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ABSTRACT: Despite the improvement of the surgical technique and several experiences reported in literature about prosthetic incisional hernioplasty, the prevalence rate of recurrence and of the classic complications has not changed over the years. We analyze our caseload, establishing some technical cornerstones in order to reduce their occurrence.
283 patients underwent incisional hernioplasty in our Department of Surgery in the decade 1999-2008. They were retrospectively divided into four groups (A-D) according to the surgical technique adopted for a comparative analysis: A, 37 primary direct closure; B, 207 Rives-Stoppa procedures; C, 9 Chevrel procedures; D, 30 intraperitoneal repairs. The outcomes were considered in terms of postoperative surgical complications.
In total, we observed 11 cases of hernia recurrence (3.9%), 13 cases of infections (4.6%), 7 cases of seroma/hematoma (2.4%) and one case of acute respiratory insufficiency.
The Rives-Stoppa procedure is, among all those practised, the treatment of choice in incisional hernioplasty. Thanks to the introduction of some simple modifications to this technique and preventing the postoperative infections, we obtained excellent results in terms of recurrence rate (only 1 case on 207 patients, 0.48%) and morbidity.
European review for medical and pharmacological sciences 06/2011; 15(6):644-8. · 1.04 Impact Factor
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ABSTRACT: Association between cervico-thoracic liposarcoma and HIV infection is uncommon. The etiopathology remains unclear and clinical symptoms can be various, often not very evident or absolutely absent. Preoperative diagnosis is based on modern imaging techniques. In selected cases, the ideal procedure is surgical treatment which allows good long-term results. A case of cervico-thoracic liposarcoma in HIV patient is presented.
Il Giornale di chirurgia 11/2008; 29(10):427-8.
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ABSTRACT: In the industrialized West countries the breast cancer represents the most frequent malignant neoplasia in the women. From over 30 years we have a progressive increase of frequency of breast carcinoma. Mortality is substantially unchanged. The Authors, on the base of casuistry accumulated in five years of activity, trace a diagnostic-therapeutic run to the purpose to favour a line of behavior, practice and actual, for the management of breast cancer.
Il Giornale di chirurgia 06/2008; 29(5):221-9.
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ABSTRACT: The Lichtenstein inguinal hernioplasty in the original version or with small variations currently allows good results both from the surgical point of view and in terms of reduction of the sanitary expenses. "Tension free" repair and diffusion of local anesthesia allow a drastic reduction of the hospital stay, a early time of the working activity and the diffusion of the admission to the Day Hospital. The authors introduce the own casuistic that comprise 1116 inguinal hernioplasty in 1,034 patients and on the base of two studies, a retrospective one and another prospective, they conclude that a greater attention in the behavior of the intervention and a more accurate preparation of the patients represent fundamental moments to obtain even more satisfactory results.
Il Giornale di chirurgia 11/2006; 27(10):368-71.
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ABSTRACT: Primary leiomyosarcoma of venous origin is a rare but frequently lethal disease. Clinical symptoms can be different, often not much evident or absolutely absent. Preoperative diagnosis is difficult also with modern imaging and only pathological examination can identify this malignant tumor. Successful therapy requires early surgery but the long-term survival is poor. A case of leiomyosarcoma arising from veins has been presented.
Il Giornale di chirurgia 11/2006; 27(10):381-3.
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ABSTRACT: The Authors conducted a study on 780 patients who underwent surgery. Fourteen patients developed operative table-induced pressure ulcers of different gravity. This paper is a description of these 14 cases. From the literature and from experience we know that the major exogenous risk factor for intraoperative pressure ulcers is the operation time. Therefore, special attention should be paid to preoperative, intraoperative and postoperative prevention. The knowledge of the pathology, specialized personnel and the use of appropriate facilities can reduce the risks of complication that are important sanitary and economic issue.
Il Giornale di chirurgia 06/2005; 26(5):224-8.
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ABSTRACT: The nature of polypoid lesions of the gallbladder is difficult to define. Surgical indication still remains controversial but in some cases mandatory. In this clinical study data were retrospectively evaluated in 25 patients with polypoid lesions who underwent laparoscopic surgery to elucidate the ultrasonic findings and to establish criteria for the best treatment.
Il Giornale di chirurgia 05/2005; 26(4):139-42.
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A Forte,
A D'Urso,
V Urbano,
R Lo Russo,
L S Gallinaro,
V Petrozza,
D Campagna,
C Marani,
N Martone,
M Bezzi,
F Carpino
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ABSTRACT: The concept of the sentinel lymphatic node was introduced by Cabanas in 1977, but it has proved to be successful for the treatment of the melanoma and breast cancer only since the 90s. Many studies have recently extended this technique to other neoplasias. This study deals with 36 patients who were to undergo surgery for 14 gastric adenocarcinomas, 11 of the colon and 11 pulmonary. Once the neoplastic mass was detected, 2 to 5 ml of a vital dye (Blu Patent) were injected in the serosa along the perimeter of the tumor by means of several 0.5 ml injections. A lymphatic node was diagnosed in 22 patients, respectively 10 gastric neoplasias, 6 pulmonary, 6 of the colon. In 14 cases the lymphatic node was found to be negative, in 8 cases positive. In the remaining 14 patients the lymphatic node was not detected. Although data do not always agree, the sentinel lymphatic node technique seems to have been successful for this kind of tumors. For this reason we have carried out this study and published our first data.
