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1.
Updates Surg ; 66(3): 217-22, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24771284

RESUMO

The treatment of hemorrhoidal disease using stapled anopexy (SA) is still burdened by a high incidence of recurrence. Probably this condition is secondary to inadequate removal of the prolapsed tissue due to the reduced capacity of resection from the adopted device. In order to limit the incidence of failures by providing a removal of a greater amount of prolapsed tissue was considered the opportunity to use the STARR technique even in the presence of haemorrhoidal disease not burdened by symptoms of obstructed defecation. We evaluated the early and at a distance results of 285 patients who had undergone in 2007-2011 surgical resection with trans-anal circular stapler for symptomatic III-IV degree haemorrhoids without obstructed defecation disorders. 237 patients were subjected to SA, while in the remaining 48, since on intervention prolapse committed the CAD more than half of the device, we performed a STARR. adopted the Chi square test (C) considering significant p-values less than 0.05. The anamnestic preoperative evaluation allowed to put the correct indication for surgical treatment in 80% of patients. Mean operative times, hospital stay, incidence of early and more important complications, the symptomatic recurrence of disease (5%) were not dissimilar in the two groups under consideration. Conversely (p < 0.05) the relief of residual asymptomatic disease (24 vs. 10%) was significant . The overall satisfaction was significantly higher in the ST group (73.5 vs 58.6%). The STARR in case of massive prolapse who express themselves with only haemorrhoidal disease is a safe technique, able to optimize the long-term effectiveness of trans-anal resection surgery, limiting the incidence of symptomatic recurrences. The information offered to the patient at the time of the consent to surgery must be extensive and detailed, always considering the possibility of adopting the two techniques alternately and that, at completion of the intervention, could be necessary also the removal of persistent skin tags.


Assuntos
Hemorroidas/cirurgia , Grampeamento Cirúrgico/métodos , Adulto , Idoso , Canal Anal/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva
2.
Ann Ital Chir ; 82(2): 147-50, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21682106

RESUMO

We report a case of significant splenomegaly by myelofibrosis, treated in our institution, that we believe relevant to the completeness parade of symptoms and the exceptional size.


Assuntos
Cuidados Paliativos , Mielofibrose Primária/complicações , Esplenectomia , Esplenomegalia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Esplenomegalia/etiologia , Resultado do Tratamento
3.
Ann Ital Chir ; 82(1): 61-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21657157

RESUMO

The recognition of undifferentiated forms of endocrine tumors in the extrapulmonary sites is considered as extremely infequent. Immunohistochemical patterns of this tumor are similar to small cell neuroendocrine cancer of the lung and as the pulmonary one, it is more aggressive than carcinoma without neuroendocrine differentiation. We report a case of a 68 years old woman with a primary small cell carcinoma of the breast gland presented as a palpable and mobile 2 cm mass, located in the upper outer quadrant of her right breast. It was treated with surgery and the diagnosis was made after surgical treatment, thanks to the immunohistochemical studies of tissue.


Assuntos
Neoplasias da Mama , Carcinoma de Células Pequenas , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/cirurgia , Feminino , Humanos
4.
Chir Ital ; 61(3): 341-6, 2009.
Artigo em Italiano | MEDLINE | ID: mdl-19694237

RESUMO

Radiation proctitis, is a relatively frequent complication resulting from the direct or collateral irradiation of the rectum in radiotherapy treatment for genito-urinary or anorectal malignancies. The main symptoms are diarrhoea, tenesmus, proctorrhagia, anal pain, mucorrhoea and faecal incontinence. The evolution of chronic radiation proctitis requires treatment for related anaemia, anal incontinence and micturition disorders. The approach and type of treatment depend on the severity of the symptoms and on the endoscopic aspect, in relation to the response to previous medical therapy performed. In our experience, endoscopic treatment is the best choice in the presence of ongoing bleeding and the possible development of severe anaemia. The surgical option is mandatory in patients at high risk of sepsis, requiring a faecal diversion constructed using the Hartmann technique. We report two cases, observed during the last two years, one treated with endoscopic bipolar coagulation and the other with a double urinary and faecal diversion.


Assuntos
Proctite/etiologia , Proctite/terapia , Neoplasias da Próstata/radioterapia , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/uso terapêutico , Quimioterapia Combinada , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Glucocorticoides/uso terapêutico , Hemostase Endoscópica/métodos , Humanos , Fotocoagulação a Laser/métodos , Masculino , Radioterapia/efeitos adversos , Estudos Retrospectivos , Índice de Gravidade de Doença , Sigmoidoscopia/métodos , Resultado do Tratamento
5.
Ann Ital Chir ; 80(5): 407-9, 2009.
Artigo em Italiano | MEDLINE | ID: mdl-20131557

RESUMO

This report describes the case of a patient with a chronic pilonidal cyst developed squamous cell carcinoma. The case was treated with primary radical excision, followed adjuvant radiation and chemiotherapy. Recurrence following such treatment was high and prognosis poor compared with non melanoma skin cancer.


Assuntos
Neoplasias Abdominais/etiologia , Carcinoma de Células Escamosas/etiologia , Seio Pilonidal/complicações , Adulto , Doença Crônica , Humanos , Masculino , Períneo , Seio Pilonidal/patologia
6.
Chir Ital ; 60(4): 529-33, 2008.
Artigo em Italiano | MEDLINE | ID: mdl-18837253

RESUMO

The latest hepatic surgical strategies enable liver resections to be performed on a larger number of patients, improving the survival rate. Moreover, the contribution of radiological techniques and chemotherapy to surgery has led to the multidisciplinary management of patients suffering from liver metastases, involving surgeons, radiologists and oncologists. If surgical treatment is not considered curative, it is appropriate to advise alternative strategies in order to down-stage the disease and make it resectable.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Humanos
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