Publications (8)7.8 Total impact
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Article: Facial nerve function after parotidectomy for neoplasms with deep localization.
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ABSTRACT: To determine whether the deep location of a parotid gland neoplasm is specific risk factor for facial nerve paralysis after parotidectomy. We retrospectively reviewed 88 patients, including 59 with a benign superficial neoplasm of the parotid treated by superficial parotidectomy (group 1); 5 with a benign deep neoplasm treated by total parotidectomy (group 2); 20 with a malignant superficial neoplasm treated by total parotidectomy (group 3); and 4 with a malignant deep neoplasm treated by total parotidectomy (group 4). Temporary facial nerve paralysis developed in 10.3%, 20%, 10%, and 50% of groups, 1, 2, 3, and 4, respectively. Permanent facial nerve paralysis developed in 0%, 0%, 10% and 50% of groups 1, 2, 3, and 4, respectively. The risk factor associated with nerve damage resulting from surgery for parotid neoplasms were malignancy and deep localization. However, the deep location of a benign tumor was not a major risk factor for permanent paralysis.Surgery Today 02/2006; 36(4):308-11. · 1.22 Impact Factor -
Article: Thyroid teratoma in a six-year-old boy.
Thyroid 08/2004; 14(7):553-4. · 4.79 Impact Factor -
Article: False-positive finding on 18F-FDG PET after chemotherapy for primary diffuse large B-cell lymphoma of the thyroid: a case report.
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ABSTRACT: Primary non-Hodgkin lymphoma of the thyroid is an uncommon disease. It is a potentially aggressive disease and diffuse large B-cell lymphoma of the thyroid may result in 5 year survival rates <50%. Hence adequate follow-up and multimodality treatment for recurrent or persistent disease are required. Since 18F-FDG PET is considered the imaging method of choice for the detection and staging of lymphoma, this was used for restaging of a case of diffuse large B-cell lymphoma of the thyroid after chemotherapy and its diagnostic value is questioned in the present case report. In fact, PET showed a false-positive finding which led to unnecessary surgery.Japanese Journal of Clinical Oncology 05/2004; 34(5):280-1. · 1.78 Impact Factor -
Article: Predictors of outcome for patients with differentiated and aggressive thyroid carcinoma.
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ABSTRACT: To identify the risk factors affecting the outcome of operations for differentiated and aggressive thyroid carcinoma which may indicate the need for a more aggressive surgical treatment. Retrospective study. University hospital. 143 patients underwent total thyroidectomy with or without central neck lymphadenectomy or modified neck dissection. There were 85 papillary, 34 follicular, 6 widely-invasive follicular, 6 insular, five oxyphilic, five tall cell, and two diffuse sclerosing papillary carcinomas. Disease-related survival. At 12-years, the survival was 96%, being 98% among patients with differentiated and 83% among those with aggressive carcinoma (p = 0.0006). Insular and oxyphilic carcinomas had the worst prognosis (at 10 years, 67% and 60%, respectively, p < 0.0001). The high-risk age, metastases, and extent score (AMES) group had worse survival than the low-risk group (12 years, 84% compared with 98%, p = 0.001). Among patients with differentiated carcinoma, the low-risk AMES group had also better outcome than those in the high-risk AMES group (at 12 years, 100% compared with 86%, p < 0.0001), but there was no such difference among patients with aggressive disease. Multivariate analysis showed that women (RR 14.28, 95% confidence interval (CI) 1.13 to 180.28), patients with tumours > or = 5 cm in size (RR 9.60, 95%CI 1.01 to 91.43) and AMES high-risk patients (RR 30.17, 95% CI 1.57 to 577.48) had the worst outcome. In patients with differentiated thyroid carcinoma, total thyroidectomy and, if the AMES score indicates a high risk, central neck lymphadenectomy with or without modified neck dissection, is associated with a favourable outcome. Poorer outcome is expected if the carcinoma is aggressive, and an aggressive surgical approach is advocated as a routine.The European journal of surgery. Supplement.: = Acta chirurgica. Supplement 07/2003; -
Article: [Lymphectomy for well differentiated or "aggressive" thyroid malignancies. Indications, complications and results of our experience].
