the MSC and ASC karyotype to be normal. It is therefore important that all the results obtained on MSC and ASC karyotype analysis be published. Given this context, the aim of this manuscript, aim of this manuscript is to verify the karyotype stability of ASC in view of their applications in clinical trials. ASC obtained from the adipose tissue of 4 donors were expanded over extended culture time. Based on previous ASC expansions we hypothesized to be able to obtain 6 x 10(8) cells by passage 7. Karyotype analysis of 30 metaphases was planned to be investigated at passage 2, 7, and 15 in all the cultures. No abnormalities were found in the karyotype of two donors at all the passages tested, while a translocation was found in 2 metaphases of a donor at passage 7, but not at passage 15, and in the fourth donor in 5 metaphases a trisomy was found at passage 15. Chromosomal abnormalities were detected only after extended ASC expansion. Whether these anomalies can be related to risk for the patient's safety will have to be demonstrated by in-vivo studies.


Subject(s)
Adipose Tissue/cytology , Karyotype , Plastic Surgery Procedures , Stem Cells/ultrastructure , Surgery, Oral/methods , Adult , Humans , Male , Mesenchymal Stem Cells/ultrastructure , Middle Aged
3.
Eur Rev Med Pharmacol Sci ; 17(24): 3362-6, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24379068

ABSTRACT

BACKGROUND: Persistent differentiated papillary thyroid cancer (PTC) with metastasis followed by radical locoregional surgery is an indication for limited reoperation. Despite excellent prognosis the major challenge is controlling locoregional recurrences. AIM: To evaluate the efficacy of radioguided excision with combined use of gamma probe and an hand-held gamma camera. PATIENTS AND METHODS: From June 2009 to January 2012, we enrolled twenty-two patients with locoregional PTC recurrences, previously undergone to central and/or lateral neck dissection for PTC. The diagnosis of recurrent PTC was based on thyroglobulin (TG) evaluation [basal and after thyroid stimulating hormone (TSH) stimulation], ultrasound (US), iodine-131 (131I) whole body scan (WBS) and fine needle aspiration cytology (FNAC). In the morning of surgery, radiotracer was injected directly into the lesions by US guide. Careful dissection was carried out using gamma probe and hand held gamma camera. Metastatic lymph nodes were identified and excised. RESULTS: In all the patients recruited, 39 pathologic nodes were injected and 61 nodes were removed. Among the removed nodes, 22 (36.1%) were additional nodes (not injected by radiotracer). Of the additional lymph nodes, 7 (31.8%) were metastatic. Mean radioactive count of the lesion (28.633±9.218 counts/s) was higher than tumor bed (385.73±192.23 counts/s) (p < 0.0001). No complications were observed during radioguided excision, neither on post-operative period. CONCLUSIONS: The use of hand-held gamma camera in addition to gamma probe in our preliminary study allows a minimally invasive procedure and safer identifications of the lesions and ensures the completeness of the excision in a difficult surgical field.


Subject(s)
Carcinoma/surgery , Lymph Node Excision/instrumentation , Neoplasm Recurrence, Local/surgery , Radiosurgery/instrumentation , Thyroid Neoplasms/surgery , Adult , Carcinoma/diagnostic imaging , Carcinoma/pathology , Carcinoma, Papillary , Equipment Design , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/pathology , Radiography , Radiopharmaceuticals , Reoperation , Technetium Tc 99m Aggregated Albumin , Thyroid Cancer, Papillary , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/pathology , Time Factors , Treatment Outcome
4.
G Chir ; 34(9-10): 263-6, 2013.
Article in English | MEDLINE | ID: mdl-24629812

ABSTRACT

AIM: To demonstrate the utility of the renal artery embolization (RAE) in the dissection of gross neoplasms and the reduction in blood loss and operative time. CASE REPORT: We report a case of a gross left renal neoplasm (with the diameter of about 12 cm) in a 45 years old Caucasian female who underwent to renal artery embolization 24 hours before left nephroureterectomy. This procedure has determined a reduction in operative times (about 90 minutes) because of the ligature of the renal vein was facilitated. Intraoperative blood loss was of about 100 ml and the patient didn't need of blood transfusions; the abdominal drain was removed in third postoperative day (daily drained serous fluid was about 20 ml). The patient was discharged 7 days later. CONCLUSION: RAE facilitates the dissection of gross neoplasms (diameter> than 10 cm), so causing a reduction in intraoperative blood loss and in blood transfusion. The operative times are lower because the ligature of the renal vein is less difficult and the dissection is facilitated for the presence of tissue oedema. The disadvantages are the incomplete hembolyzation, coil migration, hematomes, post-infarction syndrome (nausea, vomit, abdominal pain, leucocytosis, hyperpyrexia, hematoma); other risks include the possibility of pulmonary embolism, intestinal infarction and infections. Its reduced utilization could be due to the lack of randomized prospective studies showing its potential benefits.


