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1.
Surg Today ; 29(2): 174-7, 1999.
Article in English | MEDLINE | ID: mdl-10030745

ABSTRACT

The authors present two case reports of mesenteric cystic neoformations which they themselves observed and, with the help of the literature regarding this pathology, discuss the problems of both diagnosis and treatment.


Subject(s)
Mesenteric Cyst/diagnostic imaging , Adult , Female , Humans , Laparotomy , Male , Mesenteric Cyst/pathology , Mesenteric Cyst/surgery , Tomography, X-Ray Computed
2.
Ann Ital Chir ; 67(5): 615-9, 1996.
Article in Italian | MEDLINE | ID: mdl-9036819

ABSTRACT

The authors have completed an analytic research about costs of hospitalization and treatment for inguinal hernioplasty and costs of anesthesiologic and surgical techniques and hospitalization regimen. The authors consider possible in about 50% of cases the tension-free hernioplasty carried out with local anesthesia and day or one day surgery regimen and they have estimated that it is very less costly then traditional herniorraphy carried out with general anesthesia and hospitalization: L. 1.056.075 versus L. 2.252.650. In Emilia-Romagna we could have a considerable cost-saving, even if only the 50% of patients treated for uncomplicated inguinal hernia every year (7.133 patients with mean hospital stay = 5,8 days and total hospitalization = 41.731 days during 1993) could benefit by treatment in one day surgery regimen. In fact, leaving out of account the advantage of the rapid return the patient to work, the costs of hospital stay, esteemed in L. 25.038.600.000, would be L. 8.558.700.000. A considerable increase of one day surgery hernioplasties should be expected by the hospital administration in budget planning.


Subject(s)
Ambulatory Surgical Procedures/economics , Hernia, Inguinal/surgery , Hospitalization/economics , Surgical Procedures, Operative/economics , Adolescent , Adult , Aged , Aged, 80 and over , Costs and Cost Analysis , Humans , Italy , Middle Aged , Time Factors
3.
Ann Ital Chir ; 67(4): 463-8, 1996.
Article in Italian | MEDLINE | ID: mdl-9005761

ABSTRACT

The authors proceeded to point out the hospital stay costs and the operating-room costs of the cholecystectomy after the introduction of the laparoscopic technique, underlining the higher economic advantages. The total unit cost for laparoscopic cholecystectomy, even if there are higher costs due to the surgical equipment, thanks to the mini-invasive approach and to the reduced hospital stay, results lower (17%) then the total unit cost for laparotomic cholecystectomy (L. 3.982.489 vs. L. 4.825.300). Let us suppose that in the Emilia Romagna Region an 80% of patients underwent to laparoscopic cholecystectomy and only a 20% underwent to laparotomic cholecystectomy: in this case there could be the economic savings of L. 3.777.478.902 and concerning the hospital stay there could be the savings of 17.928 days too. This cost estimation is important if we consider that the rate of cholecystectomy procedures, in our local area, per 1000 inhabitants, increased from 2.29 in 1990 to 3.99 in 1992 (rate of increase: 74%).


Subject(s)
Cholecystectomy, Laparoscopic/economics , Health Expenditures , Adult , Aged , Costs and Cost Analysis , Female , Humans , Italy , Male , Middle Aged
4.
Ann Ital Chir ; 67(4): 469-73, 1996.
Article in Italian | MEDLINE | ID: mdl-9005762

ABSTRACT

The authors proceeded to point out the hospital stay costs and the operating-room costs of the operations for benign adnexal pathologies, especially concerning the ovarian cysts, after having introduced the laparoscopic technique. The highly costs, due to the laparoscopic surgical equipment, are compensated by the reduced hospital stay. The total unit cost for laparoscopic approach results lower then the total unit cost for laparotomic approach (L. 3.253.923 versus L. 4.662.892). If we consider that, in our local area, in 1993, 1212 operations were performed, with 5454 days of postoperative hospital stay, we could suppose that the laparoscopic approach affords higher savings. This cost estimation is important if we consider the diffusion of the mini-invasive procedures.


Subject(s)
Laparoscopy/economics , Ovarian Cysts/surgery , Adolescent , Adult , Aged , Costs and Cost Analysis , Female , Hospital Charges , Humans , Middle Aged
5.
Minerva Chir ; 48(15-16): 813-9, 1993 Aug.
Article in Italian | MEDLINE | ID: mdl-8247291

ABSTRACT

Pulmonary hamartoma is a rare benign tumor often found by chance. Only in 10% of cases are some calcifications like "pop corn". Fibrobroncho-scopy is help only in endobronchial forms; they don't reach 10% of cases. Computed Tomography and transparietal biopsy can be diagnostic. In the uncertain cases and in presence of symptoms, thoracotomy with exeresis of tumor is justified.