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ABSTRACT: The aim of this retrospective study was to assess the role of lymphectomy in the treatment of well differentiated and aggressive carcinomas of the thyroid gland. From 1987 to 2002, 231 patients were operated on in our Division; 97 were male (42%) and 134 female (58%), with a mean age of 48 years (range 17-45). One hundred and ninety-four patients had well differentiated thyroid carcinomas, and 37 aggressive thyroid cancer. We performed a follow-up on 171/231 patients (74%) who underwent surgery from 1997 to 1998. Among the 143 patients with well differentiated neoplasms, 93 were treated with total thyroidectomy (65%), and 50 with total thyroidectomy with simultaneous or subsequent lymphectomy (35%); 92 patients underwent postsurgical radiomethabolic therapy (64%). Two patients developed non-functional metastases and died because of disease progression. Of the 28 patients affected by aggressive tumours, 8 underwent total thyroidectomy (29%) and 20 total thyroidectomy with simultaneous or subsequent central lymphectomy (71 %). All 28 patients with aggressive malignancies underwent postsurgical radiomethabolic therapy (100%). Three patients developed diffuse non-functional metastases and died because of disease progression.Chirurgia italiana 57(2):145-51. -
Article: [Pancreaticojejunostomy by simple introduction after pancreaticoduodenectomy].
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ABSTRACT: The method which most surgeons still prefer in the treatment of the pancreatic stump after pancreaticoduodenectomy is pancreaticojejunostomy. In this article, we describe our preliminary experience with a fast, effective method, consisting in an end-to-end pancreaticojejunostomy by simple introduction, in 11 cases operated on without morbidity or mortality. From 1998 to 2002, 11 patients with pancreatic head or distal bile duct neoplasms underwent pancreaticoduodenectomy. After removal of the specimen, the residual pancreatic stump was prepared towards the left for about two centimetres, mobilizing the posterior surface from the porto-meseraic axis. A single layer of interrupted suture, consisting only in two posterior stitches, was enough in all cases; each stitch was done taking the stump full-thickness at about one centimetre from the transection margin (so as to introduce a corresponding portion of parenchyma into the jejunal lumen), and from the superior and inferior margin, respectively, of the pancreas. On the intestinal side, the stitches were passed full-thickness from the inner surface to the outside, 6 to 7 millimetres from the transection margin. After introducing the stump completely into the intestinal lumen, three anterior stitches were always done and knotted between the pancreatic capsule and the jejunum. All the anastomoses proved to be perfectly sealed.Chirurgia italiana 56(3):431-6. -
Article: [Ultrasonic scalpel in thyroid surgery].
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ABSTRACT: In order to evaluate the harmonic scalpel during "open" thyroid surgery, a prospective randomized study was performed using the device versus the traditional procedure. One hundred and forty-two multinodular goiter patients were selected for total thyroidectomy and subdivided into two gender- and age-matched groups. In the first group of 72 patients, the surgical procedure was performed with the US scalpel without using any electrical device or vascular ligatures; in the second group of 70 patients, the traditional technique was employed. No statistically significant differences were recorded with regard to permanent inferior laryngeal nerve palsy or hypoparathyroidism rates. Use of the harmonic scalpel was associated with a higher incidence of transient nerve injury (P < or = 0.005, 9.7% vs 1.4%), but this difference disappeared with increasing experience with the harmonic scalpel. Using the US device significantly improves surgical duration (87.5% < 1 h) and blood loss (P < or = 0.005).Chirurgia italiana 55(2):299-308. -
Article: Malignant thyroid nodules: comparison between color Doppler diagnosis and histological examination of surgical samples.
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ABSTRACT: The aim of this study was to verify the reliability of the differential diagnosis between benign and malignant thyroid nodules on the basis of vascularization. The study was conducted on 108 patients with a scintigraphically "cold" thyroid nodule, including 54 carcinomas and 54 benign nodules. All patients underwent total thyroidectomy. Diagnosis based on histological examination of the surgical specimen was compared with ultrasonographic diagnosis obtained according to a personal classification proposed by the authors. Vascular ultrasonographic investigation produced 10 false positives, 6 false negatives and 92 correct diagnoses, with 88.8% sensitivity, 81.5% specificity, an 82.7% positive predictive value and an 88% negative predictive value. It can thus be used effectively to identify the larger nodules, while it is unable to provide any indication as to their histological type. Ultrasound vascular thyroid study is a non-invasive and low-cost method and is very reliable in the differential diagnosis of cold thyroid nodules. The best ultrasonographic modality is power Doppler. Ultrasound contrast media increase vascular definition but, due to their higher cost and the longhier duration of the examination, they should only be used in the case of small nodules.Chirurgia italiana 54(5):643-7.
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Institutions
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2003–2006
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Sapienza University of Rome
- Department of Surgical Sciences
Roma, Latium, Italy
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