Subject(s)
Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/therapy , Embolization, Therapeutic , Kidney Neoplasms/pathology , Kidney Neoplasms/therapy , Renal Artery , Carcinoma, Renal Cell/surgery , Female , Humans , Kidney Neoplasms/surgery , Middle Aged , Neoplasm Staging , Nephrectomy/methods , Preoperative Period , Treatment Outcome
5.
G Chir ; 33(10): 314-7, 2012 Oct.
Article in English | MEDLINE | ID: mdl-23095558

ABSTRACT

OBJECTIVE: Minimally invasive video-assisted thyroidectomy (MIVAT) is a technically demanding procedure and requires a surgical team skilled in both endocrine and endoscopic surgery. A time consuming learning and training period is mandatory at the beginning of the experience. The aim of our report is to focus some aspects of the learning curve of the surgeon who practices video-assisted thyroid procedures for the first time, through the analysis of our preliminary series of 36 cases. PATIENTS AND METHODS: From September 2004 to April 2005 we selected 36 patients for minimally invasive video-assisted surgery of the thyroid. The patients were considered eligible if they presented with a nodule not exceeding 35 mm in maximum diameter; total thyroid volume within normal range; absence of biochemical and echographic signs of thyroiditis. We analyzed surgical results, conversion rate, operating time, post-operative complications, hospital stay, cosmetic outcome of the series. RESULTS: We performed 36 total thyroidectomy. The procedure was successfully carried out in 33/36 cases. Post-operative complications included 3 transient recurrent nerve palsies and 2 transient hypocalcemias; no definitive hypoparathyroidism was registered. All patients were discharged 2 days after operation. The cosmetic result was considered excellent by most patients. CONCLUSIONS: Advances in skills and technology have enabled surgeons to reproduce most open surgical techniques with video-assistance or laparoscopically. Training is essential to acquire any new surgical technique and it should be organized in detail to exploit it completely.


Subject(s)
Learning Curve , Thyroidectomy/education , Thyroidectomy/methods , Video-Assisted Surgery , Adult , Aged , Female , Humans , Male , Middle Aged
6.
G Chir ; 28(8-9): 340-3, 2007.
Article in Italian | MEDLINE | ID: mdl-17785050

ABSTRACT

Blood in the urine (hematuria) can originate from any site along the urinary tract and may be the only sign of renal or vesical malignancy. Therefore, literature recommends for the evaluation of any case of macroscopic or microscopic hematuria. Our aim was to define the diagnostic role of multidetector CT urography (MDCTu) in the evaluation of this symptom through the analysis of 181 consecutive patients from January 2003 to March 2006.


Subject(s)
Hematuria/diagnostic imaging , Tomography, X-Ray Computed , Adult , Hematuria/etiology , Humans , Urography/methods
7.
G Chir ; 27(4): 179-82, 2006 Apr.
Article in Italian | MEDLINE | ID: mdl-16768876

ABSTRACT

Surgery is the only curative treatment for primary hyperparathyroidism (pHPT). Surgical exploration is recommended for all patients with biochemically documented pHPT and signs or symptoms of the disease. Some patients are asymptomatic, others have subtle symptoms that disappear after parathyroid surgery. Felix Mandl successfully performed the first parathyroidectomy in 1925, using a bilateral neck exploration (BNE) with examination of all four glands and this remained the procedure of choice for pHPT into the 1990s. As over 80% of pHPT cases are due to a single parathyroid adenoma, many authors have questioned the need of BNE and have proposed directed unilateral approaches, termed "mini-invasive parathyroidectomies". The aim of this report is to define which is the actual role of the conventional surgical approach to pHPT.


Subject(s)
Hyperparathyroidism, Primary/diagnosis , Hyperparathyroidism, Primary/surgery , Diagnostic Techniques, Surgical , Humans , Neck
8.
G Chir ; 27(3): 85-9, 2006 Mar.
Article in Italian | MEDLINE | ID: mdl-16681866

ABSTRACT

Through the analysis of our preliminary experience on 36 consecutive cases of thyroid surgery, we assessed the feasibility of the rapid intraoperative assay of the intact parathyroid hormone (iPTH) as predictive risk factor of hypocalcemia versus seric calcium level on the first post-operative day to select the patients eligible to an early discharge. Furthermore, we managed to determine if iPTH level during thyroid surgery could point out the cases in which parathyroid autotransplantation is necessary, as the macroscopic evaluation of the parathyroid gland's viability is inadequate.