Subject(s)
Hamartoma/diagnosis , Lung Diseases/diagnosis , Aged , Female , Humans , Male , Middle Aged
6.
Minerva Chir ; 48(5): 227-30, 1993 Mar 15.
Article in Italian | MEDLINE | ID: mdl-8506041

ABSTRACT

Eight cases of Meckel's diverticulum observed by the authors are reported. Different investigative methods, clinical and surgical aspects are discussed. Even asymptomatic Meckel's diverticulum discovered incidentally at surgery should usually be removed.


Subject(s)
Meckel Diverticulum , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Meckel Diverticulum/diagnosis , Meckel Diverticulum/surgery , Middle Aged
7.
Minerva Chir ; 48(5): 221-5, 1993 Mar 15.
Article in Italian | MEDLINE | ID: mdl-8506040

ABSTRACT

Gastrointestinal carcinoids are infrequent but at the same time hardly rare tumours. They are often chance findings but, as is clearly reported in the literature, their potential malignancy should not be overlooked. They are most commonly localised in the appendix. The authors describe two case reports of carcinoid tumours of the appendix, one of which was diagnosed during left hemicolectomy due to Crohn's disease and the other during acute appendicitis. Prognostic and therapeutic problems are discussed in the light of the most recent literature.


Subject(s)
Appendiceal Neoplasms , Carcinoid Tumor , Adult , Female , Humans , Male
8.
Minerva Chir ; 46(11): 623-6, 1991 Jun 15.
Article in Italian | MEDLINE | ID: mdl-1944980

ABSTRACT

The authors present a case of neonatal intestinal duplication. Etiopathogenic view and the diagnostic and therapeutic problems are discussed. Echotomographic examination can provide useful diagnostic input, as in this case, even at a prenatal stage.


Subject(s)
Intestine, Small/abnormalities , Adult , Female , Humans , Infant, Newborn , Intestine, Small/diagnostic imaging , Intestine, Small/surgery , Pregnancy , Radiography , Ultrasonography, Prenatal
9.
Minerva Chir ; 46(10): 553-5, 1991 May 31.
Article in Italian | MEDLINE | ID: mdl-1681471

ABSTRACT

The paper reports the authors' personal experience regarding the use of magnetic resonance imaging in the diagnosis of cryptorchidism. The result of the study of 13 patients with non-palpable gonads, who all underwent surgical confirmation (with positive outcome in 66% of cases), encourage the use of this non-invasive method with a high anatomic resolution, which can be used to diagnose both the site, dimensions and possible structural alterations of the gonad.


Subject(s)
Cryptorchidism/diagnosis , Magnetic Resonance Imaging , Cryptorchidism/diagnostic imaging , Diagnosis, Differential , Evaluation Studies as Topic , Humans , Male , Radiography
10.
Minerva Chir ; 45(8): 555-9, 1990 Apr 30.
Article in Italian | MEDLINE | ID: mdl-2388724

ABSTRACT

The spread of mechanical staplers now makes it possible to perform anastomoses in anterior resections of the rectum that are easier and safer than manual ones. Certain related problems are well known, particularly in patients with narrow pelvis and, in low anastomoses, the fashioning of the tobacco pouch on the distal rectal stump. The technique of transutural mechanical colorectal anastomosis with circular stapler after closure of the rectal stump with linear stapler is described in detail. Advantages of the technique are: anastomoses that are technically easier and safer because making of the tobacco pouch on the distal rectal stump is avoided; pollution of the operating field is reduced to the minimum; there are no problems related to differences in lumen of the colorectal stumps.


Subject(s)
Rectum/surgery , Surgical Staplers , Anastomosis, Surgical , Humans
11.
Minerva Chir ; 45(5): 233-6, 1990 Mar 15.
Article in Italian | MEDLINE | ID: mdl-2377294

ABSTRACT

The Authors refer some diagnostic and therapeutic observations about pelvic-perineal recurrence after abdominal-perineal excision of rectum (AAP). They analyze new possibilities of diagnostic instrumentation, in particularly TC and RM scanner, comparing the results and valuing the sensibility and specificity in a selected group of patients.