Il Giornale di chirurgia 04/2004; 25(3):101-4.
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ABSTRACT: In this study the Author's analyze their experience (between September 1973 and December 2002) with 108 pulmonary resections for metastatic tumors to the lungs to evaluate prognostic factors and the impact on survival of extended metastasectomy. Overall mortality and major morbidity were 1.85% and 2.78%. The actuarial survivals at 5 and 10 years were respectively 46.6% and 39.9%. The best mean survivals are observed in patients with metastases from breast, colorectal, thyroid and urinary tract carcinomas, in cases with disease free interval > 12 months and in the patients who underwent sequentially surgery and chemotherapy. Patients with pulmonary metastases also potentially benefit from iterative pulmonary resection.
Il Giornale di chirurgia 11/2003; 24(10):351-6.
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ABSTRACT: On the basis of a critical review of 936 inguinal hernioplasties performed in 8 years, the authors present their good long-term results with tension-free techniques including the original Lichtenstein technique, Lichtenstein with a sutured mesh and annulorrhaphy of the deep inguinal ring, and Lichtenstein with plug. The only two recurrences in this case series occurred with the original technique. Suturing of the mesh and deep inguinal ring annulorrhaphy proved to be reliable and inexpensive. Results were equivalent with the use of the plug, despite the presence of an additional foreign body. In conclusion, the results obtained with the three variants are practically equivalent, and the choice of technique may depend on the preference and experience of the surgeon.
Hernia 04/2003; 7(1):35-8. · 1.84 Impact Factor
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ABSTRACT: The current most important prognostic indicator in colorectal carcinoma is tumor stage at the moment of diagnosis. The role of NM23 gene as prognostic factor is controversial. The aim of this study was to investigate NM23 expression.
The study population included 104 unselected patients who underwent surgery for colorectal carcinoma between 1992 and 1997. NM23 expression was quantified by estimating the percentage of tumor cells with unequivocal reactivity. The percentage was scored: 0 when no tumor cells showed immunoreactivity; 1 when less than 10% of cells showed immunoreactivity; 2 when 11-50% of cells were positive; 3 when more than 51% of cells were positive.
Four cases belonged to group 0.21 to group 1.55 to group 2 and 24 to group 3.
NM23 cannot be considered an independent prognostic variable.
Il Giornale di chirurgia 04/2002; 23(3):61-3.
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ABSTRACT: It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results.
Il Giornale di chirurgia 04/2002; 23(3):88-92.
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ABSTRACT: The Authors suggest a training programme for surgeons in post graduates courses. With this object in view, the inguinal hernia repair by Lichtenstein has been chosen as the most suitable one. The training course has been divided into theoretic lessons and surgical practice in the operating theatre, carried out in stages as assistant and then as operating surgeon. The good standard achieved, together with the clinical results obtained, demonstrates the effectiveness of the teaching method.
Il Giornale di chirurgia 11/2001; 22(10):321-4.
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ABSTRACT: A treatment method for main bronchus fistula after pneumonectomy via median sternotomy was described by P. Abruzzini in 1961. This operation is performed in an area not involved with infection. Fifteen patients underwent the procedure in our surgical department; one of them died of myocardial infarction while all the others survived for different periods of time, closely associated with the original disease; seven were long-term survivors. The transmediastinal approach seems an effective means of managing such a difficult complication.
Lung Cancer 08/2000; 29(1):43-7. · 3.43 Impact Factor
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N Picardi,
U Di Tondo,
V Pasta,
M Monti,
E Alberti,
G Santeusanio, A Forte,
M Cappelletti,
G D'Andrea,
U Grassetti,
R Rosati,
S Guglielmi,
A Venuti,
P Marchetti,
L Boemi,
E Bilotti
Annali italiani di chirurgia 02/1982; 54(5):507-28. · 0.23 Impact Factor
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N Picardi,
U Di Tondo,
M Monti,
V Pasta,
M Cappelletti,
G Santeusanio, A Forte,
E Alberti,
G D'Andrea,
U Grassetti,
R Rosati,
S Guglielmi,
A Venuti,
P Marchetti,
L Boemi,
E Bilotti
Annali italiani di chirurgia 02/1982; 54(6):623-48. · 0.23 Impact Factor
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N Picardi,
M Manganaro,
V Russo,
M Monti,
V Pasta,
F Agosta,
A Venuti,
P Marchetti, A Forte,
U Grassetti,
G D'Andrea,
R Rosati,
S Guglielmi,
M Cappelletti
Annali italiani di chirurgia 02/1982; 54(5):497-505. · 0.23 Impact Factor
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Annali italiani di chirurgia 02/1981; 53(6):739-50. · 0.23 Impact Factor
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Annali italiani di chirurgia 02/1981; 53(5):535-50. · 0.23 Impact Factor
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Annali italiani di chirurgia 02/1981; 53(5):613-24. · 0.23 Impact Factor