Subject(s)
Parathyroid Hormone/blood , Thyroidectomy , Adult , Aged , Calcium/blood , Feasibility Studies , Female , Humans , Immunoassay , Intraoperative Period , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Thyroidectomy/adverse effects
9.
G Chir ; 26(11-12): 411-4, 2005.
Article in Italian | MEDLINE | ID: mdl-16472417

ABSTRACT

The aim of this paper is to describe a typical clinical case of tuberous sclerosis complex (Bourneville disease) and discuss controversial issues about the management of this rare condition, with a short revision of the literature. Particularly, we define which is the role of the surgeon in the treatment of this very rare condition, that should be primary approached conservatively.


Subject(s)
Angiomyolipoma , Kidney Neoplasms , Tuberous Sclerosis , Adult , Angiomyolipoma/diagnosis , Angiomyolipoma/diagnostic imaging , Female , Follow-Up Studies , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/diagnostic imaging , Radiography, Abdominal , Time Factors , Tomography, X-Ray Computed , Tuberous Sclerosis/complications , Tuberous Sclerosis/diagnosis
11.
G Chir ; 24(5): 177-82, 2003 May.
Article in Italian | MEDLINE | ID: mdl-12945168

ABSTRACT

During the surgical treatment of two patients with benign anastomotic colorectal stenosis, the Authors registered the presence of concomitant tenacious adherence of the anastomotic line to the sacral bone. Such event, according to the Authors, could represent one of the causes of failure and greater risk of perforation during the treatment with the different endoscopic therapies that, nevertheless, ought to be considered the gold standard in the therapy of benign structures. The Authors developed their hypothesis physiopathologic on the basis of personal experience and of the search a diagnostic procedure able to highlight the presence of a tenacious adherence with solid structures during the operative evaluation. If further studies focused on this subject will bring to satisfactory results, this would represent a further aid for the evaluation of the best therapeutic approach of the benign post anastomotic stenosis.


Subject(s)
Cicatrix/etiology , Colon/surgery , Intestinal Obstruction/etiology , Rectum/surgery , Tissue Adhesions/etiology , Aged , Anastomosis, Surgical/adverse effects , Constriction, Pathologic , Female , Humans , Male , Middle Aged
12.
G Chir ; 24(4): 119-21, 2003 Apr.
Article in Italian | MEDLINE | ID: mdl-12886749

ABSTRACT

A cecal mass of uncertain etiology encountered during surgery for presumed appendicitis is a dilemma for the surgeon. The differential diagnosis of an unsuspected ileocecal mass must include neoplasm, diverticular disease, inflammatory bowel disease and severe appendicitis involving the ileocecal region. Right hemicolectomy is the gold standard for the treatment of the unsuspected ileocecal mass. The Authors report a case of inflammatory tumour of caecum secondary to appendicitis in a young adult.


Subject(s)
Cecal Diseases/surgery , Granuloma, Plasma Cell/surgery , Acute Disease , Appendicitis/complications , Cecal Diseases/diagnosis , Cecal Diseases/diagnostic imaging , Cecal Diseases/etiology , Colectomy , Diagnosis, Differential , Emergencies , Follow-Up Studies , Granuloma, Plasma Cell/diagnosis , Granuloma, Plasma Cell/diagnostic imaging , Granuloma, Plasma Cell/etiology , Humans , Male , Middle Aged , Radiography, Abdominal , Time Factors , Tomography, X-Ray Computed , Ultrasonography
13.
G Chir ; 23(4): 157-61, 2002 Apr.
Article in Italian | MEDLINE | ID: mdl-12164006

ABSTRACT

Although the vestigial retrorectal cysts are still rare, the number of the observed ones is destined to increase, as methods by imaging become routinely used in the clinical practice. Once diagnosed, the removal of retrorectal lesions should be mandatory. Therefore, by reporting three clinical cases, the Authors propose notes of technique above the abdominal approach used for the surgical treatment of these retrorectal congenital neoformations. In their experience, the anterior route had no postoperative complications, short stay, no neurological consequences and good long-term results.