Subject(s)
Colorectal Neoplasms/surgery , Magnetic Resonance Imaging , Neoplasm Recurrence, Local/diagnosis , Tomography, X-Ray Computed , Adult , Aged , Colorectal Neoplasms/pathology , Follow-Up Studies , Humans , Middle Aged
12.
Minerva Chir ; 45(13-14): 923-7, 1990.
Article in Italian | MEDLINE | ID: mdl-2274247

ABSTRACT

The paper reviews the current methods of surgery for inguinal hernia in children. This is a relatively common pathology but there is still no consensus regarding the most important aspects, namely "who" should be operated, "why", "when", "what methods should be used", and "what results are achieved" The excellent outcome in addition to the rarity of relapse in cases of uncomplicated hernia, opposed to emergency operations due to strangulation which are accompanied by a significant rate of mortality, justify, with rare exceptions, early intervention once the diagnosis has been confirmed.


Subject(s)
Hernia, Inguinal/surgery , Age Factors , Child , Female , Humans , Infant , Male , Prognosis , Recurrence
13.
Minerva Med ; 80(11): 1225-31, 1989 Nov.
Article in Italian | MEDLINE | ID: mdl-2513535

ABSTRACT

A cost/benefit analysis has been carried out of the follow-up of abdomino-perineal amputation of the rectum for cancer in the light of the objectives pursuable with this practice and the diagnostic techniques available today. As regards early diagnosis of a return of the disease, it is necessary to distinguish between long-term recurrence, hepatic or pulmonary for example, in relation to their greater potential capacity for surgical exeresis and local pelviperineal recurrences which are more rarely susceptible to radical exeresis in spite of the introduction of computed tomography and nuclear magnetic resonance in the diagnostic/therapeutic routine. As for diagnosis and management of metachronous polyps as a prevention of metachronous cancer, the importance of periodic trans-stomal pancolonoscopic control of the residual colon in all patients emerges. Finally, in cost/benefit terms, the objective of a psychophysical rehabilitation of the colostomized patient is advantageous with a marked reduction in welfare expenditure for the community.


Subject(s)
Cost-Benefit Analysis , Follow-Up Studies , Rectal Neoplasms/surgery , Rectum/surgery , Abdomen/surgery , Adult , Aged , Aged, 80 and over , Colostomy/economics , Colostomy/rehabilitation , Costs and Cost Analysis , Humans , Intestinal Polyps/diagnosis , Intestinal Polyps/economics , Intestinal Polyps/surgery , Magnetic Resonance Imaging/economics , Middle Aged , Neoplasm Metastasis/diagnosis , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/economics , Perineum/surgery , Radiography, Thoracic/economics , Rectal Neoplasms/economics , Rectal Neoplasms/mortality , Time Factors , Tomography, X-Ray Computed/economics , Ultrasonography/economics
14.
Minerva Med ; 80(10): 1097-101, 1989 Oct.
Article in Italian | MEDLINE | ID: mdl-2682376

ABSTRACT

The Author critically analyzes the aims of curative surgery for rectal cancer, i.e. radical colonic resection, lymphoadenectomy, conservation of adequate post-surgical functionality of the remaining colon. Nowadays, therapy does not end with the exeresis of the primary cancer as an isolated stage but rather includes adequate follow-up to prevent metachronous cancer by detecting and removing recurrent adenomas. But it also includes early diagnosis of any recurrence of the primary cancer to facilitate adequate treatment.


Subject(s)
Colectomy/methods , Lymph Node Excision , Rectal Neoplasms/surgery , Biomarkers, Tumor/analysis , Follow-Up Studies , Humans , Neoplasm Recurrence, Local/diagnosis , Neoplasm Staging , Precancerous Conditions/diagnosis , Precancerous Conditions/surgery , Rectal Neoplasms/pathology
16.
Minerva Chir ; 44(10): 1435-9, 1989 May 31.
Article in Italian | MEDLINE | ID: mdl-2771090

ABSTRACT

After a description of the basic criteria for the correct formulation of Multiple Choice Questions (MCQ) for use in the assessment of different levels in the intellectual process (memorising, data interpretation, problem solving) a package of computer programs for the use of MCQ in the assessment of what has been learned in a General Surgery course in the Faculty of Medicine and Surgery are presented. The MCQ is a valuable didactic tool that can well supplement though not replace oral examination for assessment at all stages of a course.


Subject(s)
Education, Medical, Graduate , Educational Measurement , General Surgery/education , Software , Humans , Italy
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