Subject(s)
Cysts/surgery , Rectal Neoplasms/surgery , Sacrococcygeal Region , Teratoma/surgery , Abdomen , Adolescent , Adult , Cysts/diagnosis , Cysts/diagnostic imaging , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Rectal Neoplasms/diagnosis , Rectal Neoplasms/diagnostic imaging , Teratoma/diagnosis , Teratoma/diagnostic imaging , Tomography, X-Ray Computed
14.
G Chir ; 23(4): 163-8, 2002 Apr.
Article in Italian | MEDLINE | ID: mdl-12164007

ABSTRACT

General surgeons are more and more frequently requested to prepare an operative exposure of the spine, in order to perform anterior maneuvers of removal and stabilization of the vertebral bodies. Since 1989 to date, in collaboration with the neurosurgical équipe of Prof. G. Cantore, Neurological Sciences Department, La Sapienza University of Rome, the Authors have collected 116 cases of vertebral diseases: among them, 48 involved the thoraco-lumbar junction of the spine (D12-L2). In this paper, Authors' aim is to state precisely the surgical technique of the anterior access to the thoraco-lumbar junction: attention has been focused on this tract of the column stating its anatomical complexity and the high invasivity of the procedures requested for its exposure. Therefore, such notes of technique have been elaborated to make safer the neurosurgical demolitive and reconstructive procedures and, most of all, to reduce the surgical trauma whenever it is possible.


Subject(s)
Lumbar Vertebrae , Spinal Diseases/surgery , Spinal Fractures/surgery , Thoracic Vertebrae , Adolescent , Adult , Aged , Chordoma/surgery , Female , Follow-Up Studies , Humans , Intervertebral Disc Displacement/surgery , Male , Middle Aged , Neurilemmoma/surgery , Spinal Neoplasms/surgery , Time Factors
15.
Minerva Anestesiol ; 65(6): 440-4, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10394817

ABSTRACT

The prognostic meaning of the routine use of the methods of temporary clipping of the afferent vessel in patients with intracranial aneurysm (Grading 0-III) was the aim of the analysis in this study. In the period 1 January, 1991-31 December 1997, 304 patients underwent surgery for non-giant intracranial aneurysm and a follow-up angiography. 157 patients were operated by routinely using the temporary clipping of the afferent vessel, whereas in 147 patients the surgical procedure was performed by traditional methods. The statistical analysis showed a significant reduction (p < 0.001) in terms of risk of surgical complications in the patients who underwent surgery with the temporary clip method compared to those operated with the traditional method, with a relative risk of such complications about three times greater in the latter. The routine use of temporary clipping offers, therefore, the possibility of a significant improvement of the surgical results, not influenced by a further involvement for the structure, due to the short application time.


Subject(s)
Intracranial Aneurysm/surgery , Aneurysm, Ruptured/etiology , Aneurysm, Ruptured/surgery , Female , Humans , Intracranial Aneurysm/complications , Intracranial Aneurysm/diagnosis , Intraoperative Complications/etiology , Intraoperative Complications/surgery , Male , Neurosurgical Procedures/instrumentation , Neurosurgical Procedures/methods , Prognosis , Retrospective Studies , Surgical Instruments
16.
J Neurosurg Sci ; 42(1 Suppl 1): 77-9, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9800610

ABSTRACT

The authors' experience in the routine use of temporary clipping procedures in the surgery of endocranial aneurysms is reported. To analyse the validity of such a method we compared the outcome in a series of 153 aneurysms operated according to the traditional procedure (temporary clipping of the afferent vessel only in the case of intraoperative rupture of the aneurysmatic sac) with that of a more recent series of 225 in which the procedure was applied routinely. An unsatisfactory surgical outcome was found in 12.5% and 6.6% of patients respectively, with a corresponding unfavourable outcome in 5.6% and 2.6%.


Subject(s)
Intracranial Aneurysm/surgery , Humans , Intraoperative Complications/prevention & control , Neurosurgery/methods , Neurosurgery/trends , Postoperative Complications , Time Factors , Treatment Outcome
17.
G Chir ; 19(1-2): 35-9, 1998.
Article in Italian | MEDLINE | ID: mdl-9567494

ABSTRACT

The Authors report the case of a fifty-nine-year-old patient, affected by complete eventration of the left diaphragm and cranial stomach dislocation with axial volvulus, associated with an upward movement of part of the left colon and some jejunal loops. The subclinical condition had been occasionally discovered during a routine chest X-ray at the age of eighteen and the patient remained without symptoms up to five years ago, when he began to show significant digestive and cardiorespiratory symptoms. The patient has been successfully treated via thoracotomy with phrenic alloplastic using Gore-Tex patch and has obtained an immediate remission of the symptoms. Left diaphragmatic eventration of the adult is a rare pathology, either congenital or acquired, with few and definite surgical indications such as severe digestive and cardiorespiratory symptoms. Different surgical techniques including the use of patches are herein illustrated.


Subject(s)
Diaphragmatic Eventration/surgery , Surgical Mesh , Diaphragmatic Eventration/diagnostic imaging , Humans , Male , Middle Aged , Polytetrafluoroethylene , Radiography
18.
Ital J Neurol Sci ; 19(3): 176-9, 1998 Jun.
Article in English | MEDLINE | ID: mdl-10933473

ABSTRACT

Intramedullary cavernous angiomas are rare vascular malformations; all published cases have been surgically approached posteriorly by standard laminectomy. We describe the case of a 63-year-old man with an intramedullary cavernous angioma, anteriorly located in the thoracic spinal cord. The angioma was operated on by transthoracic approach and totally removed.


Subject(s)
Brain Neoplasms/surgery , Hemangioma, Cavernous/surgery , Medulla Oblongata , Brain Neoplasms/diagnosis , Hemangioma, Cavernous/diagnosis , Humans , Magnetic Resonance Imaging , Male , Medulla Oblongata/pathology , Medulla Oblongata/surgery , Middle Aged , Treatment Outcome
19.
Can J Neurol Sci ; 24(4): 313-9, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9398978

ABSTRACT

BACKGROUND: A reliable marker for tumor oligodendroglial cells is not yet available, so that the histological recognition of the tumor still encounters uncertainties. There is no general agreement also on prognostic factors in oligodendroglioma. The inconsistency concerns mainly the histopathological factors. The aim of the study was recognition of prognostic factors in oligodendroglioma. METHODS: In a series of ninety-eight oligodendrogliomas, including twenty mixed oligoastrocytomas, clinical [sex, age at surgery, tumor location, symptoms at presentation], therapeutic [extent of resection, year of surgery, post-operative Karnofsky score, post-operative radiotherapy, post-operative chemotherapy], histological [cell density, nuclear pleomorphism, vascular endothelial proliferation, necrosis, microcysts, mitoses, mitotic index (MI), apoptosis, apoptotic index (AI)] and immunohistochemical parameters [MIB-1 and PCNA Labeling Indexes (LIs), staining for GFAP, positivity for p53] were correlated with survival in uni- and multivariate analysis in order to identify their prognostic significance. RESULTS: Age at surgery, extent of surgical resection, year of surgery, post-operative Karnofsky score and MIB-1 LI were associated with survival in both uni- and multivariate analysis. Location, symptoms at presentation, mitoses, MI, AI, and PCNA LI showed a significant correlation with survival in uni- but not in multivariate analysis. The twenty cases of oligoastrocytomas did not show any difference in survival from pure oligodendrogliomas. CONCLUSIONS: Some clinical and therapeutic factors together with MIB-1 LI play a prognostic role. MIB-1 LI is prognostic with a cutoff of 8%. Histology gives a limited contribution to the prognosis. Oligoastrocytomas had the same outcome and prognostic factors as pure oligodendrogliomas.


Subject(s)
Brain Neoplasms/pathology , Oligodendroglioma/pathology , Adolescent , Adult , Aged , Analysis of Variance , Brain Neoplasms/therapy , Combined Modality Therapy , Factor Analysis, Statistical , Female , Humans , Immunohistochemistry , Male , Middle Aged , Oligodendroglioma/therapy , Prognosis , Survival Rate
20.
G Chir ; 18(10): 488-92, 1997 Oct.
Article in Italian | MEDLINE | ID: mdl-9479950

ABSTRACT

In the Authors experience with surgical management of sacral chordomas, an unusual complication represented by posterior herniation of the rectum was observed. Weakness of the posterior pelvic floor is at the basis of this complication, which the Authors defined "sacrocele". Posterior herniation of the rectum highly impairs the patient quality of life and may contraindicate radiation therapy. Therefore, the Authors routinely reconstruct the posterior pelvic floor by using a polyglactin mesh following any sacrectomy. This technique is simple and safe. Authors' experience on a limited series is presently reported.


Subject(s)
Postoperative Complications/prevention & control , Rectal Diseases/prevention & control , Sacrum/surgery , Surgical Mesh , Adult , Aged , Chordoma/surgery , Female , Hernia/prevention & control , Herniorrhaphy , Humans , Male , Middle Aged , Postoperative Complications/surgery , Rectal Diseases/etiology , Rectal Diseases/surgery
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